Electrolysis - a new method of renal ablation?

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dc.contributor.authorLloyd, M.
dc.contributor.authorMiller, J.
dc.contributor.authorMoretti, K.
dc.contributor.authorTexler, M.
dc.contributor.authorMaddern, G.
dc.date.issued2012
dc.description.abstractWHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD? Various sources of energy have been used in this technique previously, e.g. freezing (cryotherapy) or radiofrequency ablation. This technique under investigation uses a low electrical current to cause necrosis (destruction) of a specific area of the kidney. This is achieved by inserting a fine insulated wire catheter into the kidney and applying direct current electricity. Chemicals including acid and chloride ions and others are produced and cause tissue destruction. Electrolysis has been used previously in other organs, including the liver and lung, to treat tumours successfully in humans. This is an animal study to determine if this technique will be effective in the kidney. Pigs were used as they have similar kidneys to humans. The pigs underwent the procedure of renal electrolysis successfully; the area of renal tissue was completely treated with tissue necrosis produced and the longer the treatment duration the increased area treated. There were side-effects including bleeding as has been described in the article and may be seen in other focal ablation techniques. SUMMARY - OBJECTIVE - To present a novel method of renal ablation using direct current electrolysis, using a porcine model to assess the safety and efficacy of the technique. MATERIALS AND METHODS - In all, 20 anaesthetised pigs were used, after receiving ethical approval. The pigs were housed and managed in accordance with Institute of Medical and Veterinary Science guidelines. - A single 6 F catheter incorporating cathode and anode was inserted directly into the renal parenchyma via a loin incision. A direct current of 100 mA was applied for varying times. - Several treatments were performed in each pig and a total of 72 treatments were analysed. - The pigs were recovered and observed for 3 days with an analysis of electrolytes and creatinine after ablation. The pigs were humanely killed at 3 days and the kidneys submitted for histological analysis. RESULTS - Complete tissue destruction was seen in the area of kidney treated with no viable cells. - A sharp line of demarcation was noted between normal renal parenchyma and the area of coagulative necrosis. The area of tissue ablation was reliably predicted from the duration of application of the electrolytic current. - One pig developed a secondary haemorrhage. CONCLUSIONS - Renal electrolysis is a new method of focal renal ablation. The procedure may be carried out using a fine ablation catheter (6 F) allowing for the development of minimal intervention treatment of small renal masses. - This study shows the technique to be effective and safe. As with other renal ablative techniques there is a small risk of postoperative haemorrhage.
dc.description.statementofresponsibilityMark Lloyd, John Miller, Kim L. Moretti, Michael Texler and Guy J. Maddern
dc.identifier.citationBJU International, 2012; 110(S4):77-79
dc.identifier.doi10.1111/j.1464-410X.2012.11478.x
dc.identifier.issn1464-4096
dc.identifier.issn1464-410X
dc.identifier.orcidMoretti, K. [0000-0002-6712-6551]
dc.identifier.orcidMaddern, G. [0000-0003-2064-181X]
dc.identifier.urihttp://hdl.handle.net/2440/75066
dc.language.isoen
dc.publisherBlackwell Publishing Ltd
dc.rights© 2012 The Authors
dc.source.urihttps://doi.org/10.1111/j.1464-410x.2012.11478.x
dc.subjectelectrolysis
dc.subjectfocal ablation
dc.subjectrenal
dc.titleElectrolysis - a new method of renal ablation?
dc.typeJournal article
pubs.publication-statusPublished

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