Name: thermal ablation for the treatment of abdominal tumors
Uploaded: 2011-03-07T15:30:00
Duration: 7 min 16 s
Description: Watch this Scientific Journal Video about Thermal Ablation for the Treatment of Abdominal Tumors at JoVE.com

लेखकों के लिए नैदानिक ​​ट्यूमर पृथक कार्यक्रम के साथ उनके नेतृत्व के लिए फ्रेड ली, जूनियर, शुक्रिया अदा करना चाहूँगा, और लिसा Sampson, जनवरी Ketzler और विस्कॉन्सिन मैडिसन विश्वविद्यालय में अनुसंधान और नैदानिक ​​कार्यक्रम के साथ उनकी सहायता के लिए Marci केंद्र.

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	<li>Wong, S. L., Mangu, P. B., Choti, M. A., Crocenzi, T. S., Dodd, G. D., Dorfman, G. S., Eng, C., Fong, Y., Giusti, A. F., Lu, D., Marsland, T. A., Michelson, R., Poston, G. J., Schrag, D., Seidenfeld, J., Benson, A. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=American+society+of+clinical+oncology+2009+clinical+evidence+review+on+radiofrequency+ablation+of+hepatic+metastases+from+colorectal+cancer.">American society of clinical oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer.</a> J. Clin. Oncol. 28, 493-508 (2010).</li><li>Gervais, D. A., Goldberg, S. N., Brown, D. B., Soulen, M. C., Millward, S. F., Rajan, D. 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D. i., Rolle, E., Solbiati, L., Tinelli, C., Rossi, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sustained+complete+response+and+complications+rates+after+radiofrequency+ablation+of+very+early+hepatocellular+carcinoma+in+cirrhosis:+is+resection+still+the+treatment+of+choice?.">Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: is resection still the treatment of choice?.</a> Hepatology. 47, 82-89 (2008).</li><li>Zagoria, R. J., Traver, M. A., Werle, D. M., Perini, M., Hayasaka, S., Clark, P. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Oncologic+efficacy+of+ct-guided+percutaneous+radiofrequency+ablation+of+renal+cell+carcinomas.">Oncologic efficacy of ct-guided percutaneous radiofrequency ablation of renal cell carcinomas.</a> AJR Am J Roentgenol. 189, 429-436 (2007).</li><li>Gervais, D. A., McGovern, F. J., Arellano, R. S., McDougal, W. S., Mueller, P. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Radiofrequency+ablation+of+renal+cell+carcinoma:+part+1,+indications,+results,+and+role+in+patient+management+over+a+6-year+period+and+ablation+of+100+tumors.">Radiofrequency ablation of renal cell carcinoma: part 1, indications, results, and role in patient management over a 6-year period and ablation of 100 tumors.</a> AJR Am J Roentgenol. 185, 64-71 (2005).</li><li>Solazzo, S. A., Liu, Z., Lobo, S. M., Ahmed, M., Hines-Peralta, A. U., Lenkinski, R. E., Goldberg, S. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Radiofrequency+ablation:+importance+of+background+tissue+electrical+conductivity--an+agar+phantom+and+computer+modeling+study.">Radiofrequency ablation: importance of background tissue electrical conductivity--an agar phantom and computer modeling study.</a> Radiology. 236, 495-502 (2005).</li><li>Lu, D. S. K., Raman, S. S., Vodopich, D. J., Wang, M., Sayre, J., Lassman, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+vessel+size+on+creation+of+hepatic+radiofrequency+lesions+in+pigs:+assessment+of+the+"heat+sink"+effect.">Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: assessment of the "heat sink" effect.</a> AJR Am J Roentgenol. 178, 47-51 (2002).</li><li>Lubner, M. G., Brace, C. L., Hinshaw, J. L., Lee, F. T. