Background And Aims: Radiofrequency ablation (RFA) is a well-recognized local ablative technique applied in the treatment of different solid tumors. Intraoperative RFA has been used for non-metastatic unresectable pancreatic ductal adenocarcinoma (PDAC), showing increased overall survival in retrospective studies. A novel RFA probe has recently been developed, allowing RFA under endoscopic ultrasound (EUS) guidance. Aim of the present study was to assess the feasibility and safety of EUS-guided RFA for unresectable PDACs.
Methods: Patients with unresectable non-metastatic PDAC were included in the study following neoadjuvant chemotherapy. EUS-guided RFA was performed using a novel monopolar 18-gauge electrode with a sharp conical 1 cm tip for energy delivery. Pre- and post-procedural clinical and radiological data were prospectively collected.
Results: Ten consecutive patients with unresectable PDAC were enrolled. The procedure was successful in all cases and no major adverse events were observed. A delineated hypodense ablated area within the tumor was observed at the 30-day CT scan in all cases.
Conclusions: EUS-guided RFA is a feasible and safe minimally invasive procedure for patients with unresectable PDAC. Further studies are warranted to demonstrate the impact of EUS-guided RFA on disease progression and overall survival.
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http://dx.doi.org/10.1007/s00464-018-6217-x | DOI Listing |
J Clin Med
January 2025
Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, 47121 Romagna, Italy.
Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) is a promising minimally invasive technique for the treatment of pancreatic lesions. This review first focuses on the technical aspects in EUS-RFA: the procedure typically employs EUS probes with integrated radiofrequency electrodes, enabling accurate targeting and ablation of pancreatic lesions. Different types of RFA devices, monopolar and bipolar energy delivery systems, are discussed, along with considerations for optimal ablation, including energy settings, procedure time, and pre- and post-procedural management.
View Article and Find Full Text PDFArq Gastroenterol
October 2024
Universidade de São Paulo, Hospital das Clínicas, Unidade de Endoscopia Gastrointestinal, São Paulo, SP, Brasil.
Background: In the past decades, endoscopic ultrasound has developed from a diagnostic tool to a platform for many therapeutic interventions. Various technological advancements have emerged since the last Brazilian Consensus, demanding a review and update of the recommendations based on the best scientific evidence.
Methods: A group of 32 renowned echoendoscopists selected eight relevant topics to be discussed to generate clinical questions.
Diagnostics (Basel)
September 2024
Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Radiofrequency ablation (RFA) under endoscopic ultrasound (EUS) guidance has been developed and utilized over the last decade to provide the loco-regional treatment of solid and cystic pancreatic neoplastic lesions. The advantage of this approach relies on the close proximity of the EUS transducer to the target pancreatic lesion, which, coupled with the development of specifically designed RFA ablation devices, has made the procedure minimally invasive, with a clear reduction in adverse events as compared to the high morbidity of the surgical approach. EUS-RFA has been applied so far to pancreatic functional and non-functional neuroendocrine neoplasms, pancreatic ductal adenocarcinoma or metastases to the pancreas, and pancreatic neoplastic cysts.
View Article and Find Full Text PDFCureus
August 2024
Department of Gastroenterology and Hepatology, Asian Institute of Gastroenterology, Hyderabad, IND.
VIPomas are a rare type of functional pancreatic neuroendocrine tumors (PNETs), causing symptoms due to their hypersecretion in the gastrointestinal tract. The rare association of PNETs with tumors of endocrine organs such as pituitary and parathyroid glands is called multiple endocrine neoplasia (MEN1) syndrome. Due to their indolent course, VIPomas often present late in the illness and may already have metastatic disease.
View Article and Find Full Text PDFEndosc Ultrasound
February 2024
Division of Gastroenterology, Inova Fairfax Hospital, Falls Church, VA, USA.
Recent years have brought to light newly developed therapeutic modalities for the treatment of premalignant and malignant pancreatic lesions. The role of EUS-guided radiofrequency ablation (EUS-RFA) as a treatment modality for malignant pancreatic lesions is still under evaluation. Several animal studies and human studies have demonstrated the safety and efficacy of EUS-RFA in the management of premalignant and malignant pancreatic lesions.
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