Endoscopic ultrasound guided radiofrequency ablation,for pancreatic cystic neoplasms and neuroendocrine tumors  

作　　者：Madhava Pai Nagy Habib Hakan Senturk Sundeep Lakhtakia Nageshwar Reddy Vito R Cicinnati Iyad Kaba Susanne Beckebaum Panagiotis Drymousis Michel Kahaleh William Brugge 

机构地区：[1]HPB Unit,Hammersmith Hospital,Imperial College [2]Emcision Limited [3]Department of Gastroenterology,Bezmi Alem University [4]Asian Institute of Gastroenterology [5]Department of Transplant Medicine,University Hospital Münster [6]Division of Gastroenterology and Hepatology,Department of Medicine,Weill Cornell Medical College [7]Massachusetts General Hospital,Harvard Medical School

出　　处：《World Journal of Gastrointestinal Surgery》2015年第4期52-59,共8页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIM: To outline the feasibility, safety, adverse events and early results of endoscopic ultrasound(EUS)-radiofrequency ablation(RFA) in pancreatic neoplasms using a novel probe. METHODS: This is a multi-center, pilot safety feasibility study. The intervention described was radiofrequency ablation(RF) which was applied with an innovative monopolar RF probe(1.2 mm Habib EUS-RFA catheter) placed through a 19 or 22 gauge fine needle aspiration(FNA) needle once FNA was performed in patients with a tumor in the head of the pancreas. The HabibTM EUSRFA is a 1 Fr wire(0.33 mm, 0.013") with a working length of 190 cm, which can be inserted through the biopsy channel of an echoendoscope. RF power is applied to the electrode at the end of the wire to coagulate tissue in the liver and pancreas.RESULTS: Eight patients [median age of 65(range 27-82) years; 7 female and 1 male] were recruited in a prospective multicenter trial. Six had a pancreatic cysticneoplasm(four a mucinous cyst, one had intraductal papillary mucinous neoplasm and one a microcystic adenoma) and two had a neuroendocrine tumors(NET) in the head of pancreas. The mean size of the cystic neoplasm and NET were 36.5 mm(SD ± 17.9 mm) and 27.5 mm(SD ± 17.7 mm) respectively. The EUSRFA was successfully completed in all cases. Among the 6 patients with a cystic neoplasm, post procedure imaging in 3-6 mo showed complete resolution of the cysts in 2 cases, whilst in three more there was a 48.4% reduction [mean pre RF 38.8 mm(SD ± 21.7 mm) vs mean post RF 20 mm(SD ± 17.1 mm)] in size. In regards to the NET patients, there was a change in vascularity and central necrosis after EUS-RFA. No major complications were observed within 48 h of the procedure. Two patients had mild abdominal pain that resolved within 3 d. CONCLUSION: EUS-RFA of pancreatic neoplasms with a novel monopolar RF probe was well tolerated in all cases. Our preliminary data suggest that the procedure is straightforward and safe. The response ranged from complete resolution to a 50% reduction in size.AIM： To outline the feasibility, safety, adverse eventsand early results of endoscopic ultrasound （EUS）-radiofrequency ablation （RFA） in pancreatic neoplasmsusing a novel probe.METHODS： This is a multi-center, pilot safety feasibilitystudy. The intervention described was radiofrequencyablation （RF） which was applied with an innovativemonopolar RF probe （1.2 mm Habib EUS-RFA catheter）placed through a 19 or 22 gauge fine needle aspiration（FNA） needle once FNA was performed in patients witha tumor in the head of the pancreas. The Habib？ EUSRFAis a 1 Fr wire （0.33 mm, 0.013＂） with a workinglength of 190 cm, which can be inserted throughthe biopsy channel of an echoendoscope. RF poweris applied to the electrode at the end of the wire tocoagulate tissue in the liver and pancreas.RESULTS： Eight patients [median age of 65 （range27-82） years; 7 female and 1 male] were recruited in aprospective multicenter trial. Six had a pancreatic cystic neoplasm （four a mucinous cyst, one had intraductal papillary mucinous neoplasm and one a microcystic adenoma） and two had a neuroendocrine tumors （NET） in the head of pancreas. The mean size of the cystic neoplasm and NET were 36.5 mm （SD ± 17.9 mm） and 27.5 mm （SD ± 17.7 mm） respectively. The EUSRFA was successfully completed in all cases. Among the 6 patients with a cystic neoplasm, post procedure imaging in 3-6 mo showed complete resolution of the cysts in 2 cases, whilst in three more there was a 48.4% reduction [mean pre RF 38.8 mm （SD ± 21.7 mm） vs mean post RF 20 mm （SD ± 17.1 mm）] in size. In regards to the NET patients, there was a change in vascularity and central necrosis after EUS-RFA. No major complications were observed within 48 h of the procedure. Two patients had mild abdominal pain that resolved within 3 d. CONCLUSION： EUS-RFA of pancreatic neoplasms with a novel monopolar RF probe was well tolerated in all cases. Our preliminary data suggest that the procedure is straightforward and safe. The respons

关 键 词：ENDOSCOPIC ultrasound RADIOFREQUENCYABLATION PANCREAS CYSTIC NEOPLASMS Neuroendocrinetumors 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.9[医药卫生—诊断学] R739.4[医药卫生—临床医学]