Experimental study on the feasibility and safety of radiofrequency ablation for secondary splenomagely and hypersplenism.
OBJECTIVE
To assess the feasibility and safety of radiofrequency ablation (RFA) in treatment of secondary splenomagely and hypersplenism.


METHODS
Sixteen healthy mongrel dogs were randomly divided into two groups, group I (n=4) and group II (n=12). Congestive splenomegaly was induced by ligation of splenic vein and its collateral branches in both groups. At the end of 3rd week postoperation, RFA in spleen was performed in group II via laparotomy, complications of RFA were observed, CT scan was performed and the spleens were obtained. The radiofrequency (RF) thermal lesions and histopathology of spleen were examined regularly.


RESULTS
No complication or death was observed in both groups; CT revealed that the splenomegaly lasted over 2 months after ligation of splenic vein; the segmental RF lesions included hyperintense zone of coagulative necrosis and more extensive peripheral hypointense infarcted zone, the latter was called "bystander effect". The infarcted zone would be absorbed and subsequently disappeared in 4-6 weeks after RFA accompanied with shrinkage of the remnant spleen. The fundamental histopathological changes of splenic lesions caused by RF thermal energy included local coagulative necrosis, peripheral thrombotic infarction zone, subsequent tissue absorption and fibrosis in the zone of thrombotic infarction, the occlusion of vessels in remnant viable spleen, deposition of extensive fibrous protein, and disappearance of congestive splenic sinusoid - "splenic carnification". Those pathologic changes were underline of shrinkage of spleen.


CONCLUSIONS
It is feasible and safe to perform RFA in spleen to treat experimental splenomegaly and hypersplenism. The RFA could be safely performed clinically via laparotomy or laparoscopic procedure while spleen was strictly separated from surrounding organs.
Liu
Quan-Da
QD
Institute of Hepatobiliary Surgery, Southwest Hepatobiliary Surgery Hospital, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. liuquanda@sina.com
Ma
Kuan-Sheng
KS
He
Zhen-Ping
ZP
Ding
Jun
J
Huang
Xue-Quan
XQ
Dong
Jia-Hong
JH
D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005240:Feasibility Studies; D006971:Hypersplenism / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D000078702:Radiofrequency Therapy; D011859:Radiography; D015203:Reproducibility of Results; D012449:Safety; D013163:Splenomegaly / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*