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Sinusoidal obstruction syndrome in the animal model: influence on liver surgery

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Abstract

Purpose

In recent years, multimodal treatment approaches have led to an increased median survival time of patients with colorectal liver metastases. In particular, this results from new perioperative chemotherapy regimens, which in turn are accompanied by an increased risk of perioperative bleeding and/or liver failure due to the hepatotoxic side effects. Nineteen to 58 % of patients treated with oxaliplatin develop sinusoidal obstruction syndrome (SOS). The influence of preexisting SOS on liver surgery remains controversial.

Methods

Animals were operated 4 days after SOS induction with monocrotaline and received either vascular occlusion in the form of Pringle maneuver (PM) or hepatectomy (LR; 70 %) or a combination of both (LR + PM). Postoperative liver function was assessed by determination of liver enzyme levels, bile production, and tissue oxygen saturation.

Results

Preexisting SOS impaired morbidity after liver resection, reflected by elevated liver enzyme levels, reduced bile secretion, and low liver tissue oxygenation levels. Mortality was increased by up to 25 %. Additional ischemia in the form of PM showed no further impact in the LR ± PM group compared to LR alone.

Conclusion

PM without LR results in high enzyme distribution in the SOS group. SOS significantly affects the outcome after liver resection in our experimental rat model only without PM and showed no protective effect in ischemia in the form of PM.

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References

  1. Leporrier J, Maurel J, Chiche L, Bara S, Segol P, Launoy G (2006) A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. Br J Surg 46:765–781

    Google Scholar 

  2. Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier A (2006) Epidemiology and management of liver metastases from colorectal cancer. Ann Surg 244:254–259

    Article  PubMed  PubMed Central  Google Scholar 

  3. Adam R, Delvart V, Pascal G, et al. (2004) Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 240:644–657

    Article  PubMed  PubMed Central  Google Scholar 

  4. Grundmann R, Hermanek P, Merkel S, et al. (2008) Diagnosis and treatment of colorectal liver metastases—workflow. Zentralbl Chir 133:267–284

    Article  CAS  PubMed  Google Scholar 

  5. DeLeve L, McCuskey R, Wang X, et al. (1999) Characterization of a reproducible rat model of hepatic veno-occlusive disease. Hepatology 29:1779–1791

    Article  CAS  PubMed  Google Scholar 

  6. DeLeve L, Shulman H, Mcdonald G (2002) Toxic injury to hepatic sinusoids: sinusoidal obstruction syndrome (veno-occlusive disease. Semin Liver Dis 22:27–42

    Article  PubMed  Google Scholar 

  7. Hubert C, Fervaille C, Sempoux C, Horsmans Y, Humblet Y, Machiels J, et al. (2010) Prevalence and clinical relevance of pathological hepatic changes occurring after neoadjuavnt chemotherapy for colorectal liver metastases. Surgery 147:185–194

    Article  PubMed  Google Scholar 

  8. Rubbia-Brandt L, Mentha G, Terris B (2005) Sinusoidal obstruction syndrome is a major feature of hepatic lesions associated with Oxaliplatin pretreatment on respectability of hepatic colorectal metastases. J Am Coll Surg 202:199–200

    Article  Google Scholar 

  9. DeLeve L (2007) Hepatic microvasculature in liver surgery. Semin Liver Dis 27:390–400

    Article  CAS  PubMed  Google Scholar 

  10. Rubbia-Brandt L (2010) Sinusoidal obstruction syndrome. Clin Liver Dis 14:651–668

    Article  PubMed  Google Scholar 

  11. Karoui M, Penna C, Amin-Hashem M, et al. (2006) Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg 243:1–7

    Article  PubMed  PubMed Central  Google Scholar 

  12. Nakano H, Oussoultzoglou E, Ross E, et al. (2008) Sinusoidal injury increase morbidity after major hepatectomy in patients with colorectal liver metastases receiving preoperative chemotherapy. Ann Surg 247:118–124

    Article  PubMed  Google Scholar 

  13. Khan AZ, Morris-Stiff G, Makuuchi M (2009) Patterns of chemotherapy-induced hepatic injury and their implications for patients undergoing liver resection for colorectal liver metastases. J Hepato-Biliary-Pancreat Surg 16:137–144

    Article  Google Scholar 

  14. Tanaka K, Adam R, Shimada H, Azoulay D, Levi F, Bismuth H (2003) Role of neoadjuvant chemotherapy in the treatment of multiple colorectal metastases to the liver. Br J Surg 90:963–969

    Article  CAS  PubMed  Google Scholar 

  15. Mehta N, Ravikumar R, Coldham C, et al. (2008) Effect of preoperative chemotherapy on liver resection for colorectal liver metastases. Eur J Surg Oncol 34:782–786

    Article  CAS  PubMed  Google Scholar 

  16. Scoggins C, Campbell M, Landry C, et al. (2009) Preoperative chemotherapy does not increase morbidity or mortality of hepatic resection for colorectal cancer metastases. Ann Surg Oncol 16:35–41

    Article  PubMed  Google Scholar 

  17. Narita M, Hatano E, Tamaki N, et al. (2009) Dai-kenchu to attenuates rat sinusoidal obstruction syndrome by inhibiting the accumulation of neutrophils in the liver. J Gastroenterol Hepatol 24:1051–1057

