Feasibility of bloodless liver resection using Lumagel, a reverse thermoplastic polymer, to produce temporary, targeted hepatic blood flow interruption.
Feasibility of bloodless liver resection using Lumagel, a reverse thermoplastic polymer, to produce temporary, targeted hepatic blood flow interruption.
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使用 Lumagel（一种反向热塑性聚合物）进行无血肝脏切除术的可行性，以产生暂时的、有针对性的肝血流中断。
DOI：
10.1111/j.1477-2574.2011.00412.x
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Madras,PeterN
中科院分区：
文献类型：
--
作者：
Pomposelli,JamesJ;Akoad,Mohamed;Flacke,Sebastian;Benn,JamesJ;Solano,Mauricio;Kalra,Aarti;Madras,PeterN
背景Lumagel是一种反向热敏聚合物（RTP），通过可逆性堵塞肾动脉的节段性分支，提供靶向的血流阻断，从而实现无血肾部分切除术。将这项技术扩展到肝脏需要开发的技术，用于临时闭塞的肝动脉和选定的门静脉branchs.MethodsA三个阶段，15猪的研究进行，以确定可行性，技术和生存的影响，使用Lumagel闭塞的流入血管的目标部分的肝脏。使用血管造影技术将Lumagel输送到通过术前动脉和静脉分支的3-D血管重建确定的部位。在切除过程中，靶向肝脏肿块在不夹闭血管的情况下切除。三个生存的猪在3周被处死，其余在6周的病理studies.ResultsSix动物（100%）存活，正常生长，血液检查，没有不良事件。3只左外叶切除术在切除过程中未发生出血; 1只右正中切除术流血的; 2只对照动物流血的显著。终端前的血管造影和尸检显示没有局部病理，没有远程organsduration.ConclusionsTargeted流量中断的左外侧叶的猪肝是可行的，并允许切除无出血，毒性或病理后遗症。由于广泛的侧支静脉网，靶向剩余的肝脏将需要更精细的栓塞沉积。
BackgroundLumagel, a reverse thermosensitive polymer (RTP), provides targeted flow interruption to the kidney by reversibly plugging segmental branches of the renal artery, allowing blood-free partial nephrectomy. Extending this technology to the liver requires the development of techniques for temporary occlusion of the hepatic artery and selected portal vein branches.MethodsA three-phased, 15 swine study was performed to determine feasibility, techniques and survival implications of using Lumagel for occlusion of inflow vessels to targeted portions of the liver. Lumagel was delivered using angiographic techniques to sites determined by pre-operative 3-D vascular reconstructions of arterial and venous branches. During resection, the targeted liver mass was resected without vascular clamping. Three survival swine were sacrificed at 3 weeks; the remainder at 6 weeks for pathological studies.ResultsSix animals (100%) survived, with normal growth, blood tests and no adverse events. Three left lateral lobe resections encountered no bleeding during resection; one right median resection bled; two control animals bled significantly. Pre-terminal angiography and autopsy showed no local pathology and no remote organ damage.ConclusionsTargeted flow interruption to the left lateral lobe of the swine liver is feasible and allows resection without bleeding, toxicity or pathological sequelae. Targeting the remaining liver will require more elaborate plug deposition owing to the extensive collateral venous network.
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改善了心脏护理病房的入院标准。
DOI：
10.1001/jama.1981.03320180029024
发表时间：
1981
期刊：
JAMA
影响因子：
--
作者：
R. Fuchs;S. Scheidt
通讯作者：
S. Scheidt
重症监护的使用：大学医院和社区医院的比较
影响因子：
--
作者：
E. Draper;D. Wagner;W. Knaus
通讯作者：
W. Knaus
影响因子：
158.5
作者：
GOLDMAN, L;WEINBERG, M;STIRATELLI, R
通讯作者：
STIRATELLI, R
当今重症监护服务的范围
DOI：
--
发表时间：
1981
期刊：
影响因子：
--
作者：
W. Knaus;D. Wagner;E. Draper;D. E. Lawrence;J. Zimmerman
通讯作者：
J. Zimmerman
影响因子：
158.5
作者：
G. Foote;S. Schabel;M. Hodges
通讯作者：
M. Hodges