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Intraoperative adverse events during irreversible electroporation-a call for caution
Patryk Kambakamba1, John M Bonvini2, Michael Glenck3
1Department of Surgery and Transplantation, Swiss HPB Center, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
American Journal of Surgery
|October 8, 2016
Summary
Intraoperative adverse events, mainly cardiac issues like blood pressure elevation and arrhythmia, are common during irreversible electroporation for solid tumors. However, these events rarely prevent the procedure from being completed.
Area of Science:
- Oncology
- Medical Devices
- Surgical Procedures
Background:
- Irreversible electroporation (IRE) is a growing treatment for solid tumors.
- Limited safety data exists for IRE procedures.
- This study focuses on intraoperative adverse events during IRE for tumor ablation.
Purpose of the Study:
- To document intraoperative adverse events in patients undergoing IRE for solid tumors.
- To identify the types and frequency of complications.
- To analyze factors associated with adverse events.
Main Methods:
- Retrospective analysis of 43 patients undergoing IRE for hepato-pancreato-biliary and retroperitoneal malignancies (2012-2015).
- Data collected on demographic and intraoperative factors.
- Adverse events categorized as cardiac, surgical, or equipment-related.
Main Results:
- 47% of patients (n=20) experienced adverse events.
- Cardiac events were most frequent (90%, n=18), including blood pressure elevation (77%) and arrhythmia (16%).
- Previous cardiovascular disease and proximity of needle placement to the celiac trunk were linked to cardiac events.
Conclusions:
- Intraoperative cardiac adverse events are frequent during irreversible electroporation.
- Most cardiac events are manageable and do not halt the ablation procedure.
- IRE demonstrates a generally manageable safety profile regarding intraoperative complications.
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