Effects of TVE application during 70% hepatectomy on regeneration capacity of rats.
BACKGROUND
For adequate control of excess bleeding during liver resection, total vascular exclusion (TVE) is preferred by surgeons, especially when the tumor is located in the posterior liver lobes or near the cava. To the authors' knowledge, the effects of TVE technique on the postoperative liver regeneration process have not thus far been evaluated yet in the literature. This study was planned to compare the effects of liver resections performed either with portal pedicle clamping or with TVE on the regeneration process.


METHODS
Seventy percent hepatectomy was performed with portal pedicle clamping (n=10, Group A) or with TVE (n=10, Group B) in rats. At 48 h after resection, sampling was performed for the measurement of serum transaminase, alkaline phosphatase (ALP), tissue malondialdehyde (MDA), and glutathione (GSH) levels. Liver regeneration rate, proliferating cell nuclear antigen (PCNA) labeling, and mitotic indices were also evaluated.


RESULTS
Liver injury determinants (serum transaminases, ALP, and tissue MDA levels) were found significantly higher in group B than in group A. Liver regeneration rate, liver GSH levels, PCNA labeling index, and mitotic index were significantly lower in group B than in group A.


CONCLUSIONS
The injury during TVE seems to be greater than during resection with portal pedicle clamping. The negative effect of this oxidative damage may influence the regenerative capacity of the remnant liver tissue.
Topaloglu
Serdar
S
First Department of Surgery, Ankara Numune Training and Research Hospital, 06100 Sihhiye, Ankara, Turkey. serdartopaloglu@yahoo.com
Izci
Erdal
E
Ozel
Hakan
H
Topaloglu
Eda
E
Avsar
Fatih M
FM
Saygun
Oral
O
Ucar
Gulberk
G
Sokmensuer
Cenk
C
Hengirmen
Suleyman
S
D000818:Animals; D003250:Constriction; D006498:Hepatectomy / Q000379:methods*; D006499:Hepatic Artery / Q000601:surgery; D006503:Hepatic Veins / Q000601:surgery; D007511:Ischemia / Q000209:etiology*; D008099:Liver / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D008115:Liver Regeneration; D008297:Male; D023421:Models, Animal; D009336:Necrosis; D018384:Oxidative Stress; D011169:Portal Vein / Q000601:surgery; D051381:Rats; D017208:Rats, Wistar; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods