Radiofrequency-assisted partial splenectomy: Histopathological and immunological assessment of the splenic remnant in a porcine model
Background Radiofrequency (RF) ablation has recently been expanded from palliative treatment into tissue-preserving surgery with controversial results. RF has been accused of septic complications and dysfunction of the target organ due to uncontrolled energy distribution. The aim of this study was t...
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| Veröffentlicht in: | Surgical endoscopy 2008-05, Vol.22 (5), p.1309-1316 |
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| description | Background
Radiofrequency (RF) ablation has recently been expanded from palliative treatment into tissue-preserving surgery with controversial results. RF has been accused of septic complications and dysfunction of the target organ due to uncontrolled energy distribution. The aim of this study was to evaluate the short- and long-term implications of RF energy to the remaining splenic tissue after laparoscopic and open RF-assisted partial splenectomy.
Methods
Thirty pigs randomly underwent laparoscopic RF partial splenectomy (
n
= 10), open RF partial splenectomy (
n
= 10) using the Radionics Cooltip radiofrequency system (Tyco Hellas), while a third group (
n
= 10) underwent the conventional procedure. Intraoperative parameters were recorded.
Complete blood counts, along with splenic function tests, were estimated preoperatively, immediately postoperatively, and at 1 and 6 months after the procedure. Histology was also evaluated.
A separate group of five animals randomly undergo conventional resection (
n
= 2) and open RF resection (
n
= 3). These animals were sacrificed 1 month postoperatively and were used for histology only.
Results
The blood loss was minimal in both RF groups. No septic complications were observed throughout the follow-up period. Laboratory values at 1 month postoperatively showed decreased splenic function in both RF groups. Histology at 1 month was indicative of a chronic inflammatory reaction to the RF groups whereas, in the control group, prominent hypervascular granulated tissue was observed. Six months postoperatively, the platelet count remained elevated in the RF groups. Histology revealed intense fibrosis at the ablation site, as opposed to friable granulated tissue in the conventional group.
Conclusions
Radiofrequency energy acts as an excellent haemostatic tool. The healing process shifts from the thermal injury to chronic inflammatory reaction and, 6 months later, to intense fibrosis as opposed to the hypervascular granulated tissue presented in the nonablated spleen. However, the longer the RF energy is applied, the more the splenic function is transiently affected. |
| doi_str_mv | 10.1007/s00464-007-9617-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69935171</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1472798431</sourcerecordid><originalsourceid>FETCH-LOGICAL-c496t-ed1d8a894eebc315618cb2c09936dafaa78d0edbfd6c89b88c9cfbebe16e0fb13</originalsourceid><addsrcrecordid>eNqFkd9qFTEQxoNY7PHoA3gjQdC7rcn-TbwrRa1QKIheh2wy26ZskjWzCz0P4Hs3yx48IIhXGWZ-801mPkLecHbBGes-ImN1Wxc5LGTLu-LxGdnxuiqLsuTiOdkxWbGi7GR9Tl4iPrCMS968IOdcsLJjDduR39-1dXFI8GuBYA6FRnQ4g6WTTrPTI8VphABmjv7wiV7nWpz0fB_HeOdMLutgqfN-CacMIiB6CDONA53vYZNwhibwQee0C1TTKSbjAlAfLYyvyNmgR4TXx3dPfn75_OPquri5_frt6vKmMLVs5wIst0ILWQP0puJNy4XpS8OkrFqrB607YRnYfrCtEbIXwkgz9NADb4ENPa_25MOmO6WYF8ZZeYcGxlEHiAuqNis1vPs_yGVXc5nvuyfv_gIf4pJCXkKVXNZN1YlVjW-QSRExwaCm5LxOB8WZWp1Um5NqDVcn1WPueXsUXnoP9tRxtC4D74-Axnz3IelgHP7hSla1-UDr8HLjMJfCHaTTD_89_QnDkLru</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219453781</pqid></control><display><type>article</type><title>Radiofrequency-assisted partial splenectomy: Histopathological and immunological assessment of the splenic remnant in a porcine model</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Zacharoulis, Dimitris ; Poultsidis, Antigoni ; Katsogridakis, Emmanuel ; Kalala, Fani ; Nakou, Marianna ; Chatzitheofilou, Constantine</creator><creatorcontrib>Zacharoulis, Dimitris ; Poultsidis, Antigoni ; Katsogridakis, Emmanuel ; Kalala, Fani ; Nakou, Marianna ; Chatzitheofilou, Constantine</creatorcontrib><description>Background
Radiofrequency (RF) ablation has recently been expanded from palliative treatment into tissue-preserving surgery with controversial results. RF has been accused of septic complications and dysfunction of the target organ due to uncontrolled energy distribution. The aim of this study was to evaluate the short- and long-term implications of RF energy to the remaining splenic tissue after laparoscopic and open RF-assisted partial splenectomy.
