The measurement of liver resection margins.
BACKGROUND
All tissue shrinks to some degree when placed in formalin fixative solution. The degree of shrinkage of liver tissue has particular relevance to the measurement of resection margins, as the current recommendation is that the surgeon should aim to achieve a resection margin of at least 1 cm. We were unable to find any published data concerning shrinkage of liver tissue in formalin. The aim of this study was therefore to quantify the shrinkage of liver specimens in the fixation process.


METHODS
Distances of 10, 30 and 50 mm were measured and marked on 18 fresh liver specimens. The specimens were then fixed in 10% formalin solution for 24 h, and the distances were re-measured to assess shrinkage.


RESULTS
The observed shrinkage at all three distances was <10% after 24 h in formalin. The degree of shrinkage was statistically significant.


CONCLUSIONS
Although the degree of shrinkage is small, it may be important when considering resection margins of the order of 1 cm and should therefore be taken into account.
Rutherford
E E
EE
Department of General Surgery, Royal Surrey County Hospital, Guildford, Surrey, UK.
Karanjia
N D
ND