CT-guided instillation of 5% dextrose in water into the anterior pararenal space before renal radiofrequency ablation in a porcine model: Positive and negative effects

PURPOSE: To assess the positive and negative effects of computed tomographic (CT)-guided instillation of 5% dextrose in water (D5W) into the anterior pararenal space before renal radiofrequency (RF) ablation in a porcine model. MATERIALS AND METHODS: Under CT guidance, D5W Was instilled into the right anterior pararenal space of 10 pigs and RF ablation performed in the right kidney. For the control lesions, RF ablation was performed in the left kidney of the same pigs without pretreatment with D5W. Approximately 1 week after RF ablation, bowel adhesion to both kidneys was compared by using a 5-point scale at open laparotomy, as follows: grade 0 = no adhesion, grade 1 = detachable adhesion, grade 2 = grade 1 adhesion plus other adhesion to organs, grade 3 = undetachable adhesion, and grade 4 = bowel perforation. The areas of coagulation necrosis in both kidneys were compared at pathologic examination. RESULTS: Bowel adhesions to the right kidneys were classified as grade 0 in nine pigs and as grade 1 in one pig, whereas those to the left kidneys were classified as grade 2 in two pigs and as grade 3 in eight (P<.05). The mean areas of coagulation necrosis in right and left kidneys were 0.58 cm(2) +/- 0.5 and 1.53 cm(2) +/- 1.3, respectively (P<.05). CONCLUSIONS: CT-guided D5W instillation has a positive effect in reducing the amount of bowel adhesion injury during RF ablation. However, this technique may limit the area of coagulation necrosis in a swine model. Longer term pathologic evaluation is necessary to fully understand the effects of D5W instillation.