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Published in: Surgical Endoscopy 2/2005

01-02-2005 | Original article

Radiofrequency tissue ablation in an experimental model of grade IV renal trauma: a preliminary report

Authors: M. Kontos, E. Felekouras, E. Drakos, E. Pikoulis, D. Mitropoulos, C. Staikou, D. Hatzianastasiou, F. Sigala, A. Papalois, E. Papalambros, E. Bastounis

Published in: Surgical Endoscopy | Issue 2/2005

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Abstract

Background

The kidney is one of the most frequently injured intraabdominal organs. In this study, we investigated the efficacy and safety of radiofrequency ablation (RFA) as a kidney-preserving hemostatic technique for grade IV renal trauma.

Methods

A grade IV injury was induced in the right kidney of 12 Landrace pigs. Then RFA was applied around the injury in 10 animals until hemostasis was achieved; two animals were not treated (control group). The treated animals were killed humanely on days 0, 3, 7, 14 and 21 and examined. The kidneys were subjected to histologic and radiologic examination.

Results

The two untreated animals died from hypovolemic shock. Hemostasis was achieved in all treated animals. We had no operative deaths and no morbidity. No blood, pus, urine, or other fluid was found at the time of death. In one animal, a fistulous lesion leading to the collecting system was identified, but no urine leakage was observed. At histology, the ablated areas were found to consist of three zones: an inner necrotic one, a zone of neutrophils digesting necrotic tissue, and an outer zone with possibly reversible damage.

