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1Liver-directed therapies for liver metastases from neuroendocrine neoplasms:Can laser ablation play any role?显示文摘Aggressive cytoreduction can prolong survival in patients with unresectable liver metastases(LM)from neuroendocrine neoplasms(NEN),and minimally invasive,liver-directed therapies are gaining increasing interest.Catheter-based treatments are used in disseminated disease,whereas ablation techniques are usually indicated when the number of LM is limited.Although radiofrequency ablation(RFA)is by far the most used ablative technique,the goal of this opinion review is to explore the potential role of laser ablation(LA)in the treatment of LM from NEN.LA uses thinner needles than RFA,and this is an advantage when the tumors are in at-risk locations.Moreover,the multi-fiber technique enables the use of one to four laser fibers at once,and each fiber provides an almost spherical thermal lesion of 12-15 mm in diameter.Such a characteristic enables to tailor the size of each thermal lesion to the size of each tumor,sparing the liver parenchyma more than any other liver-directed therapy,and allowing for repeated treatments with low risk of liver failure.A recent retrospective study reporting the largest series of LM treated with LA documents both safety and effectiveness of LA,that can play a useful role in the multimodality approach to LM from NEN.Sergio Sartori Lara Bianchi Francesca Di Vece Paola Tombesi 2020World Journal of Gastroenterology2020,26,23:1
2微创介入中智能化光学辅助技术与激光消融治疗的研究进展显示文摘微创介入治疗近年来发展迅速,具有重要临床价值。然而,微创条件下手术视野与操作范围受限,手术结果高度依赖医生经验。为解决这一问题,临床关注的焦点是如何实现手术信息的可视化、手术定量信息的获取和治疗范围的精准控制。光学辅助与激光消融技术在解决该问题上发挥了重要作用。增强现实技术提供新的可视化方式,光学追踪与传感为术中提供多维的定量信息,而激光消融则提供了精准治疗的途径。同时,光学技术与计算机视觉、人工智能、材料科学等多学科结合,推动微创介入朝着智能化、精准化、个性化的方向发展。聚焦于微创介入中的光学辅助与激光消融技术,主要从增强现实、光学追踪与感知、激光消融三方面,对相关研究进展进行综述。梁利斌 李亮 高婷婷 王广志 丁辉 万明习 张镇西 2023中国激光2023,50,15:0
3Hemorrhagic cardiac tamponade after percutaneous laser ablation of a liver metastasis in segment II显示文摘Despite percutaneous laser thermal ablation(LTA)of liver tumors being regarded as a safe technique,major complications can occur.We report the first case of hemorrhagic cardiac tamponade after LTA of a colorectal metastasis in segment II of the liver.Unpredictable heat diffusion causing indirect thermal injury to the pericardium with resultant hemorrhagic reaction was hypothesized as the most likely cause of tamponade.A pericardial drain was emergently placed,200 mL of bright red blood were drained,and the patient showed rapid hemodynamic improvement.For lesions located in segment II of the liver and strictly close to the pericardium,a careful risk/benefit analysis should be made by the multidisciplinary team to identify the best treatment option,taking into account both effectiveness and complications of each available technique.Paola Tombesi Francesca Di Vece Silvia Rinaldi Matteo Bertini Sergio Sartori 2016Hepatoma Research2016,2,1:0
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