Li HM, Xing YL, Chen ZQ, Duan SX, Ma YY, Niu LZ. Hypertension and tachycardia induced by irreversible electroporation in pancreatic cancer: An analysis based on clinical data. World J Gastrointest Surg 2025; 17(9): 110577 [DOI: 10.4240/wjgs.v17.i9.110577]
Corresponding Author of This Article
Li-Zhi Niu, PhD, Chief Physician, Professor, Department of Oncology, Guangzhou Fuda Cancer Hospital, No. 2 Tangde West Road, Tianhe District, Guangzhou 510665, Guangdong Province, China. niuboshi@fudahospital.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hong-Mei Li, Yan-Li Xing, Li-Zhi Niu, Department of Oncology, Guangzhou Fuda Cancer Hospital, Guangzhou 510665, Guangdong Province, China
Zi-Qing Chen, Shi-Xiong Duan, Department of Radiology, Guangzhou Fuda Cancer Hospital, Guangzhou 510665, Guangdong Province, China
Yang-Yang Ma, Central Laboratory, Guangzhou Fuda Cancer Hospital, Guangzhou 510665, Guangdong Province, China
Co-corresponding authors: Yang-Yang Ma and Li-Zhi Niu.
Author contributions: Li HM wrote the paper; Xing YL performed the study selection; Chen ZQ and Duan SX collected the data; Niu LZ and Ma YY designed the project, edited the manuscript, and made equal contributions as co-corresponding authors; all authors reviewed the final manuscript.
Supported by International Science Foundation of Guangzhou Fuda Cancer Hospital, No. Y2022-MS-02.
Institutional review board statement: This study was approved by the Ethic Committee of Fuda Cancer Hospital, No. FDCT-L-QX-2018-01.
Informed consent statement: Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data are available upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Zhi Niu, PhD, Chief Physician, Professor, Department of Oncology, Guangzhou Fuda Cancer Hospital, No. 2 Tangde West Road, Tianhe District, Guangzhou 510665, Guangdong Province, China. niuboshi@fudahospital.com
Received: June 11, 2025 Revised: July 3, 2025 Accepted: August 1, 2025 Published online: September 27, 2025 Processing time: 107 Days and 5.4 Hours
Abstract
BACKGROUND
Irreversible electroporation (IRE) is a novel non-thermal ablation technology for unresectable tumors. Hypertension and tachycardia usually occur during the IRE. To date, there has been little explanation about this phenomenon.
AIM
To investigate the reasons of hypertension and tachycardia and appropriate preventive measures.
METHODS
IRE was performed under general anesthesia and neuromuscular blockade. Systolic blood pressures, diastolic blood pressures, heart rate, and the distance of the electrode from abdominal aorta and adrenal gland during IRE were recorded.
RESULTS
All of 78 patients underwent 96 IRE sessions, 44 (56.4%) patients occurred hypertension when the electrode was close to the abdominal aorta (< 2.0 cm). The median systolic blood pressures and diastolic blood pressures was 194 and 108 mmHg. Furthermore, 11 (14.1%) patients occurred tachycardia when the electrode was close to the adrenal gland (< 1.3 cm). The median heart rate of patients with tachycardia was 114 beats per minute. Furthermore, hypertension and tachycardia can be prevented with nicardipine and esmolol before treatment.
CONCLUSION
Intraoperative hypertension and tachycardia occur because electrodes close to the abdominal aorta (< 2.0 cm) and adrenal glands (< 1.3 cm), which can be prevented by preoperative treatment of vasoactive drugs.
Core Tip: This study highlights the incidence of intraoperative hypertension and tachycardia during irreversible electroporation for unresectable tumors, significantly correlated with electrode proximity to the abdominal aorta and adrenal glands. Notably, hypertension was observed in 56.4% of patients when electrodes were less than 2.0 cm from the aorta, while 14.1% experienced tachycardia with electrodes nearer than 1.3 cm to the adrenal glands. Preemptive administration of nicardipine and esmolol effectively mitigates these cardiovascular responses, suggesting essential preoperative management for enhancing patient safety during irreversible electroporation.
