The new technology of enhanced radiofrequency ablation is safe and effective for treating giant hepatic hemangioma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the safety and efficacy of the enhanced radiofrequency ablation (RFA) new technology for treatment of giant hepatic hemangiomas.</p><p><b>METHODS</b>From August 2010 to September 2011, 30 patients with giant hepatic hemangiomas (average diameter: 7.7+/-1.9 cm, range: 5.0 to 12.8 cm) were treated with enhanced RFA. The original lesion diameter, enhanced radiofrequency duration, and cases of RFA-induced burning were recorded. Cases requiring a second RFA treatment were also recorded. Correlation analysis was carried out to determine the association of enhanced RFA with adverse events and change in lesion diameter.</p><p><b>RESULTS</b>The rate of completely destroyed lesions by enhanced RFA was 70.96%, and the total rate of reduced lesions was 87.1%. No severe adverse events occurred. The duration of enhanced radiofrequency correlated positively with the original lesion diameter (r=0.687, P less than 0.01). The enhanced RFA treatment significantly reduced the average lesion diameter (follow-up: 6.2+/-1.8 cm; t=6.417, P less than 0.01).</p><p><b>CONCLUSION</b>The new minimally-invasive technology of enhanced radiofrequency ablation is effective and safe for treating giant hepatic hemangiomas and produces an obvious, short-term curative effect.</p>

Primary duct closure versus T-tube drainage following laparoscopic choledochotomy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effects of primary duct closure and T-tube drainage in laparoscopy choledochotomy to treat the common bile duct stones.</p><p><b>METHODS</b>The enrollment of the patients was in accordance with 6 criteria. 55 patients with cholecystolithiasis and secondary common bile duct stones from January 2000 to February 2003 were treated with laparoscopic choledochotomy. The patients were randomly divided into two groups: primary duct closure group and T-tube drainage group. Their all data were recorded and studied prospectively,and patients were followed up after discharge.</p><p><b>RESULTS</b>There were 27 patients and 28 patients in primary duct closure group and T-tube drainage group respectively. The operation time and the results of following up between the two groups had no significant difference. Compared with T-tube drainage group, primary duct closure group had less the total quantity of postoperative transfusion and hospital costs, shorter postoperative hospital stay. The incidence of postoperative complications in primary duct closure group was 11.1% (3/27), and all of them were biliary complications. The incidence of postoperative complications in T-tube drainage group was 28.6% (8/28), and seven of them were biliary complications. The incidence of severe complications that needed reoperations was 10.7% (93/28), and all of them were caused by T-tubes. There was no mortality in two groups.</p><p><b>CONCLUSIONS</b>The primary duct closure in laparoscopic choledochotomy can avoid the deficiency of T-tube drainage, and it is feasible and safe and lower complications in treating the common bile duct stones, so we advocate it in appropriate cases.</p>

Clinical research on radiofrequency ablation for hypersplenism / 中华外科杂志

<p><b>OBJECTIVE</b>To study the security and curative effect of radiofrequency ablation (RFA) for hypersplenism due to portal hypertension in the near future.</p><p><b>METHODS</b>12 patients of the disease were treated with RFA. The blood count showed that WBC is (2.0 +/- 0.7) x 10(9)/L, PLT (25 +/- 10) x 10(9)/L, RBC (3.08 +/- 0.56) x 10(9)/L. In manners of systemic anaesthesia, through skin or in the operation or under the celioscopes the RFA needles are inserted the upper and middle parts of spleen in the instructing of US. Average time of RFA is (36.4 +/- 5.4) s.</p><p><b>RESULTS</b>After the RFA, 1 case develop hematoma under the envelope of liver, and 1 case developed skin burn; 6 patients appeared middle or little fluid in the left thorax, 2 of them were drawn through puncture. The volume of spleen and damaged part of spleen from RFA were determined by enhanced CT in the days of 10 after RFA, the percentage of damaged part of spleen from RFA is 49.1% (23.3% - 88.9%). In the days of 14 after RFA, RBC is (5.5 +/- 0.9) x 10(9)/L, PLT is (124 +/- 21.36) x 10(9)/L; In the days of 33 after RFA, RBC is (5.4 +/- 1.1) x 10(9)/L, PLT is (205 +/- 34) x 10(9)/L. The levels of WBC and PLT in the blood after RFA are significantly higher than those of levels of WBC and PLT before RFA (P < 0.01).</p><p><b>CONCLUSIONS</b>Radiofrequency ablation for Hypersplenism due to portal hypertension of hepatitis hepatocirrhosis is safety and credibility and has excellent curative effect in the near future.</p>

