EKİNOKOKUS KİSTİNİN TEDAVİSİNDE RADYOFREKANS TERMAL ABLASYON (RTA): EX-VİVO HAYVAN MODELİNDE DENEYSEL BİR ÇALIŞMA

Year 2019, Volume: 20 Issue: 4, 239 - 244, 21.10.2019

Ahmet Dumanlı , Burhan Apilioğulları , Sami Ceran Orhan Özbek Hasan Esen Bahadır Feyzioğlu

https://doi.org/10.18229/kocatepetip.492633

Abstract

AMAÇ: Radyofrekans
termal ablasyon (RTA), diğer komorbiditeleri olan inoperabl hastalarda sıklıkla
kullanılan minimal invaziv bir tekniktir. Eks vivo çalışmanın amacı, hayvan
modellerinde (eksplante edilen organlar) akciğer kistik ekinokokkozun
tedavisinde RTA'nın farklı sıcaklık ve sürelerinin etkinliğini
değerlendirmektir.

GEREÇ VE YÖNTEM:
Enfekte sığır akciğerleri toplandı. 9 adet sığır akciğerinde bulunan 45 adet
canlı kist kullanıldı. Canlı akciğer kistlerinin  radyofrekans tedavi grupları ısıya göre,
rasgele üç ana gruba ayrıldı. Grup 1 (n = 15) 90°C 'de, grup 2 (n = 15) 100°C
'de ve grup3 (n = 15) 110 °C 'de. Gruplar radyofrekans uygulama süresine göre,
üç alt gruba ayrıldı (7 dakika n = 5; 9 dakika n = 5; 11 dakika n = 5).
Tedaviden sonra tüm kistler çıkarıldı ve patolojik olarak incelendi. Eğer
patolojik olarak korunmuş bir germinal membran mevcut ise kistler canlı olarak
değerlendirildi. Germinal membran nekrotik ise başarılı bir şekilde tedavi
edilmiş olarak değerlendirildi.

BULGULAR: RTA
uygulanan 45 numunenin  41'nin patolojik
kesitlerinde germinal membran kısmi 
olarak nekrotik durumdaydı  ve
canlı olarak değerlendirildi.  Sadece 4
numunede tamamen nekrotik germinal membran mevcuttu ve 11 dakikada 110 ° C'de
başarılı bir şekilde tedavi edildi. Yıkım oranı, RTA’da uygulanan ısı artışıyla
pozitif korelasyon göstermektedir (Phi = 0.89, p = 0.006).

SONUÇ: 110 ° C'ye
kadar RTA uygulaması kist hidatiklerin öldürülmesinde etkili olmayabilir. Bu
tekniğin, insanda kistik ekinokokkoz tedavisi olarak kabul edilmeden önce hala
büyük miktarda ek klinik öncesi çalışma gerektirmektedir. 

Keywords

Radyofrekans, termal ablasyon, kistik ekinokok

RADIOFREQUENCY THERMAL ABLATION FOR TREATMENT OF CYCTIC ECHINOCOCCOSIS: AN EX-VIVO EXPERIMENTAL STUDY IN ANIMAL MODELS

Abstract

OBJECTIVE: Radiofrequency thermal ablation (RTA) is a minimally invasive technique often used in inoperable patients with other comorbidities. The aim of the ex-vivo study was to evaluate the efficacy of different temperatures and durations of RTA for treatment of lung cystic echinococcosis in animal models (explanted organs).

MATERIAL AND METHODS: Infected lungs from 45 slaughtered bovines were collected. Live pulmonary cysts were randomly divided into three main following radiofrequency treatment groups according to the heat. Group 1 (n=15) at 90 °C, group 2 (n=15) at 100 °C, and group 3 (n=15) at 110 °C. Then the groups were divided into three sub-groups according to duration of radiofrequency application (7 minute n= 5; 9 minute n=5; and 11 minute n=5). After treatment, all cysts were sectioned and examined by histology. Cysts were defined as alive if a preserved germinal layer at histology was evident, and as successfully treated if the germinal membrane was necrotic.

RESULTS: Following RTA application, 41 of 45 samples consisted of partial necrotic sections of the germinal membrane defined as alive. Only 4 of 5 samples with completely necrotic germinal membrane defined as successfully treated in 11 minute 110 °C group. The destruction rate has a positive correlation with heat of RTA application (Phi =0.89, p=0.006).

CONCLUSIONS: In our study, we determined pathologically that RTA treatment was not effective below 110 ° C. Therefore, we believe that RTA technique has not yet been used in clinical use according to the results of our study, and further studies are needed in order to be able to enter into clinical use.

Keywords

Radiofrequency, Thermal ablation, Pulmonary cysts

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