- 作者：Petros Ypsilantis ; Maria Panopoulou ; Maria Lambropoulou ; Christina Tsigalou ; Michail Pitiakoudis ; Ioannis Tentes ; Sofia Kartali ; Fotini Papachristou ; Nikolaos Papadopoulos ; Constantinos Simopoulos
- 关键词：liver ; radiofrequency ; ablation ; bacterial ; translocation ; intestine ; barrier
- 刊名：Journal of Surgical Research
- 出版年：2010
- 出版时间：15 June 2010
- 年：2010
- 卷：161
- 期：2
- 页码：250-258
- 全文大小：619 K
Background
In this experimental study, we investigated the possibility of bacterial translocation, constituting a potential cause of infectious complications, after performing large volume hepatic radiofrequency ablation (RFA).Materials and Methods
Wistar rats were subjected to RFA of the left median liver lobe (approximately 28.5 % of the liver volume) after midline laparotomy. At 30min, 24h, 48h, 72h or 1 wk postoperatively, (1) blood samples were collected from the portal and systemic circulation for assessment of endotoxin concentration, (2) tissue specimens were excised from mesenteric lymph nodes, non-ablated liver, pancreas, spleen, kidneys, and lungs for bacterial culture, and (3) segments of terminal ileum were excised for histopathologic examination, morphometric analysis, and apoptotic and mitotic rate estimation. At 1 and 48h, ileal mucosa was collected for oxidative state assessment on the basis of glutathione to glutathione disulfate (GSH/GSSG) ratio.
Results
Endotoxin levels were increased in both the portal and systemic circulation. Intestinal bacteria were isolated from all the organs at all time points. Ileal mucosa became gradually atrophic, with a decrease in villous height and density. There was an increase of crypt apoptotic rate, a decrease of GSH/GSSG ratio, while there were only mild signs of inflammation.
Conclusions
Large volume liver RFA in the rat resulted to endotoxemia and translocation of intestinal bacteria to proximal and distal to the intestine organs at both the early and late post-RFA periods. The intestinal mucosa barrier was disrupted as suggested by ileal mucosal atrophy, increased crypt apoptosis, and induction of oxidative stress.