Methods
Thirty pigs randomly underwent laparoscopic RF partial splenectomy (
n
= 10), open RF partial splenectomy (
n
= 10) using the Radionics Cooltip radiofrequency system (Tyco Hellas), while a third group (
n
= 10) underwent the conventional procedure. Intraoperative parameters were recorded.
Complete blood counts, along with splenic function tests, were estimated preoperatively, immediately postoperatively, and at 1 and 6 months after the procedure. Histology was also evaluated.
A separate group of five animals randomly undergo conventional resection (
n
= 2) and open RF resection (
n
= 3). These animals were sacrificed 1 month postoperatively and were used for histology only.
Results
The blood loss was minimal in both RF groups. No septic complications were observed throughout the follow-up period. Laboratory values at 1 month postoperatively showed decreased splenic function in both RF groups. Histology at 1 month was indicative of a chronic inflammatory reaction to the RF groups whereas, in the control group, prominent hypervascular granulated tissue was observed. Six months postoperatively, the platelet count remained elevated in the RF groups. Histology revealed intense fibrosis at the ablation site, as opposed to friable granulated tissue in the conventional group.
Conclusions
Radiofrequency energy acts as an excellent haemostatic tool. The healing process shifts from the thermal injury to chronic inflammatory reaction and, 6 months later, to intense fibrosis as opposed to the hypervascular granulated tissue presented in the nonablated spleen. However, the longer the RF energy is applied, the more the splenic function is transiently affected.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-007-9617-x</identifier><identifier>PMID: 18027050</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Ablation ; Animals ; Biological and medical sciences ; Blood Platelets ; Cardiovascular disease ; Catheter Ablation ; Energy ; Gastroenterology ; General aspects ; Gynecology ; Hepatology ; Histology ; Hospitals ; Immunology ; Inflammation ; Laboratory animals ; Laparoscopy ; Laparoscopy - methods ; Liver, biliary tract, pancreas, portal circulation, spleen ; Lymphocytes ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Models, Animal ; Other treatments ; Postoperative Period ; Proctology ; Radio frequency ; Random Allocation ; Spleen ; Spleen - pathology ; Spleen - surgery ; Splenectomy - methods ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Swine ; Treatment. General aspects ; Tumors ; Wound Healing</subject><ispartof>Surgical endoscopy, 2008-05, Vol.22 (5), p.1309-1316</ispartof><rights>Springer Science+Business Media, LLC 2007</rights><rights>2008 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c496t-ed1d8a894eebc315618cb2c09936dafaa78d0edbfd6c89b88c9cfbebe16e0fb13</citedby><cites>FETCH-LOGICAL-c496t-ed1d8a894eebc315618cb2c09936dafaa78d0edbfd6c89b88c9cfbebe16e0fb13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-007-9617-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-007-9617-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20365611$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18027050$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zacharoulis, Dimitris</creatorcontrib><creatorcontrib>Poultsidis, Antigoni</creatorcontrib><creatorcontrib>Katsogridakis, Emmanuel</creatorcontrib><creatorcontrib>Kalala, Fani</creatorcontrib><creatorcontrib>Nakou, Marianna</creatorcontrib><creatorcontrib>Chatzitheofilou, Constantine</creatorcontrib><title>Radiofrequency-assisted partial splenectomy: Histopathological and immunological assessment of the splenic remnant in a porcine model</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Radiofrequency (RF) ablation has recently been expanded from palliative treatment into tissue-preserving surgery with controversial results. RF has been accused of septic complications and dysfunction of the target organ due to uncontrolled energy distribution. The aim of this study was to evaluate the short- and long-term implications of RF energy to the remaining splenic tissue after laparoscopic and open RF-assisted partial splenectomy.
