title: The application of cold-plasma coagulation on the visceral pleura results in a predictable depth of necrosis without fistula generation.
abstract: A technique for the safe transfer of electric energy to the pulmonary surface for the potential evaporation of malignant tumours is non-existent to date. By conducting the current study, we wanted to generate data on the potential beneficiary effects and complications of using cold-plasma coagulation on the pulmonary surface. Cold-plasma coagulation was applied to the pulmonary surface in eight female mini-pigs via a thoracoscopic access. After 12 days, we performed a re-thoracoscopy on the contralateral side. After a further 12 days, we performed a median sternotomy and did cold-plasma coagulation on previously untreated areas of either lung. No pulmonary fistulas were detected. In two of the eight pigs, we found a localized chronic pneumonia. None of the pigs died during the course of the study. Morbidity was also low with two pigs refusing food intake, one pig with dyspnoea after difficult intubation and one pig coughing. All events were self-limited and occurred only on post-operative Day 1. The treatment effect was almost linear and correlated to the generator energy applied. The differences between the effects reached statistical significance (P < 0.05). The application of cold-plasma coagulation to the pulmonary surface is safe in pigs. A potential clinical application of this technique is treatment of malignant pleural mesothelioma.
authors.affiliation: Department of Surgery/Thoracic Surgery, University Clinic of Schleswig-Holstein, Luebeck, Germany. drmartinhoffmann@googlemail.com
authors.forename: Martin
authors.initials: M
authors.lastname: Hoffmann
authors.forename: Anita
authors.initials: A
authors.lastname: Ulrich
authors.forename: Erik
authors.initials: E
authors.lastname: Schloericke
authors.forename: Stefan
authors.initials: S
authors.lastname: Limmer
authors.forename: Jens Karsten
authors.initials: JK
authors.lastname: Habermann
authors.forename: Heike
authors.initials: H
authors.lastname: Wolken
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bruch
authors.forename: Peter
authors.initials: P
authors.lastname: Kujath
mesh_terms: D000818:Animals; D057908:Argon Plasma Coagulation / Q000295:instrumentation*; D004195:Disease Models, Animal; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D008654:Mesothelioma / Q000473:pathology / Q000601:surgery*; D009336:Necrosis / Q000150:complications / Q000473:pathology; D010994:Pleura / Q000473:pathology / Q000601:surgery*; D010997:Pleural Neoplasms / Q000473:pathology / Q000601:surgery*; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D013552:Swine; D013556:Swine, Miniature; D013906:Thoracoscopy; D016896:Treatment Outcome