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Interstitial laser coagulation: evaluation of the effect of normal liver blood perfusion and the application mode on
D Albrecht1, C T Germer, C Isbert
1Department of Surgery, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Germany.
Background And Objective:
The effect of temporarily interrupted hepatic blood flow and multiple-fiber application on necrosis volume in interstitial laser coagulation (ILC) was investigated.
Study Design/Materials And Methods:
Single- and multiple-fiber ILC were performed in porcine livers with normal as well as interrupted perfusion. Temperatures were determined. Lesions were measured and studied by light microscopy 4 hours post-treatment.
Results:
ILC with multiple-fiber application led to significantly greater individual lesion volumes (3.7 +/- 0.5 cm3) than single-fiber application (2.5 +/- 0.5 cm3) (P < .01). The interruption of hepatic perfusion led to a significant increase in lesion volume with single- (7.5 +/- 1.0 cm3) as well as multiple-fiber application (12.6 +/- 2.2 cm3) (P < .01). Superposition of the lesions in the multiple-fiber application mode was only determined with interrupted perfusion (total volume: 50.3 +/- 6.6 cm3).
Conclusion:
Interruption of hepatic perfusion increases lesion volumes significantly. ILC for treating liver tumors should preferably be performed by application routes that permit temporary interruption of hepatic perfusion.