    Article  PubMed  Google Scholar 

  18. Higgins G, Anderson R (1931) Experimental pathology of the liver: restoration of the liver following partial hepatectomy. Arch Pathol 12:186–202

    Google Scholar 

  19. Manekeller S, Minor T (2005) Influence of neoadjuvant chemotherapy on liver integrity and ischemic tolerance. Langenbeck's Arch Surg 390:475

    Google Scholar 

  20. Schreinemachers M, Doorschodt B, Florquin S, et al. (2010) Pulsatile perfusion preservation of warm ischaemia-damaged experimental kidney grafts. Br J Surg 97:349–358

    Article  CAS  PubMed  Google Scholar 

  21. Manekeller S, Seinsche A, Sioutis M, Hirner A (2009) Extended liver resection after preoperative chemotherapy: influence on regeneration and endoplasmatic reticulum stress response. Langenbeck's Arch Surg 394:681–688

    Article  Google Scholar 

  22. Manekeller S, Sioutis M, Hirner A, Minor T (2008) Influence of neoadjuvant chemotherapy on liver integrity and ischemic tolerance. Z Gastroenterol 46:17–21

    Article  CAS  PubMed  Google Scholar 

  23. Robinson MS, Wilson CH, Burt AD, Manas DM, White SA (2012) Chemotherapy-associated liver injury in patients with colorectal liver metastases: a systematic review and meta-analysis. Ann Surg Oncol 19(13):4287–4299

    Article  PubMed  PubMed Central  Google Scholar 

  24. Pethick WH. Special Report on Pictou Cattle Disease, Department of Agriculture, Canada, Health of Animals Branch. Ottawa: Canadian Government Printing Bureau 1907:1–19

  25. Cushny AR (1911) On the action of senecio alkaloids and the causation of the hepatic cirrhosis of cattle (Pictou, Molteno, or Winton disease. J Pharmacol Exp Ther 2:531–548

    CAS  Google Scholar 

  26. Willmot F, Robert G (1920) Senecio disease, or cirrhosis oft he liver due to senecio poisoning. Lancet 2:848–849

    Article  Google Scholar 

  27. Vreuls CPH, Driessen A, Olde Damink SWM, et al. (2016) Sinusoidal obstruction syndrom (SOS): a light and electron microscopy study in human liver. Micron 84:17–22

    Article  CAS  PubMed  Google Scholar 

  28. Kneuertz P, Maithel S, Staley C, Kooby D (2001) Chemotherapy-associated liver injury: impact on surgical management of colorectal cancer liver metastases. Ann Surg Oncol 18:181–190

    Article  Google Scholar 

  29. Aloia T, Sebagh M, Plasse M, et al. (2006) Liver histology and surgical outcomes after preoperative chemotherapy with fluorouracil plus oxaliplatin in colorectal cancer liver metastases. J Clin Oncol 24:4983–4990

    Article  CAS  PubMed  Google Scholar 

  30. Nordlinger B, Sorbye H, Glimelius B, et al. (2008) Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC intergroup trial 40983): a randomised controlled trial. Lancet 371(9617):1007–1016

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Lehmann K, Rickenbacher A, Weber A, Pestalozzi BC, Clavien PA (2012) Chemotherapy before liver resection of colorectal metastases friend or foe? Ann Surg 255(2):237–247

    Article  PubMed  Google Scholar 

  32. Krieger PM, Tamandl D, Herberger B, et al. (2001) Evaluation of chemotherapy-associated liver injury in patients with colorectal cancer liver metastases using indocyanine green clearance testing. Ann Surg Oncol 18:1644–1650

  33. Pawlik T, Olino K, Gleisner A (2007) Preoperative chemotherapy for colorectal liver metastases: impact on hepatic histology and postoperative outcome. J Gastrointest Surg 11:860–868

    Article  PubMed  Google Scholar 

  34. Shulman H, McDonald G, Mattews D, et al. (1980) An analysis of hepatic venocclusive disease and centrilobular hepatic degeneration following bone marrow transplantation. Gastroenterology 79:1178–1191

    CAS  PubMed  Google Scholar 

  35. Welsh F, Tilney H, Tekkis P (2007) Safe liver resection following chemotherapy for colorectal metastases is a matter of timing. Br J Cancer 96:1037–1042

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This study was supported by grants from the Deutsche Forschungsgemeinschaft (MA4461/4-1).

Author’s contribution

AJ: acquisition of data, analysis and interpretation of data, drafting of manuscript.

SW: analysis and interpretation of data, drafting of manuscript, critical revision.

JCK: critical revision.

SM: study conception and design, analysis and interpretation of data, drafting of manuscript, critical revision.

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Authors and Affiliations

  1. Department of Surgery, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany

    Azin Jafari, Sven Wehner, Jörg C Kalff & Steffen Manekeller

Authors
  1. Azin Jafari
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  2. Sven Wehner
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  3. Jörg C Kalff
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  4. Steffen Manekeller
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Corresponding author

Correspondence to Steffen Manekeller.

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Funding

This study was funded by grants from the Deutsche Forschungsgemeinschaft (MA4461/4-1).

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed (87-51.04.2010.A042).

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Jafari, A., Wehner, S., Kalff, J.C. et al. Sinusoidal obstruction syndrome in the animal model: influence on liver surgery. Langenbecks Arch Surg 402, 115–122 (2017). https://doi.org/10.1007/s00423-016-1506-0

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  • DOI: https://doi.org/10.1007/s00423-016-1506-0

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