Liver regeneration after extensive hepatectomy in rats: effect of preoperative chemotherapy with intravenous 5-fluorouracil

Purpose: To evaluate the effect of preoperative intravenous chemotherapy with 5-fluorouracil on liver regeneration in an experimental model of major hepatectomy in rats. Methods: Wistar rats were divided into two groups of 20 animals each and submitted to 70% hepatectomy 24 h after intravenous injection of 5-fluorouracil 20 mg/kg (fluorouracil group, FG) or 0.9% saline (control group, CG). After hepatectomy, each group was subdivided into two subgroups of 10 animals each according to the day of sacrifice (24 h or 7 days). Liver weight during regeneration, liver regeneration rate using Kwon formula, and the immunohistochemical markers proliferating cell nuclear antigen (PCNA) and Ki-67 were used to assess liver regeneration. Results: At early phase (24 h after hepatectomy) it was demonstrated the negative effect of 5-fluorouracil on liver regeneration when assessed by Kwon formula (p < 0.0001), PCNA analysis (p = 0.02). With regeneration process complete (7 days), it was possible to demonstrate the sustained impairment of chemotherapy with 5-fluorouracil on hepatocytes regeneration phenomenon when measured by Kwon formula (p = 0.009), PCNA analysis (p = 0.0001) and Ki-67 analysis (0.001). Conclusions: Preoperative chemotherapy with intravenous 5-fluorouracil negatively affected the mechanisms of liver regeneration after major hepatectomy in rats.

Multiple factors affect the regeneration of liver

SUMMARY OBJECTIVE To study factors affecting the liver regeneration after hepatectomy METHODS With 3D reconstitution technology, liver regeneration ability of 117 patients was analysed, and relative factors were studied. RESULTS There was no statistically difference between the volume of simulated liver resection and the actual liver resection. All livers had different degrees of regeneration after surgery. Age, gender and blood indicators had no impact on liver regeneration, while surgery time, intraoperative blood loss, blood flow blocking time and different ways of liver resection had a significant impact on liver regeneration; In addition, the patients' own pathological status, including, hepatitis and liver fibrosis all had a significant impact on liver regeneration. CONCLUSION 3D reconstitution model is a good model to calculate liver volume. Age, gender, blood indicators and biochemistry indicators have no impact on liver regeneration, but surgery indicators and patients' own pathological status have influence on liver regeneration.

RESUMO OBJETIVO Estudar os fatores que afetam a regeneração hepática após hepatectomia. MÉTODOS A capacidade de regeneração hepática de 117 pacientes foi analisada com a tecnologia de reconstituição 3D e foram estudados os fatores relacionados. RESULTADOS Não houve diferença estatística significante entre o volume de ressecção hepática simulada e a ressecção atual. Todos os fígados apresentaram diferentes graus de regeneração após cirurgia. Idade, gênero e indicadores sanguíneos não tiveram impacto na regeneração hepática, enquanto que tempo de cirurgia, perda sanguínea intraoperatória, tempo de bloqueio do fluxo sanguíneo e diferentes formas de ressecção mostraram impacto significante na regeneração do órgão. Além disso, condições patológicas dos pacientes, incluindo hepatite e fibrose hepática, tiveram impacto significante na regeneração hepática. CONCLUSÃO O modelo de reconstituição 3D é um bom modelo para calcular o volume do fígado. Idade, gênero, indicadores sanguíneos e bioquímicos não tiveram impacto na regeneração hepática, mas indicadores operatórios e condição patológica dos pacientes mostraram influência na regeneração do órgão.

Behavior od collagen extracellular liver matrix during regenerative growth after partial hepatectomy of after stimulation by exogenous hepatotrophic factors

During regeneration after partial hepatectomy, the hepatic parenchyma grows by reproducing its histological elements at different rates. The hepatic cells grow more rapidy and the collagen components of the extracellular matrix more slowly. This report studies the behavior of liver tissue collagen intact livers, increased in size by stimulation with exogenous hepatotrophic factors, comparing them to regenerated livers after hepatectomy. The series consists of a group of rats (n = 4), seven days after 70 percent hepatectomy, with an average growth of the residual liver mass of 71.55 percent and another group (n = 4), seven days after stimulation of the intract livers with an average growth of 121.05 percent. The exogenous hepatotrophic factors administered intraperitoneally (portal) included glucose, amino acids, insultin, glucagon and triiodothyronine. The hepatic collagen content was compared by studyng slides stained with Picrossirius and examined with an optical microscope attached to a computer with an image analyzing program. The hepatic collagen was reduced from 2.07 percent + 0.13 to 1.14 + 0.08 (a difference of 44.57 percent; P<0.001) after hepatectomy and from 1.98 percent + 0.19 to 1.24 percent + 0.07 (difference of 37.46 percent; P<0.01) after exogenous hepatotrophic factors stimulation. It was concluded that the production of collagen in hepatic growth initiating with intact livers stimulated by exogenous hepatotrophic factors, occurs with a time difference similarly to what is observed after 70 percent hepatectomy.

Territórios venosos do fígado em natimortos de termo. Estudo anátomo-cirúrgico e sua importância nas hepatectomias parciais regradas / Venous sites of the liver in stilborn at term anatomicsurgical study and its importance in ruled partial hepatectomies

Foram selecionados 45 natimortos de termo, cujos fígados ao método de injeçäo e corrosäo para a obtençäo de "cats" vasculares, visando o estudo de seus territórios venosos. Em nosso estudo, pudemos observar que 31 natimortos (68,9 por cento) apresentaram um padräo de três segmentos; 12 (26,7 por cento), um padräo de quatro segmentos; e dois (4,4 por cento), um padräo de cinco segmentos. O conhecimento dos territórios venosos tem-se mostrado indispensável para a perfeita execuçäo da cirurgia resseccional hepática