Published online Feb 15, 2021. doi: 10.4251/wjgo.v13.i2.109
Peer-review started: October 27, 2020
First decision: November 18, 2020
Revised: November 30, 2020
Accepted: December 11, 2020
Article in press: December 11, 2020
Published online: February 15, 2021
Processing time: 97 Days and 1.1 Hours
The results of the heat irrigating effect of radiofrequency ablation (RFA) are uncertain, and the accurate impact of the heat irrigating effect on regional liver tissue is unknown due to a lack of control experiments.
The aim of this study was to determine the influence of the heat irrigating effect of RFA on regional liver tissue in Bama miniature pigs.
Eight Bama miniature pigs were randomly divided into the observation group (group A) and the control group (group B), with 4 pigs/group. An RFA electrode needle was implanted near the hepatic segment vasculature (3-5 mm from the hepatic segment portal vein) under ultrasound guidance in group A. Similarly, an RFA electrode needle was implanted far from the hepatic segment vasculature (8-10 mm from the hepatic segment portal vein) in group B. The left internal lobe and right medial lobe were chosen as RFA sites in each pig. RFA was performed at the left internal lobe on day one in each pig, and at the right medial lobe 7 d later. Each RFA lasted 12 min. The general status of the pigs and serious complications were observed during the perioperative period. The pigs were sacrificed and the livers were removed immediately after RFA on the eighth day. The samples were roughly observed. Hematoxylin-eosin and Ki67 staining, as well as TUNEL detection, were performed on the tissue sections.
All 8 animals successfully underwent ultrasound-guided RFA. No serious complications, such as massive hemorrhage, biliary fistula, severe pleural effusion, pneumothorax, peripheral organ failure, or renal failure occurred in any of the animals during the perioperative period. The RFA coagulative necrosis lesion was spherical and the surrounding liver tissue showed an inflammatory response. The difference in the Suzuki score of the liver tissue surrounding the ablated portal vein, and its distal area between groups A and B, was statistically significant (P < 0.05). More apoptotic cells were seen in liver tissue surrounding the ablated portal vein and its distal area in group A, while fewer apoptotic cells in the same area were seen in group B. The difference in the apoptotic index of the above area between group A and group B was statistically significant (P < 0.05). Cells staining positive for Ki67 were observed in liver tissue at the left internal lobe around the ablated portal vein and its distal area in group A. No Ki67 staining positive cells were observed in other tissue sections. The difference in the Ki67 staining positive index in the above area was statistically significant (P < 0.05) between group A and group B.
Changes as a result of thermal damage occur in liver tissue around the ablated portal vein and its distal area due to the heat irrigating effect when the RFA electrode tip is close to (< 5 mm) the portal vein.
Core Tip: This is a basic experimental research paper on the heat irrigating effect of radiofrequency ablation (RFA). To determine the influence of the heat irrigating effect of RFA on the regional liver tissue in Bama miniature pigs, we designed a series of research experiments. We found changes due to thermal damage in the liver tissue around the ablated portal vein and its distal area as a result of the heat irrigating effect when the RFA electrode tip was close to (< 5 mm) the portal vein.