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Importance of eliminating portal flow to produce large intrahepatic lesions with interstitial laser coagulation

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Background Interstitial laser coagulation is a local treatment modality for solid tumours, such as liver metastases. Perfusion by the vascular system can transfer heat from the treatment site, thereby reducing the volume of destroyed tissue.

Methods This effect was investigated in a pig model (n=10). Lesions were produced in the liver with four interstitial laser fibres (5 W per fibre for 6 min): (1) with flow through the liver (n=9); (2) with the portal vein clamped (n=8); and (3) with both hepatic artery and portal vein clamped (n=6). The pigs were killed and the liver was dissected; lesions were assessed macroscopically and microscopically.

Results The volume of the lesion was significantly larger when portal flow was eliminated (30·6 versus 6·4 cm3, P<0·001).

Conclusion Hepatic blood flow substantially reduces the size of the lesion produced by laser coagulation. Portal flow should therefore be occluded during laser treatment to produce lesions of clinically relevant dimensions.
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Document Type: Research Article

Affiliations: 1: Departments of Surgery 2: Epidemiology and Biostatistics, Erasmus University and University Hospital `Dijkzigt', Rotterdam, The Netherlands 3: Rare Earth Medical, West Yarmouth, Massachusetts, USA

Publication date: September 1, 1997

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