Short- and Long-term Histological Changes in Liver Parenchyma After Different Resection Methods and Their Potential Role in Treatment of Colorectal Liver Metastasis

Abstract

Background/aim: Optimal surgical margins, parenchymal-sparing technique and the effect of the surgical devices on the liver resection surface are currently hot topics. The aim of this study was to set up a surviving animal model to detect histological changes on the resection surface induced by the resection method and the thermal effect of monopolar electrocautery in 'spray mode'.

Materials and methods: Eighteen male Wistar rats were used; all rats were subjected to standardized liver resection and resection surface coagulation. Resection surface samples were collected immediately after the operation from the first group, and at 1 week and 3 weeks after the operation from the second and third groups, respectively. The samples were histologically investigated.

Results: Spray diathermy was shown to cause parenchymaI destruction of varying depth on the resection surface due to immediate coagulation and consequent necrosis.

Conclusion: Spray diathermy on the resection surface can also destroy the area that contains possible tumor cells after R1 resection and increases the tumor clearance without worse survival outcomes.

Keywords: Colorectal liver metastasis; parenchymal-sparing liver resection; spray diathermy; surgical margin.