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microwave+tumor+ablation:+mechanism+of+action,+clinical+results,+and+devices.">Microwave tumor ablation: mechanism of action, clinical results, and devices.</a> J Vasc Interv Radiol. 21, 192-203 (2010).</li><li>Andreano, A., Huang, Y., Meloni, M. F., Lee, F. T. J., Brace, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microwaves+create+larger+ablations+than+radiofrequency+when+controlled+for+power+in+ex+vivo+tissue.">Microwaves create larger ablations than radiofrequency when controlled for power in ex vivo tissue.</a> Med Phys. 37, 2967-2973 (2010).</li><li>Simon, C. J., Dupuy, D. E., Mayo-Smith, W. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microwave+ablation:+principles+and+applications.">Microwave ablation: principles and applications.</a> Radiographics. 25, S69-S83 (2005).</li><li>Shibata, T., Iimuro, Y., Yamamoto, Y., Maetani, Y., Ametani, F., Itoh, K., Konishi, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small+hepatocellular+carcinoma:+comparison+of+radio-frequency+ablation+and+percutaneous+microwave+coagulation+therapy.">Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy.</a> Radiology. 223, 331-337 (2002).</li><li>Ong, S. L., Gravante, G., Metcalfe, M. S., Strickland, A. D., Dennison, A. R., Lloyd, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+and+safety+of+microwave+ablation+for+primary+and+secondary+liver+malignancies:+a+systematic+review.">Efficacy and safety of microwave ablation for primary and secondary liver malignancies: a systematic review.</a> Eur J Gastroenterol Hepatol. 21, 599-605 (2009).</li><li>Liang, P., Wang, Y., Zhang, D., Yu, X., Gao, Y., Ni, X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+guided+percutaneous+microwave+ablation+for+small+renal+cancer:+initial+experience.">Ultrasound guided percutaneous microwave ablation for small renal cancer: initial experience.</a> J. Urol. 180, 844-848 (2008).</li><li>Hinshaw, J. L., Shadid, A. M., Nakada, S. Y., Hedican, S. P., Winter, T. C., Lee, F. T. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+percutaneous+and+laparoscopic+cryoablation+for+the+treatment+of+solid+renal+masses.">Comparison of percutaneous and laparoscopic cryoablation for the treatment of solid renal masses.</a> AJR Am J Roentgenol. 191, 1159-1168 (2008).</li><li>Atwell, T. D., Farrell, M. A., Callstrom, M. R., Charboneau, J. W., Leibovich, B. C., Frank, I., Patterson, D. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+cryoablation+of+large+renal+masses:+technical+feasibility+and+short-term+outcome.">Percutaneous cryoablation of large renal masses: technical feasibility and short-term outcome.</a> AJR Am J Roentgenol. 188, 1195-1200 (2007).</li><li>Sheen, A. J., Poston, G. J., Sherlock, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cryotherapeutic+ablation+of+liver+tumours.">Cryotherapeutic ablation of liver tumours.</a> Br J Surg. 89, 1396-1401 (2002).</li><li>Callstrom, M. R., Atwell, T. D., Charboneau, J. W., Farrell, M. A., Goetz, M. P., Rubin, J., Sloan, J. A., Novotny, P. J., Welch, T. J., Maus, T. P., Wong, G. Y., Brown, K. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Painful+metastases+involving+bone:+percutaneous+image-guided+cryoablation--prospective+trial+interim+analysis.">Painful metastases involving bone: percutaneous image-guided cryoablation--prospective trial interim analysis.</a> Radiology. 241, 572-580 (2006).</li></ol>

