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Accuracy and effectiveness of laparoscopic vs open hepatic radiofrequency ablation

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Abstract

Background

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.

Methods

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°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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, 75235-9092, Dallas, TX, USA

    D. J. scott, W. N. Young, J. B. Fleming, J. F. Huth, R. V. Rege, D. R. Jeyarajah & D. B. Jones

  2. Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, 75235-9092, Dallas, TX, USA

    L. M. Watumull

  3. Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, 75235-9092, Dallas, TX, USA

    G. Lindberg

Authors
  1. D. J. scott
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  2. W. N. Young
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  3. L. M. Watumull
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  4. G. Lindberg
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  5. J. B. Fleming
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  6. J. F. Huth
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  7. R. V. Rege
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  8. D. R. Jeyarajah
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  9. D. B. Jones
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Additional information

Online publication: 21 December 2000

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scott, D.J., Young, W.N., Watumull, L.M. et al. Accuracy and effectiveness of laparoscopic vs open hepatic radiofrequency ablation. Surg Endosc 15, 135–140 (2001). https://doi.org/10.1007/s004640080066

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  • DOI: https://doi.org/10.1007/s004640080066

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