CT-guided instillation of 5% dextrose in water into the anterior pararenal space before renal radiofrequency ablation in a porcine model: positive and negative effects.
OBJECTIVE
To assess the positive and negative effects of computed tomographic (CT)-guided instillation of 5% dextrose in water (D5W) into the anterior pararenal space before renal radiofrequency (RF) ablation in a porcine model.


METHODS
Under CT guidance, D5W was instilled into the right anterior pararenal space of 10 pigs and RF ablation performed in the right kidney. For the control lesions, RF ablation was performed in the left kidney of the same pigs without pretreatment with D5W. Approximately 1 week after RF ablation, bowel adhesion to both kidneys was compared by using a 5-point scale at open laparotomy, as follows: grade 0=no adhesion, grade 1=detachable adhesion, grade 2=grade 1 adhesion plus other adhesion to organs, grade 3=undetachable adhesion, and grade 4=bowel perforation. The areas of coagulation necrosis in both kidneys were compared at pathologic examination.


RESULTS
Bowel adhesions to the right kidneys were classified as grade 0 in nine pigs and as grade 1 in one pig, whereas those to the left kidneys were classified as grade 2 in two pigs and as grade 3 in eight (P<.05). The mean areas of coagulation necrosis in right and left kidneys were 0.58 cm2+/-0.5 and 1.53 cm2+/-1.3, respectively (P<.05).


CONCLUSIONS
CT-guided D5W instillation has a positive effect in reducing the amount of bowel adhesion injury during RF ablation. However, this technique may limit the area of coagulation necrosis in a swine model. Longer term pathologic evaluation is necessary to fully understand the effects of D5W instillation.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, and Seoul National University Hospital, 135-710, Korea. rapark@skku.edu
Byung Kwan
BK
Park
Seung Hyup
SH
Kim
Jae Young
JY
Byun
Yon Su
YS
Kim
Ghee Young
GY
Kwon
In Sung
IS
Jang
D000818:Animals; D017115:Catheter Ablation; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D009336:Necrosis / Q000209:etiology / Q000517:prevention & control; D015641:Radiography, Interventional / Q000379:methods*; D018709:Statistics, Nonparametric; D013552:Swine; D000267:Tissue Adhesions / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed
D005947:Glucose