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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  124. Kongress der Deutschen Gesellschaft für Chirurgie; 20070501-20070504; München; DOC07dgch7761 /20071001/
    Publication Date: 2007-10-02
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    Keywords: CELLS ; GROWTH ; tumor ; Germany ; INHIBITION ; MICROSCOPY ; VOLUME ; liver ; SURGERY ; ACTIVATION ; MICROCIRCULATION ; RAT ; RATS ; SUPPRESSION ; IMPLANTATION ; EMBOLISM ; helium ; INSUFFLATION ; laparoscopy ; LIVER-CANCER ; TUMOR-GROWTH ; interaction ; PNEUMOPERITONEUM ; ANIMAL-MODEL ; histo morphology tumor volume ; intravital microscopy
    Abstract: Background: Previouse studies indicate that helium pneumoperitoneum used for laparoscopic surgery suppresses whereas carbon dioxide pneumoperitoneum increases postoperative tumor growth. The pathomechanisms of decreased tumor growth by helium are unknown. This study was designed to examine the effect of the Lyases helium. carbon dioxide (CO2), and air, and xenon, which can be used to induce pneumoperitoneum in laparoscopy on tumor volume, histomorphology, and leukocyte-endothelium interaction measured by intravital microscopy in rats with implanted liver malignoma (Morris hepatoma 3924A). Methods: In 46 rats, Morris hepatoma 3294A cells were implanted intrahepatically. After implantation, rats were randomized into two main groups. In the first main group, 10 animals were prepared for examination of leukocyte-endothelium interaction by intravital video microscopy and were randomized into two groups. Five days after implantation they underwent laparoscopy using either helium (n = 5) or CO2 (n = 5). Ten days after implantation the rats underwent intravital video microscopy to assess leukocyte-endothelium interaction in the tumor and liver vessels. In the second main group 36 rats were prepared for examination of tumor volume arid histomorphology. They were randomized into five groups. Five days after implantation they underwent laparoscopy using helium (n 7), carbon dioxide (n = 7), room air (n = 7), or xenon (n = 8). The control group (n = 7) received anesthesia only. Rats were killed 10 days after tumor implantation to assess tumor volume and histomorphology. Results: Compared to the control group or groups that received CO2, room air, or xenon for pneumoperitoneum, the establishment of helium pneumoperitoneum caused a significantly smaller tumor volume (Kruskal-Wallis test, p = 0.001; median tumor-volume: control group, 44 mm(3); helium 19 mm(3)). There was no significant difference in histomorphology between the groups. There was only a statistically significant difference in the development of central tumor necrosis in accordance to tumor volume (Mann-Whitney test, p = 0.03). In the tumor samples, roller counts were statistically significantly higher in the helium group compared to the CO2 group (p = 0.04). For sticker counts, no statistically significant effects due to liver/tumor (p = 0.13) or treatment (p = 0.48) were observed. Conclusions: There was a significant decrease in tumor volume using helium pneumoperitoneum for laparoscopy compared to the other gases. Here, we demonstrate that suppression Of tumor growth is not due to variation of histomorphology. It seems that helium pneumoperitoneum effects a higher leukocyte-endothelium interaction and thereby a higher immune activation. This could be one explanation for the statistically significantly smaller tumor volume after laparoscopy with helium compared to laparoscopy with CO2
    Type of Publication: Journal article published
    PubMed ID: 15529193
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  • 3
    ISSN: 1432-2277
    Keywords: Key words Ischaemia/reperfusion injury ; Hepatic microcirculation ; Leucocyte-endothelium interaction ; Antithrombin III ; Aprotinin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Disturbance in hepatic microcirculation and leucocyte-endothelium interaction after warm ischaemia represents one of the leading mechanisms for postoperative organ dysfunction. Recent studies have shown that pretreatment with antithrombin III (AT III) and aprotinin reduces the leucocyte-endothelium interaction in ischaemic small intestine and during extracorporal circulation in cardiac surgery. Standardized warm hepatic ischaemia and intravital fluorescence videomicroscopy was performed in an experimental study with rats. Animals were pretreated with AT III or aprotinin. Analysis of intravital videomicroscopy showed that the hepatic microcirculation after warm hepatic ischaemia in rats was significantly enhanced by AT III and aprotinin, most likely by reducing the leucocyte-endothelium interaction. We concluded that drug application before the Pringle manoeuvre might reduce the reperfusion damage after liver resection.
    Type of Medium: Electronic Resource
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