title: Sinusoidal obstruction syndrome in the animal model: influence on liver surgery.
abstract: OBJECTIVE
  In recent years, multimodal treatment approaches have led to an increased median survival time of patients with colorectal liver metastases. In particular, this results from new perioperative chemotherapy regimens, which in turn are accompanied by an increased risk of perioperative bleeding and/or liver failure due to the hepatotoxic side effects. Nineteen to 58 % of patients treated with oxaliplatin develop sinusoidal obstruction syndrome (SOS). The influence of preexisting SOS on liver surgery remains controversial.
  
  
  METHODS
  Animals were operated 4 days after SOS induction with monocrotaline and received either vascular occlusion in the form of Pringle maneuver (PM) or hepatectomy (LR; 70 %) or a combination of both (LR + PM). Postoperative liver function was assessed by determination of liver enzyme levels, bile production, and tissue oxygen saturation.
  
  
  RESULTS
  Preexisting SOS impaired morbidity after liver resection, reflected by elevated liver enzyme levels, reduced bile secretion, and low liver tissue oxygenation levels. Mortality was increased by up to 25 %. Additional ischemia in the form of PM showed no further impact in the LR ± PM group compared to LR alone.
  
  
  CONCLUSIONS
  PM without LR results in high enzyme distribution in the SOS group. SOS significantly affects the outcome after liver resection in our experimental rat model only without PM and showed no protective effect in ischemia in the form of PM.
authors: Department of Surgery, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
authors: Azin
authors: A
authors: Jafari
authors: Department of Surgery, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
authors: Sven
authors: S
authors: Wehner
authors: Department of Surgery, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
authors: Jörg C
authors: JC
authors: Kalff
authors: Department of Surgery, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany. steffen.manekeller@ukb.uni-bonn.de.
authors: Steffen
authors: S
authors: Manekeller
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D006498:Hepatectomy; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D000860:Hypoxia; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy; D008297:Male; D016686:Monocrotaline; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D016686:Monocrotaline
keywords: Hepatectomy; Liver failure; Monocrotaline; Oxaliplatin; Pringle maneuver; Sinusoidal obstruction syndrome (SOS)