A Novel Method for Monitoring Liver Ethanol Injections

Kairemo, Kalevi; Vehmas, Tapio; Bondestam, S.

doi:10.1016/s0741-8329(99)00031-2

Cited by 1 publication

(1 citation statement)

References 25 publications

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“…The depth of degeneration also markedly increased within 5 min to a maximum depth of 1 mm. These results are quite different from studies of in vivo ethanol injection into the liver of animals which have reported a large area of necrosis of 1.5 mm, with a spread of ethanol into an area of up to 29 mm, 15 min after injection of 0.3 ml of ethanol [ 21 , 22 ]. Reasons for these differences include (1) the increase in the diffusion range of anhydrous alcohol by the pressure of the local injection, and (2) blockage of further absorption of the alcohol by the necrotic layer.…”

Section: Discussioncontrasting

confidence: 83%

Safety and efficacy of dehydrated ethanol soaking of the operative field in the treatment of spontaneous hepatocellular carcinoma rupture

et al. 2018

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BackgroundThe aim of our study was to evaluate the clinical safety and value of ethanol surgical field infiltration (ESFI), combined with distilled water peritoneal lavage (DWPL), after hepatectomy in patients with hepatocellular carcinoma (HCC) rupture.MethodsRat liver tissue samples were soaked in dehydrated ethanol for different soaking times, and 18 rats were assigned to three groups that underwent different soaking methods of the hepatectomy cut surface. We retrospectively reviewed 45 patients who underwent hepatectomy for treatment of ruptured HCC. Among these, EFSI combined with DWPL was used in 21 patients (DAW group), with only DWPL used in the other 24 patients (DW group). Clinical outcomes were compared between the two groups.ResultsFor in vitro experiments, the depth of coagulation degeneration and necrosis increased with the duration of soaking. For in vivo experiments, rats in all three groups survived until postoperative day 7 without significant postoperative complication. In patients, the rate of post-operation complication was comparable between the two groups (P = 0.398), with no between-group differences in liver function levels. The incidence of peritoneal dissemination was significantly higher for DW than DAW group (P = 0.037). Kaplan–Meier test identified dehydrated ethanol treatment as a significant factor of disease-free survival (DFS) (P = 0.036). On univariate analysis, dehydrated ethanol treatment was associated with better prognostic outcomes, although it was not retained as an independent factor of patient outcome.ConclusionsDehydrated ethanol soaking of the cut surface of the hepatectomy could potentially lower the risk of metastasis and improve the effect of hepatectomy for ruptured HCC as well as showed potential therapeutic value for intraoperative iatrogenic rupture of HCC.Electronic supplementary materialThe online version of this article (10.1186/s12957-018-1390-x) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 83%