ABSTRACT
BACKGROUND: The use of direct current electrolysis as a local nonthermal ablative technique for colorectal liver metastases promises to be a simple, safe, and effective therapy. Under general anesthesia, electrolysis is presently limited to tumors smaller than 5 cm, due to the protracted nature of its administration. In an attempt to enhance the effect of electrolysis, a direct current was passed through a preinjected bolus of acetic acid. METHODS: The effect of a combination of electrolysis and an injection of acetic acid was tested in the liver of eight normal pigs. The volumes of necrosis caused were analyzed. RESULTS: Acetic acid independently produced a volume of necrosis but did not provide a volumetric or rate advantage when used in combination with a direct current. Statistically, the only main effect on the volume of necrosis was a result of electrolysis. CONCLUSION: The use of 50% acetic acid to augment the efficacy of direct current electrolysis cannot be recommended.
Subject(s)
Acetic Acid/administration & dosage , Electrodes , Electrolysis/instrumentation , Electrolysis/methods , Liver , Animals , Injections , Liver/drug effects , Liver/pathology , Necrosis , SwineSubject(s)
Carcinoma, Hepatocellular/therapy , Liver Neoplasms/therapy , Aged , Electrolysis , Humans , MaleABSTRACT
Electrolysis is a method of tissue ablation that creates chemical species and a pH gradient in response to direct current. Initial studies of electrolysis in animal models and humans have shown that it is a safe, predictable and effective process for destroying normal and tumour-bearing liver in a linear, dose-dependent manner. Presently, the amount of current that is applied (in coulombs) has to be calculated using historical data, with inherent inaccuracy. The present study tested whether pH could be used as a real-time monitor in order to predict more accurately the extent of necrosis. A total of 70 electrolytic lesions were created in 14 pigs, with pH monitoring of the lesion edge. The normal range of pH values was 6.5-8.7. A pH of less than 6 (at the anode) or more than 9 (at the cathode) reflected total cellular necrosis. When a pH value was recorded between 6.0 and 6.5 at the anode or between 8.7 and 9.0 at the cathode, the presence of necrosis was variable. In conclusion, during electrolytic ablation, pH measurement can monitor the extent of the induced necrosis.
