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- Title
Accuracy and effectiveness of laparoscopic vs open hepatic radiofrequency ablation.
- Authors
scott, D.; Young, W.; Watumull, L.; Lindberg, G.; Fleming, J.; Huth, J.; Rege, R.; Jeyarajah, D.; Jones, D.; Scott, D J; Young, W N; Watumull, L M; Fleming, J B; Huth, J F; Rege, R V; Jeyarajah, D R; Jones, D B
- Abstract
<bold>Background: </bold>The purpose of this study was to compare the accuracy (in terms of ultrasound-guided probe placement) and the effectiveness (in terms of pathologic tumor-free margin) of laparoscopic vs open radiofrequency (RF) ablation.<bold>Methods: </bold>Using a previously validated tissue-mimic model, 1-cm simulated hepatic tumors were ablated in 10 pigs randomized to open or laparoscopic techniques. Energy was applied until tissue temperature reached 100 degrees C (warm-up) and thereafter for 8 min. A pathologist blinded to technique examined all specimens immediately after treatment. Analysis was by Fisher's exact test and the Mann-Whitney U test; p < 0.05 was considered significant.<bold>Results: </bold>Off-center distance (3.5 +/- 1.6 vs 4.2 +/- 1.4 mm), size (24.7 +/- 3.1 vs 25.6 +/- 3.8 mm), symmetry (40% vs 73%), margin positivity (33% vs 9%), and margin distance (1.1 +/- 1.2 vs 2.2 +/- 1.6 mm) were not significantly different between laparoscopic (n = 15) and open (n = 11) ablations, respectively. The proportion of round/ovoid lesions (20% vs 64%) was lower (p = 0.043), and warm-up time (20.2 +/- 14.0 vs 10.7 +/- 7.5) was longer (p = 0.049) for the laparoscopic than for the open groups, respectively.<bold>Conclusion: </bold>Accurate probe placement can be achieved using laparoscopic and open RF ablation techniques. The physiologic effects of laparoscopy may alter ablation shape and warm-up time. Additional studies are needed to establish effective ways of achieving complete tumor destruction.
- Subjects
ANIMAL experimentation; BIOLOGICAL models; CATHETER ablation; COMPARATIVE studies; LAPAROSCOPY; LIVER tumors; RESEARCH methodology; MEDICAL cooperation; NONPARAMETRIC statistics; PROBABILITY theory; RESEARCH; STATISTICAL sampling; SWINE; EVALUATION research; TREATMENT effectiveness
- Publication
Surgical Endoscopy, 2001, Vol 15, Issue 2, p135
- ISSN
0930-2794
- Publication type
journal article
- DOI
10.1007/s004640080066