title: Importance of eliminating portal flow to produce large intrahepatic lesions with interstitial laser coagulation.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Erasmus University, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Heisterkamp
authors.forename: R
authors.initials: R
authors.lastname: van Hillegersberg
authors.forename: P G
authors.initials: PG
authors.lastname: Mulder
authors.forename: E L
authors.initials: EL
authors.lastname: Sinofsky
authors.forename: J N
authors.initials: JN
authors.lastname: IJzermans
mesh_terms: D000818:Animals; D005260:Female; D017075:Laser Coagulation / Q000379:methods*; D008026:Ligation; D008099:Liver / Q000098:blood supply*; D011168:Portal System / Q000601:surgery*; D013552:Swine