सीएलबी: शेयरधारक और NeuWave चिकित्सा, इंक, जो पृथक प्रौद्योगिकियों विकसित के लिए सलाहकार. Triagenics, LLC के लिए सलाहकार.

थर्मल ट्यूमर पृथक कई पेट ट्यूमर है कि सर्जरी करने के लिए आग रोक रहे हैं, या / रेडियोथेरेपी और रसायन चिकित्सा के साथ इलाज विफल के लिए एक सुरक्षित और प्रभावी उपचार है. इसके अलावा, यह तेजी से कुछ रोगियों के लिए एक स्वीकार किए जाते हैं पहली पंक्ति चिकित्सा बनता जा रहा है. लाभों में शामिल हैं: एक असाधारण सुरक्षा प्रोफ़ाइल, पारंपरिक शल्य चिकित्सा, कम लागत, और उचित triaged रोगियों में उत्कृष्ट स्थानीय नियंत्रण दरों की तुलना में अधिक तेजी से स्वास्थ्य लाभ. Percutaneous प्रक्रियाओं आम तौर पर कर रहे हैं संभव है, खासकर जब hydrodissection जैसे तकनीकों का उपयोग करने के लिए सुरक्षा में सुधार और ट्यूमर लक्ष्यीकरण, इस प्रकार रुग्णता और आगे भी सीमित है. कई दशकों के लिए अभ्यास में इस तकनीक को अब का उपयोग किया गया है और उत्साहजनक परिणाम के साथ लंबी अवधि के परिणामों और आंकलोजिकल प्रभावकारिता के बारे में सवालों के कई जवाब हैं. थर्मल पृथक निश्चित रूप से कैंसर के रोगियों के प्रबंधन में आने वाले वर्षों में एक महत्वपूर्ण और बढ़ती भूमिका निभानी होगी.

Covidien / Boulder, कं में Valleylab से कूल युक्ति आरएफ एबलेशन सिस्टम

thermal ablation for the treatment of abdominal tumors

Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ablation procedure, a thin applicator is guided into the target tumor under imaging guidance. Energy is then applied to the tissue until temperatures rise to cytotoxic levels (50-60 &deg;C). Various energy sources are available to heat biological tissues, including radiofrequency (RF) electrical current, microwaves, laser light and ultrasonic waves. Of these, RF and microwave ablation are most commonly used worldwide.
During RF ablation, alternating electrical current (~500 kHz) produces resistive heating around the interstitial electrode. Skin surface electrodes (ground pads) are used to complete the electrical circuit. RF ablation has been in use for nearly 20 years, with good results for local tumor control, extended survival and low complication rates1,2. Recent studies suggest RF ablation may be a first-line treatment option for small hepatocellular carcinoma and renal-cell carcinoma3-5. However, RF heating is hampered by local blood flow and high electrical impedance tissues (eg, lung, bone, desiccated or charred tissue)6,7. Microwaves may alleviate some of these problems by producing faster, volumetric heating8-10. To create larger or conformal ablations, multiple microwave antennas can be used simultaneously while RF electrodes require sequential operation, which limits their efficiency. Early experiences with microwave systems suggest efficacy and safety similar to, or better than RF devices11-13.
Alternatively, cryoablation freezes the target tissues to lethal levels (-20 to -40 &deg;C). Percutaneous cryoablation has been shown to be effective against RCC and many metastatic tumors, particularly colorectal cancer, in the liver14-16. Cryoablation may also be associated with less post-procedure pain and faster recovery for some indications17. Cryoablation is often contraindicated for primary liver cancer due to underlying coagulopathy and associated bleeding risks frequently seen in cirrhotic patients. In addition, sudden release of tumor cellular contents when the frozen tissue thaws can lead to a potentially serious condition known as cryoshock 16.
Thermal tumor ablation can be performed at open surgery, laparoscopy or using a percutaneous approach. When performed percutaneously, the ablation procedure relies on imaging for diagnosis, planning, applicator guidance, treatment monitoring and follow-up. Ultrasound is the most popular modality for guidance and treatment monitoring worldwide, but computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used as well. Contrast-enhanced CT or MRI are typically employed for diagnosis and follow-up imaging.

Watch this Scientific Journal Video about Thermal Ablation for the Treatment of Abdominal Tumors at JoVE.com

Thermal Ablation for the Treatment of Abdominal Tumors

एक थर्मल ट्यूमर पृथक प्रक्रिया में वर्णित है. पूरी प्रक्रिया, योजना और इमेजिंग अध्ययन pretreatment, संज्ञाहरण, सहायक तकनीक percutaneous दृष्टिकोण, इमेजिंग पृथक डिवाइस के ट्यूमर, थर्मल उपचार, देखभाल के बाद इलाज के लिए मार्गदर्शन और अनुवर्ती की सुविधा सहित विस्तृत है.

पेट ट्यूमर के उपचार के लिए थर्मल एबलेशन

Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ...

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