ABSTRACT
ANTECEDENTES: La insuficiencia hepática postresección es una de las principales causas de muerte en el postoperatorio de una hepatectomía mayor. La técnica ALPPS aparece como una estrategia prometedora para evitarla, pero no existen estudios experimentales al respecto. El objetivo del trabajo es desarrollar un modelo experimental de ALPPS en ratas. MÉTODO: Se desarrolló un modelo experimental de ALPPS en 30 ratas Sprague Dawley. Se realizó la ligadura de la rama portal izquierda del lóbulo medio (LM), con lo cual se demarca el sector izquierdo (SILM) y derecho (SDLM); posteriormente se realizó la transección parenquimatosa por la línea isquémica. Se evaluaron el peso del animal, el volumen y peso del LM y de ambos. Sacrificio a los 3, 7 y 14 días (10 por grupo). RESULTADOS: No se presentaron complicaciones hemorrágicas ni ascitis en el postoperatorio. El incremento del volumen del LM fue del 24,1; 86,9 y 120,4% a los 3, 7 y 14 días. El SDLM (no ligado) se incrementó un 34,4; 78,8 y 102,0% a 3, 7 y 14 días. El SILM disminuyó un 42,6; 64,8, y 79,3% en los días 3, 7 y 14. CONCLUSIÓN: La realización del ALPPS fue posible en ratas, logrando los resultados esperados. Futuros estudios son necesarios para compararlo con la técnica de hepatectomía en 2 tiempos
BACKGROUND: Liver failure migth be a cause of death after major hepatectomies. The ALPPS technique appears to be a promising strategy to avoid it, however no experimental studies supporting this procedure have been previously described. The aim was to develop an experimental model of ALPPS in rats. Method. Experimental. A total of 30 Sprague Dawley rats were used. To develop the ALPPS procedure, ligation of the left portal branch of the middle lobe (LM) was performed. This demarcates the left side (SILM) from the right side (SDLM); parenchyma transection was performed following the demarcated line. The animal's weight, volume and weight of both LM were analyzed. Sacrifice at 3, 7 and 14 days after the procedure (10 per group) was performed. RESULTS: No bleeding or ascites were observed during the postoperative period. The LM increased by 24.1, 86.9 and 120.4% at 3, 7 and 14 days. The SDLM increased by 34.4, 78.8 and 102.0% at 3, 7 and 14 days. The SILM decreased 42.6, 64.8, and 79.3% at day 3, 7 and 14 days respectively. CONCLUSION: The ALPPS procedure can be performed in rats, achieving the expected results. Comparison studies to 2 staged hepatectomy will be necessary
Subject(s)
Animals , Male , Rats , Ligation/methods , Ligation/trends , Models, Animal , Hepatectomy/methods , Hepatectomy , Hepatectomy/veterinary , Hepatic Insufficiency/complications , Hepatic Insufficiency/etiology , Microsurgery/methods , Microsurgery/trends , Animal Experimentation , Hepatic Insufficiency/physiopathology , Hepatic Insufficiency/surgery , Microsurgery/standards , Microsurgery , Morphine/therapeutic useABSTRACT
BACKGROUND: Liver failure might be a cause of death after major hepatectomies. The ALPPS technique appears to be a promising strategy to avoid it, however no experimental studies supporting this procedure have been previously described. The aim was to develop an experimental model of ALPPS in rats. METHOD: Experimental. A total of 30 Sprague Dawley rats were used. To develop the ALPPS procedure, ligation of the left portal branch of the middle lobe (LM) was performed. This demarcates the left side (SILM) from the right side (SDLM); parenchyma transection was performed following the demarcated line. The animal's weight, volume and weight of both LM were analyzed. Sacrifice at 3, 7 and 14 days after the procedure (10 per group) was performed. RESULTS: No bleeding or ascites were observed during the postoperative period. The LM increased by 24.1, 86.9 and 120.4% at 3, 7 and 14 days. The SDLM increased by 34.4, 78.8 and 102.0% at 3, 7 and 14 days. The SILM decreased 42.6, 64.8, and 79.3% at day 3, 7 and 14 days respectively. CONCLUSION: The ALPPS procedure can be performed in rats, achieving the expected results. Comparison studies to 2 staged hepatectomy will be necessary.
