Bacterial Translocation in a Rat Model of Large Volume Hepatic Radiofrequency Ablation

Pringle Maneuver Deteriorates Gut Barrier Dysfunction Induced by Extended-Liver Radiofrequency Ablation

“…In agreement with our previous work [8], RFA on approximately 30% of liver mass in the rat led to disruption of the mechanical component of the gut barrier, as evidenced by intestinal mucosa atrophy. This effect was associated with oxidative stress, increased apoptotic activity and histologically evidenced injury of the intestinal tissue.…”

“…It has been shown that this surgical manipulation increases the volume of ablated tissue volume per RFA cycle thereby reducing the risk of local recurrence due to electrode track seeding [2,4], while it minimizes the heat sink effect [13,14]. As previously shown in a rat model, extended liver RFA disrupts gut barrier integrity with subsequent endotoxaemia and BT [8]. The present experimental study provides evidence that the concurrent application of the Pringle maneuver compromises even more the safety of the procedure by deteriorating gut barrier dysfunction and further increasing endotoxaemia and translocation of intestinal bacteria.…”

“…Moreover, BT has been identified in a wide range of diseases. Among them, pathologic conditions or surgical interventions of the liver, such as cirrhosis [19], obstructive jaundice [20], ischemia-reperfusion [15], partial hepatectomy [21] and extended RFA [8], compromise gut barrier function leading to BT.…”

“…The underlying mechanism responsible for these phenomena has not yet been fully elucidated. However, there is evidence from recent experimental studies that RFA of approximately 30% of rat liver volume leads to disruption of intestinal mucosa barrier with subsequent bacterial translocation (BT) [8].…”

“…The aim of the present study was to investigate the effect of this surgical manipulation when applied concurrently with extended liver RFA on gut barrier function and BT. For this reason, we used our previously described rat model of large-volume liver RFA-induced BT [8].…”