Brief Article
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World J Gastroenterol. Feb 28, 2013; 19(8): 1278-1282
Published online Feb 28, 2013. doi: 10.3748/wjg.v19.i8.1278
Radiofrequency ablation during continuous saline infusion can extend ablation margins
Toru Ishikawa, Tomoyuki Kubota, Ryoko Horigome, Naruhiro Kimura, Hiroki Honda, Akito Iwanaga, Keiichi Seki, Terasu Honma, Toshiaki Yoshida
Toru Ishikawa, Tomoyuki Kubota, Ryoko Horigome, Naruhiro Kimura, Hiroki Honda, Akito Iwanaga, Keiichi Seki, Terasu Honma, Toshiaki Yoshida, Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata 950-1104, Japan
Author contributions: Ishikawa T designed the research; Ishikawa T, Kubota T, Horigome R, Kimura N and Honda H performed the research; Ishikawa T conceived the study, wrote and drafted the manuscript; the other authors participated in the preparation of the manuscript.
Correspondence to: Toru Ishikawa, MD, Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, 280-7 Teraji, Niigata 950-1104, Japan. toruishi@ngt.saiseikai.or.jp
Telephone: +81-25-2336161 Fax: +81-25-2338880
Received: September 14, 2012
Revised: November 28, 2012
Accepted: December 22, 2012
Published online: February 28, 2013
Abstract

AIM: To determine whether fluid injection during radiofrequency ablation (RFA) can increase the coagulation area.

METHODS: Bovine liver (1-2 kg) was placed on an aluminum tray with a return electrode affixed to the base, and the liver was punctured by an expandable electrode. During RFA, 5% glucose; 50% glucose; or saline fluid was infused continuously at a rate of 1.0 mL/min through the infusion line connected to the infusion port. The area and volume of the thermocoagulated region of bovine liver were determined after RFA. The Joule heat generated was determined from the temporal change in output during the RFA experiment.

RESULTS: No liquid infusion was 17.3 ± 1.6 mL, similar to the volume of a 3-cm diameter sphere (14.1 mL). Mean thermocoagulated volume was significantly larger with continuous infusion of saline (29.3 ± 3.3 mL) than with 5% glucose (21.4 ± 2.2 mL), 50% glucose (16.5 ± 0.9 mL) or no liquid infusion (17.3 ± 1.6 mL). The ablated volume for RFA with saline was approximately 1.7-times greater than for RFA with no liquid infusion, representing a significant difference between these two conditions. Total Joule heat generated during RFA was highest with saline, and lowest with 50% glucose.

CONCLUSION: RFA with continuous saline infusion achieves a large ablation zone, and may help inhibit local recurrence by obtaining sufficient ablation margins. RFA during continuous saline infusion can extend ablation margins, and may be prevent local recurrence.

Keywords: Radiofrequency ablation, Ex vivo bovine liver, Large ablation zone, Saline, Glucose, Joule heat