Abstract
The effect of cryosurgery on normal liver and liver tumour was investigated using 60 adult male rats. Animals were divided into four groups Group A implanted tumour/cryosurgery (n = 19), Group B normal liver/cryosurgery (n = 17), Group C normal liver/sham cryosurgery (n = 10) and Group D implanted tumour/sham cryosurgery (n = 14). At laparotomy animals were injected into the left lateral lobe of the liver with 10(5) HSN fibrosarcoma cells or vehicle. Two weeks after implantation red cell flux was recorded in all animals, the appropriate groups treated with cryosurgery and after thawing red cell flux was monitored over the tumour and at the edge of the cryolesion and over the corresponding normal area in controls. In certain animals red cell flux was measured at hourly intervals for 8 h, and in further groups at 24 h and at 2 weeks after cryosurgery. Results demonstrated that cryosurgery significantly reduced (P < 0.01) red cell flux in both normal and tumour liver, immediately after treatment. Red cell flux remained significantly reduced (P < 0.005) at 8 h after treatment but by 24 h had returned to preoperative levels which was maintained at 2 weeks. The results suggest that microcirculatory shutdown may be a contributing factor to the tumour necrosis occurring after cryosurgery.
Highlights
Groups A and D animals each received an inoculation of 105 HSN fibrosarcoma cells (Currie & Gage, 1973) suspended in phosphate buffered saline (PBS) into the left lateral lobe of the liver
Before cryosurgery there were no significant differences in red cell flux between any of the study groups (Table I); red cell flux was greater in the tumour than normal liver but this did not reach statistical significance
Sham cryosurgery had no effect on red cell flux in either groups C or D (Table I)
Summary
Previous studies in our laboratory have demonstrated that in liver with implanted HSN fibrosarcoma, treatment with cryosurgery results in tumour destruction with no evidence of regrowth at 6 weeks (Bayjoo, 1992). It has been shown that large blood vessels may act as a heat sink to freezing (Gage et al, 1985; McIntosh et al, 1985) while smaller vessels such as arterioles and venules are less resistant with evidence of damage and gap formation in the endothelium cryosurgery resulting in extravasation of intraluminal contents (Whittaker, 1984).
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