[Cardiac hemodynamics after suprarenal ligation of the inferior vena cava and the resection of the right kidney or injection of ligustrazine in rats].
OBJECTIVE
Primary retroperitioneal tumor often invades large vessels; the difficulty of operation is the management of the vessels, especially the inferior vena cava (IVC). The suprarenal ligation of the IVC was considered to be dangerous. The aim of this study was to investigate the cardiac hemodynamics following suprarenal ligation of the IVC and the resection of the right kidney or injection of ligustrazine in rats, and to provide theories and guides for the clinical operations.


METHODS
The rats were divided into six groups of seven. The groups were control group, false operation group, suprarenal ligation of the IVC group, suprarenal ligation of IVC and resection of right kidney group, ligustrazine group, and placebo group. All rats were determined for heart rate, ejection fraction, cardiac output, stroke volume, arterial pressure at 1st, 6th, 24th, 48th hour after the operations.


RESULTS
The indexes of the false operation group had no change. CO(0.018+/-0.002 L/min), SV(0.054+/-0.008 ml), AP(H)(173+/-12 mmHg), AP(L)(161+/-11 mmHg) decreased to the lowest point at 1st hour following the suprarenal ligation of the IVC, but compensated completely at 48th hour after the operation. All rats in this group survived during the study period. CO(0.012+/-0.002 L/min), SV(0.038+/-0.005 ml), AP(H)(138+/-8 mmHg), AP(L)(131+/-9 mmHg)decreased to the lowest point at 1st hour following the suprarenal ligation of the IVC and resection of the right kidney, CO and SV were not compensated completely at 48th hour after the operation, two rats died in this group. CO (0.025+/-0.004 L/min), SV(0.063+/-0.009 ml), AP(H)(190+/-14 mmHg), AP(L)(163+/-9 mmHg)decreased to the lowest point at 1st hour following the suprarenal ligation of the IVC, but compensated quickly at 24th hour after the operation, all rats survived in this group. The placebo group, compared with the ligustrazine group, had no obvious change.


CONCLUSIONS
Cardiac function was affected by low returned blood volume following the suprarenal ligation of the IVC, but compensated completely at 48th hour after the operation. The suprarenal ligation of the IVC and injection of ligustrazine could improve cardiac function of the experimental rats. The suprarenal ligation of the IVC and resection of the right kidney, which not only increased the operative difficulty but also reduced cardiac functional compensation and appeared the death of rats, were not appropriate. We suggest to ligate the suprarenal IVC and to inject ligustrazine after resecting the tumor and infiltrated IVC, not to resect normal right kidney. To infuse solution by upper limb to increase returned blood volume in early phase after the operation.
Guo
Xue-Li
XL
Department of General Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, PR China. guoxueli2000@tom.com
Huang
Xiu-Zhen
XZ
Shi
De
D
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D006321:Heart / Q000502:physiology*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D008026:Ligation; D008297:Male; D009392:Nephrectomy; D011719:Pyrazines / Q000494:pharmacology*; D051381:Rats; D013318:Stroke Volume / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology; D014682:Vena Cava, Inferior / Q000502:physiology / Q000601:surgery*
D011719:Pyrazines; D014665:Vasodilator Agents; C017953:tetramethylpyrazine