Methods
Thirty pigs randomly underwent laparoscopic RF partial splenectomy (
n
= 10), open RF partial splenectomy (
n
= 10) using the Radionics Cooltip radiofrequency system (Tyco Hellas), while a third group (
n
= 10) underwent the conventional procedure. Intraoperative parameters were recorded.
Complete blood counts, along with splenic function tests, were estimated preoperatively, immediately postoperatively, and at 1 and 6 months after the procedure. Histology was also evaluated.
A separate group of five animals randomly undergo conventional resection (
n
= 2) and open RF resection (
n
= 3). These animals were sacrificed 1 month postoperatively and were used for histology only.
Results
The blood loss was minimal in both RF groups. No septic complications were observed throughout the follow-up period. Laboratory values at 1 month postoperatively showed decreased splenic function in both RF groups. Histology at 1 month was indicative of a chronic inflammatory reaction to the RF groups whereas, in the control group, prominent hypervascular granulated tissue was observed. Six months postoperatively, the platelet count remained elevated in the RF groups. Histology revealed intense fibrosis at the ablation site, as opposed to friable granulated tissue in the conventional group.
Conclusions
Radiofrequency energy acts as an excellent haemostatic tool. The healing process shifts from the thermal injury to chronic inflammatory reaction and, 6 months later, to intense fibrosis as opposed to the hypervascular granulated tissue presented in the nonablated spleen. However, the longer the RF energy is applied, the more the splenic function is transiently affected.</description><subject>Abdominal Surgery</subject><subject>Ablation</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Blood Platelets</subject><subject>Cardiovascular disease</subject><subject>Catheter Ablation</subject><subject>Energy</subject><subject>Gastroenterology</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Histology</subject><subject>Hospitals</subject><subject>Immunology</subject><subject>Inflammation</subject><subject>Laboratory animals</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Models, Animal</subject><subject>Other treatments</subject><subject>Postoperative Period</subject><subject>Proctology</subject><subject>Radio frequency</subject><subject>Random Allocation</subject><subject>Spleen</subject><subject>Spleen - pathology</subject><subject>Spleen - surgery</subject><subject>Splenectomy - methods</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Swine</subject><subject>Treatment. General aspects</subject><subject>Tumors</subject><subject>Wound Healing</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkd9qFTEQxoNY7PHoA3gjQdC7rcn-TbwrRa1QKIheh2wy26ZskjWzCz0P4Hs3yx48IIhXGWZ-801mPkLecHbBGes-ImN1Wxc5LGTLu-LxGdnxuiqLsuTiOdkxWbGi7GR9Tl4iPrCMS968IOdcsLJjDduR39-1dXFI8GuBYA6FRnQ4g6WTTrPTI8VphABmjv7wiV7nWpz0fB_HeOdMLutgqfN-CacMIiB6CDONA53vYZNwhibwQee0C1TTKSbjAlAfLYyvyNmgR4TXx3dPfn75_OPquri5_frt6vKmMLVs5wIst0ILWQP0puJNy4XpS8OkrFqrB607YRnYfrCtEbIXwkgz9NADb4ENPa_25MOmO6WYF8ZZeYcGxlEHiAuqNis1vPs_yGVXc5nvuyfv_gIf4pJCXkKVXNZN1YlVjW-QSRExwaCm5LxOB8WZWp1Um5NqDVcn1WPueXsUXnoP9tRxtC4D74-Axnz3IelgHP7hSla1-UDr8HLjMJfCHaTTD_89_QnDkLru</recordid><startdate>20080501</startdate><enddate>20080501</enddate><creator>Zacharoulis, Dimitris</creator><creator>Poultsidis, Antigoni</creator><creator>Katsogridakis, Emmanuel</creator><creator>Kalala, Fani</creator><creator>Nakou, Marianna</creator><creator>Chatzitheofilou, Constantine</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20080501</creationdate><title>Radiofrequency-assisted partial splenectomy: Histopathological and immunological assessment of the splenic remnant in a porcine model</title><author>Zacharoulis, Dimitris ; Poultsidis, Antigoni ; Katsogridakis, Emmanuel ; Kalala, Fani ; Nakou, Marianna ; Chatzitheofilou, Constantine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c496t-ed1d8a894eebc315618cb2c09936dafaa78d0edbfd6c89b88c9cfbebe16e0fb13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abdominal Surgery</topic><topic>Ablation</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Blood Platelets</topic><topic>Cardiovascular disease</topic><topic>Catheter Ablation</topic><topic>Energy</topic><topic>Gastroenterology</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Histology</topic><topic>Hospitals</topic><topic>Immunology</topic><topic>Inflammation</topic><topic>Laboratory animals</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Models, Animal</topic><topic>Other treatments</topic><topic>Postoperative