Abstract

Background

Radiofrequency (RF)-assisted devices are widely used for hemostasis during liver resection. This study compared the use of dual switching (DS) versus single switching (SS) control modes for RF-based liver resections in a pig model.

Methods

The RF-based system comprised a 200-W generator and three electrodes with 4-cm tips arranged in a linear configuration using an adaptor. Eight Lanyu pigs were used to assess ablation outcomes with electrode spacing of 2 or 3 cm, and ablation durations of 1.5, 2 or 3 min. All combinations were tested in DS and SS modes. Procedures were performed on left lateral, caudal and right anterior liver lobes, and after which transections were performed using a scalpel. Blood loss, complete ablation rate and ablation speed were compared.

Results

DS mode was shown to induce significantly less blood loss than SS mode when the electrode spacing was set at 2 cm and the ablation duration was 2 min or 3 min (p=.010 and .012, respectively). Extended ablation duration and narrow electrode spacing tended to induce less blood loss, regardless of operating mode. Bloodless resection was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 2–3 min. The highest rate of complete ablation (11.3 cm²/min) was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 1.5 min.

Conclusion

RF-based hepatic resection using DS mode is safe and feasible, resulting in less blood loss than SS mode with a higher rate of complete ablation (i.e., superior ablation efficiency).

中文翻译：

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实验研究采用双开关控制模式的线性射频消融术可实现快速，无血的肝切除

摘要

背景

射频（RF）辅助设备广泛用于肝切除术中的止血。这项研究比较了在猪模型中基于RF的肝切除术使用双切换（DS）与单切换（SS）控制模式的比较。

方法

基于RF的系统包括一个200 W的发生器和三个带有4 cm尖端的电极，这些电极使用适配器以线性配置排列。八只蓝猪用于评估消融效果，电极间距为2或3 cm，消融时间为1.5、2或3分钟。所有组合均在DS和SS模式下进行了测试。在左外侧，尾侧和右前肝叶上进行手术，然后用手术刀进行横切术。比较失血量，完全消融率和消融速度。

结果

当电极间距设为2 cm且消融持续时间为2分钟或3分钟时，DS模式显示的出血量明显少于SS模式，分别为2分钟或3分钟（分别为p = .010和.012）。不管操作模式如何，延长的消融持续时间和较窄的电极间距都倾向于引起较少的失血。使用DS模式进行无血切除，电极间距为2 cm，消融时间为2-3分钟。使用DS模式，电极间距为2 cm，消融时间为1.5 min，可获得最高的完全消融速率（11.3 cm ² / min）。

结论

使用DS模式的基于RF的肝切除术是安全可行的，与SS模式相比，出血量更少，具有更高的完全消融率（即更高的消融效率）。