Wang L Q, Persson B G, Bengmark S
Department of Surgery, Lund University, Sweden.
HPB Surg. 1994;8(1):37-41. doi: 10.1155/1994/68212.
As liver tumours receive some of their blood supply from the portal vein, we wanted to illustrate the influence of portal blood flow in combination with dearterialization in the treatment of liver tumours. Forty male, inbred Wistar/Furth rats with an adenocarcinoma transplanted to the liver were treated with various inflow occlusions repeated daily for 5 days. Deviation of the portal blood flow alone with an end-side porto-caval shunt did not alter the tumour growth (p = 0.089). Thirty min of repeat dearterializations was potentiated by portal deviation so that tumour growth was delayed (p = 0.004). However, repeat dearterializations for 60 min in portal deviated rats induced irreversible liver damage and all rats died in a few days. Repeated dearterializations for 60 minutes alone retarded the tumour growth as efficiently (p = 0.007). Simultaneous occlusion of the hepatic artery and the portal vein for 30 minutes with a side-side porto-caval shunted (total devascularization) did not affect tumour growth (p = 0.154). Liver aminotransferases (ASAT and ALAT) were substantially increased following dearterialization for 30 min in rats with either an end-side or a side-side porto-caval shunt. Dearterialization for 60 min in rats with end-side porto-caval shunts gave a further release of ASAT and ALAT. In conclusion, portal deviation did not augment the therapeutic benefit of repeat dearterializations for the treatment of this experimental liver tumour. Repeat dearterializations alone seemed to be a feasible and efficient therapy for liver tumours.
由于肝肿瘤部分血液供应来自门静脉,我们想要阐明门静脉血流联合去动脉化在肝肿瘤治疗中的影响。将40只移植了腺癌的雄性近交系Wistar/Furth大鼠每日重复进行不同的血流阻断处理,持续5天。仅通过端侧门腔分流使门静脉血流改道,并未改变肿瘤生长情况(p = 0.089)。门静脉改道可增强30分钟重复去动脉化的效果,从而使肿瘤生长延迟(p = 0.004)。然而,门静脉改道的大鼠进行60分钟重复去动脉化会导致不可逆的肝损伤,所有大鼠在数天内死亡。单独进行60分钟重复去动脉化同样有效地延缓了肿瘤生长(p = 0.007)。通过侧侧门腔分流同时阻断肝动脉和门静脉30分钟(完全去血管化)对肿瘤生长没有影响(p = 0.154)。在端侧或侧侧门腔分流的大鼠中,去动脉化30分钟后肝转氨酶(谷草转氨酶和谷丙转氨酶)大幅升高。端侧门腔分流的大鼠进行60分钟去动脉化后,谷草转氨酶和谷丙转氨酶进一步释放。总之,门静脉改道并未增强重复去动脉化治疗这种实验性肝肿瘤的疗效。单独重复去动脉化似乎是一种治疗肝肿瘤可行且有效的方法。