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The NanoKnife and two successful cases of intracavitary irreversible electroporation of main bronchus tumours


Authors: J. Fanta 1;  P. Horák 1;  J. Marvan 1;  M. Mašek 2;  M. Kašpar 2;  N. Pauk 3;  J. Dvořák 4
Authors‘ workplace: Chirurgická klinika 1. LF UK, Nemocnice Na Bulovce, přednosta: Doc. MUDr. J. Fanta, DrSc. 1;  Radiodiagnostická klinika 1. LF UK, Nemocnice Na Bulovce, primář: MUDr. M. Mašek. 2;  Klinika pneumologie a hrudní chirurgie 3. LF UK, Nemocnice Na Bulovce, primář: MUDr. N. Pauk, Ph. D. 3;  Ústav radiační onkologie 1. LF UK, Nemocnice Na Bulovce, přednosta: Prof. MUDr. L. Petruželka, CSc. 4
Published in: Rozhl. Chir., 2012, roč. 91, č. 11, s. 625-630.
Category: Case Report

Overview

We have used the method of irreversible electroporation (IRE) twice to treat central non-small cell lung tumours. Both tumours obstructed the right main stem bronchus. Due to a high risk of right-sided pneumonectomy we chose to apply the tissue sparing device called NanoKnife and an alternative IRE method. The first surgery was performed in August 2011 and the second one in June 2012. The first case was an epidermoid carcinoma, 3 cm in size, which completely obstructed the right main stem bronchus on the boundary line with the upper lobar bronchus and caused lung atelectasis. The second case was a carcinoid, 2 cm in size, which grew from the main stem bronchus to the carina. Pneumonectomy was contraindicated due to lung function in the first case, and the other patient preferred the IRE method to radical but risky resection with bronchoplasty. IRE was performed through open thoracotomy. No complications were detected after the surgery in both cases. The first patient was discharged on the 12th postoperative day and the second one on the 5th postoperative day. 98% regression of the tumour was detected by CT scan in the first patient, and complete regression occurred in the case of the second one. 100% apoptosis and “disparition” of the carcinoma in the first case was verified by bronchoscopy and cytology after 6 months. Both patients remain in follow-up after surgery using the IRE method and are without subjective or objective complaints and without any signs of tumour recurrence. NanoKnife and IRE without lung resection resulted in the destruction of lung tumours while preserving the lung parenchyma and pulmonary functions.

Key words:
irreversible electroporation – NanoKnife – cell surgery – lung tumors


Sources

1. Rubinski J, Onik G, Mikus P. Irreversible electroporation: a new ablation modality – clinical implications. Technol. Cancer Res Treat 2007;6(1):37–48.

2. Thomson KR, Cheung W, Ellis SJ, Fedeman D, Kavnoudias H, Loader-Oliver D, Roberts S, Evans P, Ball C, Haydon A. Investigation of the safety of irreversible electroporation in humans. J Vasc Interv Radiol 2011; 22(5): 611–21.

3. Olweny EO, Cadeddu JA. Novel methods for renal tissue ablation. Curr Opin Urol 2012 Jun 14 (ahead of print), http://www.ncbi.nlm.nih.gov/pubmed/22706069.

4. Rubinski J, Onik G, Mikus P, Rubinksi B. Optimal parameters for the destruction of prostate cancer using irreversible electroporation. J Urol 2008;180(6):2668–74.

5. Deodhar A, Monette S, Single GW, Hamilton WC jr., Thomton RH, Sofocleous CT, Maybody M, Solomon SB. Percutaneous irreversible electroporation lung ablation: preliminary results in porcine model. Cardiovasc. Intervent Radiol 2011;34(6): 1278–87.

6. Bagla S, Papadouris D. Percutaneous irreversible electroporation of surgically unresectable pancreatic cancer: a case report. J Vasc Interv Radiol 2012;23(1):142–5.

7. Usman M, Moore W, Talati R, Watkins K, Bilfinger TV. Irreversible electroporation of lung neoplasm: A case series. Med Sci monit 2012;18(6):CS43–47.

8. Phillips MA, Naravan R, Padath T, Rubinksy B. Irreversible electroporation on the small intestine. Br J Cancer 2012;106(3): 490–5.

9. Schoellnast H, Monette S, Ezell PC, Single G, Maybody M, Weiser MR, Fong Y, Solomon SB. Irreversible Electroporation Adjacent to the Rectum: Evaluation of Pathological Effects in a Pig Model. Cardiovasc. Intervent. Radiol. 2012, May 5 (ahead of print).

10. Garcia PA, Rossmeisl JH, jr., Davalos RV. Electrical conductivity changes during irreversible electroporation treatment of brain cancer. Conf. Proc. IEEE Eng Med Biol Soc 2011;2011:739–42.

11. Lee EW, Wong D, Prikhdko SV, Perez A, Tran C, Loh CT, Kee ST. Electron microscopic demonstration and evaluation of irreversible electroporation-induced nanopores on hepatocyte membranes. J Vasc Interv Radiol 2012;23(1):107–13.

12. Li W, Fan Q, Ji Z, Qiu X, Li Z. The effects of irreversible electroporation (IRE) on nerves. PloS One 2011;6(4):e18831. http:// www.ncbi.nlm.nih.gov/pubmed/21533143.

13. Deodhar A, Dickfeld T, Single GW, Hamilton WC, Thomton RH, Sofocleous CT, Maybody M, Gónen M, Rubinsky B, Solomon SB. Irreversible electroporation near the heart: ventricular arrhytmias can be prevented with ECG synchronization. AJR AM J Roentgenol 2011;196(3):W330.5.

14. Kosiek O, Strach K, Ricke J, Pech M. Irreversible electroporation – a new kid on the block– Radiologie 2012; 52(1):38–43.

15. Maor E, Ivorra A, Rubinsky B. Non Thermal Irreversible Electroporation: Novel Technology for Vascular Smooth Muscle Cell Ablation. http://www.plosone.org/article/info:doi/10.1371/journal.pone.00004757.

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