Electrolytic Ablation of Colorectal Liver Metastases: 1-Year Histological Patient Follow-Up

Berry, David P.; Dennison, Ashley R.; Ward, Robert C.; Maddern, Guy J.

doi:10.1159/000051951

Cited by 21 publications

(17 citation statements)

References 12 publications

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“…From the present study and the reviewed literature it is apparent that electrolysis is a reliable, reproducible, and predictable method for the potentially curative treatment of unresectable liver tumors. Early reports on electrolysis in humans with liver metastases have shown complete ablation of metastases with no histological recurrence at 12 months following ablation [45]. This study has also demonstrated that concurrent intermittent hepatic ischemia significantly increases the efficacy of electrolysis in producing large volumes of hepatic necrosis.…”

Section: Figuresupporting

confidence: 60%

Augmenting the Ablative Effect of Liver Electrolysis: Using Two Electrodes and the Pringle Maneuver

Berry¹,

Garcea²,

Vanderzon³

et al. 2004

Journal of Investigative Surgery

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Several methods of liver tumor ablation have been investigated, and these include the novel technique of electrolysis. Electrolysis is slower than other forms of ablative therapy. This study determined methods of increasing the ablative effect of electrolysis. Domestic white pigs were divided. One group received electrolysis using two electrode catheters, and in the other group a concurrent intermittent Pringle maneuver was performed to induce intermittent ischemia. The effect of two electrode catheters versus a single electrode catheter was compared, and the effect of the Pringle maneuver versus no Pringle was examined with two electrode catheters. The livers were harvested, and the volume of each lesion was calculated. There was a linear relationship between the volume of hepatic necrosis and the electrolytic dose in ( p < .005) in both the single-electrode-catheter and two-electrode-catheter groups. Comparison between the single-and multiple-electrode groups showed a highly significant difference in the dose response ( p < .0000002) when more than one electrode was used. Use of the Pringle maneuver during electrolysis produced larger volumes of hepatic necrosis over all doses when using two electrode catheters. Rates of necrosis were 3.8 cm 3 /100 C for a single electrode catheter, 5.46 cm 3 /100 C for two electrode catheters without Pringle, and 6.17 cm 3 /100 C for electrolysis with two electrode catheters coupled with intermittent Pringle maneuver. Thus, electrolysis was both reliable and predictable in producing hepatic necrosis in a dose-dependent manner. The time delay in achieving tumor ablation via electrolysis can be overcome by using two electrodes combined with the Pringle maneuver to increase the volume of the lesion produced.

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Section: Figuresupporting

confidence: 60%

Augmenting the Ablative Effect of Liver Electrolysis: Using Two Electrodes and the Pringle Maneuver

Berry¹,

Garcea²,

Vanderzon³

et al. 2004

Journal of Investigative Surgery

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“…It is probably due to a combination of cytotoxic chemical production, pH changes and membrane disruption, although ischaemia and other host factors may also play a role [13][14][15][16][17][18][19][20][21][22]24,[28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

“…It does not rely on thermal effects at low currents [3,[11][12][13][14][15] and has been shown to be safe, predictable and effective in a linear dose-related manner [16][17][18]. The use of small metallic electrodes makes electrolysis suitable for percutaneous use.…”

Section: Introductionmentioning

confidence: 99%

Liver electrolysis: pH can reliably monitor the extent of hepatic ablation in pigs

et al. 2002

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Electrolysis is a method of tissue ablation that creates chemical species and a pH gradient in response to direct current. Initial studies of electrolysis in animal models and humans have shown that it is a safe, predictable and effective process for destroying normal and tumour-bearing liver in a linear, dose-dependent manner. Presently, the amount of current that is applied (in coulombs) has to be calculated using historical data, with inherent inaccuracy. The present study tested whether pH could be used as a real-time monitor in order to predict more accurately the extent of necrosis. A total of 70 electrolytic lesions were created in 14 pigs, with pH monitoring of the lesion edge. The normal range of pH values was 6.5-8.7. A pH of less than 6 (at the anode) or more than 9 (at the cathode) reflected total cellular necrosis. When a pH value was recorded between 6.0 and 6.5 at the anode or between 8.7 and 9.0 at the cathode, the presence of necrosis was variable. In conclusion, during electrolytic ablation, pH measurement can monitor the extent of the induced necrosis.

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“…Some clinical studies have reported the ability of electrolysis to destroy tumor tissue in various organs such as the skin, liver, or breast. However, complete regression of a malignancy was rarely observed [Berry et al, 2000;Telló et al, 2007]. EChT-like, high-intensity focused ultrasound or RFA is not selective and will destroy normal cells as well as tumor cells.…”

Section: Electrochemical Treatment Of Cancermentioning

confidence: 99%

Microsecond and nanosecond electric pulses in cancer treatments

Breton¹,

Mir²

2011

Bioelectromagnetics

182

133

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New local treatments based on electromagnetic fields have been developed as non-surgical and minimally invasive treatments of tumors. In particular, short electric pulses can induce important non-thermal changes in cell physiology, especially the permeabilization of the cell membrane. The aim of this review is to summarize the present data on the electroporation-based techniques: electrochemotherapy (ECT), nanosecond pulsed electric fields (nsPEFs), and irreversible electroporation (IRE). ECT is a safe, easy, and efficient technique for the treatment of solid tumors that uses cell-permeabilizing electrical pulses to enhance the activity of a non-permeant (bleomycin) or low permeant (cisplatin) anticancer drug with a very high intrinsic cytotoxicity. The most interesting feature of ECT is its unique ability to selectively kill tumor cells without harming normal surrounding tissue. ECT is already used widely in the clinics in Europe. nsPEFs could represent a drug free, purely electrical cancer therapy. They allow the inhibition of tumor growth, and interestingly, nsPEF can target intracellular organelles. However, many questions remain on the mechanism of action of these pulses. Finally, IRE is a new ablation procedure using pulses that provoke the permanent permeabilization of the cells resulting in their death. This technique does not result in any thermal effect, which is its main advantage in current physical ablation technologies. For both the nsPEF and the IRE, the preservation of the normal tissue, which is characteristic of ECT, has not yet been shown and their safety and efficacy still have to be investigated thoroughly in vivo and in the clinics.

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Electrolytic Ablation of Colorectal Liver Metastases: 1-Year Histological Patient Follow-Up

Cited by 21 publications

References 12 publications

Augmenting the Ablative Effect of Liver Electrolysis: Using Two Electrodes and the Pringle Maneuver

Augmenting the Ablative Effect of Liver Electrolysis: Using Two Electrodes and the Pringle Maneuver

Liver electrolysis: pH can reliably monitor the extent of hepatic ablation in pigs

Microsecond and nanosecond electric pulses in cancer treatments

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