The feasibility and safety of radiofrequency ablation for secondary splenomegaly and hypersplenism in dogs / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the feasibility and safety of radiofrequency ablation (RFA) in spleen to treat secondary splenomegaly and hypersplenism in dogs.</p><p><b>METHODS</b>Fourteen healthy mongrel dogs were randomly divided into two groups: group A (n = 4) and group B (n = 10) Both groups underwent ligation of the splenic vein and its collateral branches to induce congestive splenomegaly. At the end of the 3rd week, radiofrequency thermal ablation of the spleen was performed in the group B via laparotomy. After splenic RFA, the procedure-related complications were observed, CT scan was performed and the spleens were obtained according to schedule. The radiofrequency (RF) thermal lesions and its histo- pathological changes of the spleen were examined regularly.</p><p><b>RESULTS</b>There were no morbidity and mortality in the experimental dogs. CT findings revealed that splenomegaly could sustained over 2 months after ligation of the splenic vein. The segmental RF lesions included hyperintense zone of coagulative necrosis and more extensively peripheral hypo-intense infarcted zone. The latter was called as "bystander effect". The infarcted zone would be absorbed and subsequently disappeared between 4 and 6 weeks after RFA, and the size of the remnant spleen shrunk, but the lesion of coagulative necrosis hardly altered. The fundamental histopathological changes of splenic lesions caused by RF thermal energy included local coagulative necrosis and the peripheral thrombotic infarction zone. Subsequently, tissue absorption and fibrosis occurred in the zone of thrombotic infarction. Simultaneously occluded vessels, fibrin deposition, and disappearance of normal splenic sinuses resulted in the condensed structure of the viable remnant spleen, which were the pathological basis responsible for the shrunk spleen.</p><p><b>CONCLUSIONS</b>It is feasible and safe to perform RFA in the spleen to treat experimental splenomegaly and hypersplenism. The RFA technique could be safely performed clinically via laparotomy or laparoscopic procedure to strictly isolate the spleen from the surrounding organs.</p>

Determination of telomerase activity in carcinoma of bile duct and its clinical significance / 第三军医大学学报

Objective　To explore the relationship between te lomerase activity and bile duct carcinoma and its significance in clinical diag nosis. Methods　Telomerase activities were examined in 23 cases of bile duct carcinoma, 5 cases of carcinoma adjacent tissues and 5 cases of nor mal bile duct tissues respectively with telomerase PCR-ELISA method. Results　Telomerase activity was detected in 18 of 23 cases (78.3%) of b ile duct carcinoma, and was not found in 5 cases of carcinoma adjacent tissues a nd 5 cases of normal bile duct tissues. The detection rate of telomerase activit y had no correlation with patients' age, sex, tumor site and size but significan tly correlated to metastasis of tumor (P<0.05). Conclusion　The level of telomerase activity was significantly higher in bile duct carcino ma and may be served as one of the clinical marker for malignant neoplasm becaus e of its spsecificity.

Determination of telomerase activity in carcinoma of bile duct and its clinical significance / 第三军医大学学报

Objective　To explore the relationship between te lomerase activity and bile duct carcinoma and its significance in clinical diag nosis. Methods　Telomerase activities were examined in 23 cases of bile duct carcinoma, 5 cases of carcinoma adjacent tissues and 5 cases of nor mal bile duct tissues respectively with telomerase PCR-ELISA method. Results　Telomerase activity was detected in 18 of 23 cases (78.3%) of b ile duct carcinoma, and was not found in 5 cases of carcinoma adjacent tissues a nd 5 cases of normal bile duct tissues. The detection rate of telomerase activit y had no correlation with patients' age, sex, tumor site and size but significan tly correlated to metastasis of tumor (P<0.05). Conclusion　The level of telomerase activity was significantly higher in bile duct carcino ma and may be served as one of the clinical marker for malignant neoplasm becaus e of its spsecificity.