Period</topic><topic>Proctology</topic><topic>Radio frequency</topic><topic>Random Allocation</topic><topic>Spleen</topic><topic>Spleen - pathology</topic><topic>Spleen - surgery</topic><topic>Splenectomy - methods</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Swine</topic><topic>Treatment. General aspects</topic><topic>Tumors</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zacharoulis, Dimitris</creatorcontrib><creatorcontrib>Poultsidis, Antigoni</creatorcontrib><creatorcontrib>Katsogridakis, Emmanuel</creatorcontrib><creatorcontrib>Kalala, Fani</creatorcontrib><creatorcontrib>Nakou, Marianna</creatorcontrib><creatorcontrib>Chatzitheofilou, Constantine</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zacharoulis, Dimitris</au><au>Poultsidis, Antigoni</au><au>Katsogridakis, Emmanuel</au><au>Kalala, Fani</au><au>Nakou, Marianna</au><au>Chatzitheofilou, Constantine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiofrequency-assisted partial splenectomy: Histopathological and immunological assessment of the splenic remnant in a porcine model</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2008-05-01</date><risdate>2008</risdate><volume>22</volume><issue>5</issue><spage>1309</spage><epage>1316</epage><pages>1309-1316</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
Radiofrequency (RF) ablation has recently been expanded from palliative treatment into tissue-preserving surgery with controversial results. RF has been accused of septic complications and dysfunction of the target organ due to uncontrolled energy distribution. The aim of this study was to evaluate the short- and long-term implications of RF energy to the remaining splenic tissue after laparoscopic and open RF-assisted partial splenectomy.
Methods
Thirty pigs randomly underwent laparoscopic RF partial splenectomy (
n
= 10), open RF partial splenectomy (
n
= 10) using the Radionics Cooltip radiofrequency system (Tyco Hellas), while a third group (
n
= 10) underwent the conventional procedure. Intraoperative parameters were recorded.
Complete blood counts, along with splenic function tests, were estimated preoperatively, immediately postoperatively, and at 1 and 6 months after the procedure. Histology was also evaluated.
A separate group of five animals randomly undergo conventional resection (
n
= 2) and open RF resection (
n
= 3). These animals were sacrificed 1 month postoperatively and were used for histology only.
Results
The blood loss was minimal in both RF groups. No septic complications were observed throughout the follow-up period. Laboratory values at 1 month postoperatively showed decreased splenic function in both RF groups. Histology at 1 month was indicative of a chronic inflammatory reaction to the RF groups whereas, in the control group, prominent hypervascular granulated tissue was observed. Six months postoperatively, the platelet count remained elevated in the RF groups. Histology revealed intense fibrosis at the ablation site, as opposed to friable granulated tissue in the conventional group.
Conclusions
Radiofrequency energy acts as an excellent haemostatic tool. The healing process shifts from the thermal injury to chronic inflammatory reaction and, 6 months later, to intense fibrosis as opposed to the hypervascular granulated tissue presented in the nonablated spleen. However, the longer the RF energy is applied, the more the splenic function is transiently affected.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18027050</pmid><doi>10.1007/s00464-007-9617-x</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2008-05, Vol.22 (5), p.1309-1316 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_69935171 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Ablation Animals Biological and medical sciences Blood Platelets Cardiovascular disease Catheter Ablation Energy Gastroenterology General aspects Gynecology Hepatology Histology Hospitals Immunology Inflammation Laboratory animals Laparoscopy Laparoscopy - methods Liver, biliary tract, pancreas, portal circulation, spleen Lymphocytes Male Medical sciences Medicine Medicine & Public Health Models, Animal Other treatments Postoperative Period Proctology Radio frequency Random Allocation Spleen Spleen - pathology Spleen - surgery Splenectomy - methods Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Swine Treatment. General aspects Tumors Wound Healing |
| title | Radiofrequency-assisted partial splenectomy: Histopathological and immunological assessment of the splenic remnant in a porcine model |
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