Conclusions

Radiofrequency ablation is an efficient and safe hemostatic method for grade IV renal trauma. Further study is needed to investigate the possible application of this method to humans and its percutaneous or laparoscopic use.
Literature
1.
go back to reference Collyer, WC, Landman, J, Olweny, EO, Andreoni, C, Kerbl, K, Bostwick, DG, Clayman, RV 2001Comparison of renal ablation with cryotherapy, dry radiofrequency and saline augmented radiofrequency in a porcine modelJ Am Coll Surg193505513PubMed Collyer, WC, Landman, J, Olweny, EO, Andreoni, C, Kerbl, K, Bostwick, DG, Clayman, RV 2001Comparison of renal ablation with cryotherapy, dry radiofrequency and saline augmented radiofrequency in a porcine modelJ Am Coll Surg193505513PubMed
2.
go back to reference Denys, AL, Baere, T, Mahe, C, Sabourin, JC, Sa Cunha, A, Germain, S, Roche, A 2001Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig modelEur Radiol1121022108PubMed Denys, AL, Baere, T, Mahe, C, Sabourin, JC, Sa Cunha, A, Germain, S, Roche, A 2001Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig modelEur Radiol1121022108PubMed
3.
go back to reference Gill, IS, Hsu, TH, Fox, RL, Matamoros, A, Miller, CD, LeVeen, RF, Grune, MT, et al. 2000Laparoscopic and percutaneous radiofrequency ablation of the kidney: acute and chronic porcine studyUrology56197200PubMed Gill, IS, Hsu, TH, Fox, RL, Matamoros, A, Miller, CD, LeVeen, RF, Grune, MT,  et al. 2000Laparoscopic and percutaneous radiofrequency ablation of the kidney: acute and chronic porcine studyUrology56197200PubMed
4.
go back to reference Goldberg, SN, Gazelle, GS, Solbiati, L, Rittman, WJ, Mueller, PR 1996Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrodeAcad Radiol3636644PubMed Goldberg, SN, Gazelle, GS, Solbiati, L, Rittman, WJ, Mueller, PR 1996Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrodeAcad Radiol3636644PubMed
5.
go back to reference Hammer, CC, Santucci, RA 2003Effect of an institutional policy of nonoperative treatment of grade I to IV renal injuriesJ Urol16917511753PubMed Hammer, CC, Santucci, RA 2003Effect of an institutional policy of nonoperative treatment of grade I to IV renal injuriesJ Urol16917511753PubMed
6.
go back to reference Hsu, TH, Fidler, ME, Gill, IS 2000Radiofrequency ablation of the kidney: acute and chronic histology in porcine modelUrology56872875PubMed Hsu, TH, Fidler, ME, Gill, IS 2000Radiofrequency ablation of the kidney: acute and chronic histology in porcine modelUrology56872875PubMed
7.
go back to reference Kim, RY, Weintraub, JL, Susman, J, Haskal, ZJ 2002Radiofrequency ablation for hemobilia secondary to hepatocellular carcinomaJ Vasc Interv Radiol13317320PubMed Kim, RY, Weintraub, JL, Susman, J, Haskal, ZJ 2002Radiofrequency ablation for hemobilia secondary to hepatocellular carcinomaJ Vasc Interv Radiol13317320PubMed
8.
go back to reference Kuo, RL, Eachempati, SR, Makhuli, MJ, Reed, RL,II 2002Factors affecting management and outcome in blunt renal injuryWorld J Surg26416419PubMed Kuo, RL, Eachempati, SR, Makhuli, MJ, Reed, RL,II 2002Factors affecting management and outcome in blunt renal injuryWorld J Surg26416419PubMed
9.
go back to reference Laeseke, PF, Winter, TC,3rd, Davis, CL, Stevens, KR, Johnson, CD, Fronczak, FJ, Webster, JG, et al. 2003Postbiopsy bleeding in a porcine model: reduction with radio-frequency ablation — preliminary resultsRadiology227493499PubMed Laeseke, PF, Winter, TC,3rd, Davis, CL, Stevens, KR, Johnson, CD, Fronczak, FJ, Webster, JG,  et al. 2003Postbiopsy bleeding in a porcine model: reduction with radio-frequency ablation — preliminary resultsRadiology227493499PubMed
10.
go back to reference Margenthaler, JA, Weber, TR, Keller, MS 2002Blunt renal trauma in children: experience with conservative management at a pediatric trauma centerJ Trauma52928932PubMed Margenthaler, JA, Weber, TR, Keller, MS 2002Blunt renal trauma in children: experience with conservative management at a pediatric trauma centerJ Trauma52928932PubMed
11.
go back to reference Miao, Y, Ni, Y, Bosmans, H, Yu, J, Vaninbroukx, J, Dymarkowski, S, Zhang, H, et al. 2001Radiofrequency ablation for eradication of renal tumor in a rabbit model by using a cooled-tip electrode techniqueAnn Surg Oncol8651657PubMed Miao, Y, Ni, Y, Bosmans, H, Yu, J, Vaninbroukx, J, Dymarkowski, S, Zhang, H,  et al. 2001Radiofrequency ablation for eradication of renal tumor in a rabbit model by using a cooled-tip electrode techniqueAnn Surg Oncol8651657PubMed
12.
go back to reference Moore, E, Shackford, S, Packter, H, McAninch, J, Browner, B, Champion, H, Flint, L, et al. 1989Organ injury scaling: spleen, liver and kidneyJ Trauma2916641666PubMed Moore, E, Shackford, S, Packter, H, McAninch, J, Browner, B, Champion, H, Flint, L,  et al. 1989Organ injury scaling: spleen, liver and kidneyJ Trauma2916641666PubMed
13.
go back to reference Nicol, AJ, Theunissen, D 2002Renal salvage in penetrating renal injuries: a prospective analysisJ Trauma53351353PubMed Nicol, AJ, Theunissen, D 2002Renal salvage in penetrating renal injuries: a prospective analysisJ Trauma53351353PubMed
14.
go back to reference Russell, RS, Gomelsky, A, McMahon, DR, Andrews, D, Nasrallah, PF 2001Management of grade IV renal injury in childrenJ Urol16610491050PubMed Russell, RS, Gomelsky, A, McMahon, DR, Andrews, D, Nasrallah, PF 2001Management of grade IV renal injury in childrenJ Urol16610491050PubMed
15.
go back to reference Santucci, RA, McAninch, JM 2001Grade IV renal injuries: evaluation, treatment and outcomeWorld J Surg2515651572PubMed Santucci, RA, McAninch, JM 2001Grade IV renal injuries: evaluation, treatment and outcomeWorld J Surg2515651572PubMed
16.
go back to reference Titton, RL, Gervais, DA, Boland, GW, Mueller, PR 2002Renal trauma: radiologic evaluation and percutaneous treatment of nonvascular injuriesAJR17815071511PubMed Titton, RL, Gervais, DA, Boland, GW, Mueller, PR 2002Renal trauma: radiologic evaluation and percutaneous treatment of nonvascular injuriesAJR17815071511PubMed
17.
go back to reference Toutouzas, KG, Karaiskakis, M, Kaminski, A, Velmahos, GC 2002Nonoperative management of blunt renal trauma: a prospective studyAm Surg6810971103PubMed Toutouzas, KG, Karaiskakis, M, Kaminski, A, Velmahos, GC 2002Nonoperative management of blunt renal trauma: a prospective studyAm Surg6810971103PubMed
18.
go back to reference Weber, JC, Navarra, G, Jiao, LR, Nicholls, JP, Jensen, SL, Habib, NA 2002New technique for liver resection using heat coagulative necrosisAnn Surg236560563PubMed Weber, JC, Navarra, G, Jiao, LR, Nicholls, JP, Jensen, SL, Habib, NA 2002New technique for liver resection using heat coagulative necrosisAnn Surg236560563PubMed
19.
go back to reference Weber, JC, Navarra, G, Habib, NA, Bachellier, P, Jaeck, D 2003Laparoscopic radiofrequency-assisted liver resectionSurg Endosc17834 Weber, JC, Navarra, G, Habib, NA, Bachellier, P, Jaeck, D 2003Laparoscopic radiofrequency-assisted liver resectionSurg Endosc17834
20.
go back to reference Wessells, H, Suh, D, Porter, JR, Rivara, F, MacKenzie, EJ, Jurkovich, GJ, Nathens, AB 2003Renal injury and operative management in the United States: results of a population-based studyJ Trauma54423430PubMed Wessells, H, Suh, D, Porter, JR, Rivara, F, MacKenzie, EJ, Jurkovich, GJ, Nathens, AB 2003Renal injury and operative management in the United States: results of a population-based studyJ Trauma54423430PubMed
Metadata
Title
Radiofrequency tissue ablation in an experimental model of grade IV renal trauma: a preliminary report
Authors
M. Kontos
E. Felekouras
E. Drakos
E. Pikoulis
D. Mitropoulos
C. Staikou
D. Hatzianastasiou
F. Sigala
A. Papalois
E. Papalambros
E. Bastounis
Publication date
01-02-2005
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 2/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-9327-y

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