Experimental Studies On Radiofrequency Ablation For Secondary Hypersplenism

BackgroundThe morbidity rate of portal hypertention complicited with liver cirrhosis due to hepatitis is high in our country. Hypersplenism and esophageal variceal bleeding are the two common manifestations of the disease. Liver transplantation can effect a permanent cure of portal hypertenion. Other treatments are only effective for its complications,such as devascularization , splenectomy and so on . Furthermore good liver function is essential for these cure strategies ,which have much intercurrent disease and great hurt. It is warranted to search for a more effective and safer minimally invasive alternative for hypersplenism before liver transplantation can apply to patients with advanced liver cirrhosis in large scale. The theory of arrestment in spleen plays an important role of the mechanism for hypersplenism. Accordingly, reducing volume of spleen is a method to cure hypersplenism. Radiofrequency ablation (RFA) is a representative technique of interstitial thermal ablation, with advantages of minimal invasion, safety and simple to deploy. RFA generates rapid vibration of the ions and grit of molecule in the tissue . The produced heat is subsequently conducted into the surrounding tissue, causing coagulative necrosis. ObjectiveTo evaluate the feasibility and efficacy of a new minimally invasive procedure of RFA for the patients with hypersplenism due to portal hypertension with liver cirrhosis after hepatitis. To sudy the possibility of the RFA technique ,which can not only cure hypersplenism but also preserve splenic function . To provide scientific data and experimental evidence for future clinical performance of RFA.This study attempted to treat hypersplenism with RFA technique with using RFA in canines with secondary hypersplenism. Methods and Results1. To explore a new, rapid, and effective way to establish an animal model.A canine model of secondary hypersplenism was established by ordinal ligation of gastrosplenic vein trunk, splenic vein and its collateral branches. The results showed that the canine models were established successfully with stable thrombocytopenia, erythropenia , hypochromia, heightening of the pressure of splenic vein and splenomegaly . The spleen in the canine models was eligible for deploying RFA.2. RFA was performed in spleen of the canines with secondary hypersplenism. Subsequently the haematological ,radiologic , pathologic outcomes and procedure-related complications were observed. The results suggest that it is feasible, safe and effective to perform RFA in the spleen to treat secondary hypersplenism. There were no major complications and mortality in the experimental canines.3. To study the feasibility of the RFA technique can cure the hypersplenism...