Alveolar Echinococcosis Of The Liver Treated By Microwave Ablation:An Ex-vivo Pilot Experimental Study In Human Organs

Objective: To evaluate microwave ablation(MWA)for treatment of alveolar echinococcosis in human explanted organs.To choose a combination of power and time to treat the alveolar echinococcosisMethods : Infected livers from patients,5 single and 6 multiple,were collected.The liver's size and calcification were generally estimated by CT.Incise the liver into two half.For one half,select the junction point of nidus and around-nidus,then take microwave ablation for the samples in different distances(1cm,2cm,3cm)and minutes(0min,5min,discontinuously 10min).Observe the extent of pathological lesion under light microscope by paraffin section by HAE standard.Results: The subjects of the study were 11 livers,while all of them were treated by microwave ablation.The observation is that the pathological section of the germinal layer in alveolar echinococcosis nidus presented II level of HAE grading within 1 centemeter in 5 minute time.There is no significant differences between control group and experimental group in 2 and 3 centimeter.The cells around nidus are disorganized and ill-defined,the cell nucleuses are concentrated,membranolysis and cytoplasm leakage,the nucleuses chromatin are condensed,the cytoplasm acidophily is intensive,and the cytoplasm is fusing.The around-nidus within 1cm,Especially,discontinuously treated 10 minutes presented membranolysis,leakage of cytoplasm,dehydration of cells,broadening of hepatic sinusoid.We continued to take microwave ablation for 5minute.The morphologic change of the cells is that the cytoplasm is extensively fusing,and it turn to a patch of homogeneous red.It presented a appearance of classical coagulative necrosis.When we sampled at 2cm spot,at ablation of 5 minute,it presented slightly dehydration of the cells,partly membranolysis and broadening of hepatic sinusoid.We continued to take microwave ablation for 5 minute.The nucleuses chromatin are condensed,compared with control group,the shape of nucleuses are ellipse.It presented slightly dehydration of the cells,membranolysis and greater broadening of hepatic sinusoid,the cells are ill-defined,the cell nucleuses are concentrated(n=8),the cytoplasm acidophily is intensive(n=8),and the cytoplasm is slightly fusing(n=8).When we sampled at 3cm spot,there is no significant differences btween control group and experimental group all aspects mentioned above.Conclusion: The alveolar echinococcosis nidus that treated by 60 watt microwave ablation presented the germinal layer in alveolar echinococcosis nidus presented II level of HAE within 1 centimeter in 10 minute time.The On the other hand,the alveolar echinococcoses around-nidus within 2cm,discontinuous 10 minutes presented a coagulative necrosis change.We can,consequently,apply the combination of 60 watt and 10 minutes in clinical practice.