Radiofrequency ablation (RFA) is an established treatment option for patients with inoperable liver tumours and is now being investigated for the treatment of lung and other solid tumours. The aim of this thesis was to investigate the use RFA to decrease blood loss during liver resection, for the treatment of the liver resection edge and to investigate the safety and efficacy of brain RFA. Blood loss is an important factor affecting both the morbidity and mortality following liver resection. The use of a novel in line RF probe to ablate the transection plane prior to liver resection resulted in decreased blood loss with easier resection. This has potential in the treatment of liver tumors in cirrhotic livers and also in other vascular organs. The other important prognostic factor affecting long-term survival in patients undergoing liver resection for liver tumors is the surgical margins. Positive margins which cannot be treated with repeat resection may be treated with cryotherapy. The use of a novel probe to ablate the resection edge with RFA was found to be equally effective as cryotherapy and superior to argon beam coagulation or diathermy in an ex-vivo model. The radiofrequency ablation of the brain was found to be safe with no hemorrhage or damage to the surrounding brain parenchyma. There was no rise in intra-cranial pressure in the animals treated with RFA. The brain RFA was found to be effective and has potential for the treatment of brain tumours. Dispersive pad site burns was a significant problem in patients treated with radiofrequency ablation for lung and liver tumours occurring in 5% of patients. Pad tissue temperature of 45oC was found to be the threshold temperature above which burns occurred. Monitoring of pad-tissue temperatures with thermocouples and application of ice packs in addition to increasing the number of pads may help decrease this complication.
| Identifer | oai:union.ndltd.org:ADTP/234937 |
| Date | January 2006 |
| Creators | Gananadha, Sivakumar, St George, UNSW |
| Publisher | Awarded by:University of New South Wales. St George |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Copyright Sivakumar Gananadha, http://unsworks.unsw.edu.au/copyright |
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