特别致谢去本杰明博士天牛他在技术问题援助。作者也想感谢马库斯Forschner博士和伯克穆勒为自己的多媒体支持，埃里卡Magelky她编辑的专业知识和丽莎霍农，罗兰Jurgons博士和斯蒂芬·冯·Hörsten教授（均来自弗朗兹 - Penzoldt中心，大学埃尔兰根），他们在动物处理和护理专业精神。我们感谢在临床化学研究所，德国海德堡大学医学院曼海姆迈克尔Neumaier教授提供MC38肿瘤细胞。 目前的工作是在用于获得程度的要求履行执行"MED博士"。在弗里德里希 - 亚历山大大学埃尔兰根 - 纽伦堡（FAU）。

中弗兰肯在德国巴伐利亚州政府授予描述的过程的权限。任何类似的实验，需要由有关当局事先批准。 注:以下手册可以通过在A，B组被排除在外有相应标志C.步骤可用于前面所讨论的A组。 1.准备<ol><li>戴上手套，放置在显微镜下的聚苯乙烯垫，并且透镜集中于垫稍稍上方的区域。 </li><li>拆分无菌纸和地方一半以上的聚苯乙烯板，另一半只是在它旁边。 </li><li>消毒手术器械，将它们放在旁边的聚苯乙烯垫无菌纸。 </li><li>伸直的大回形针形成一个拱形。把它倒过来，按入聚苯乙烯板在高端产品 - 就在旁边，其中动物的头会说谎。 </li><li>放置蒸发器的吸嘴两个肢之间S中的弓。 （ 图7） </li><li>设置一下从那里动物的头会说谎的地方40cm的加热灯。使在聚苯乙烯垫的水平不超过40℃的一定的热量。 </li><li>准备手术的动物一个单独的笼子。 </li><li>在柔性管中准备一个限定数量和体积（最多50微升）的肿瘤细胞，并储存在冰上。 </li></ol> 2.麻醉<ol><li>鼠标放置成有机玻璃盒子和（以10升/分钟的流量的5％异氟烷）开始高流动异氟烷麻醉诱导。 </li><li>经过麻醉的不同阶段会后，取出从有机玻璃中，将鼠标已经进入濒死喘息的阶段，这很容易通过呼吸频率（&lt;20次/分）和深喘着气摇晃急剧减少的认可刚过动物的整个身体。 </li><li>快速地将动物腹部向上到无菌的悬垂性聚苯乙烯覆盖垫，并继续通过插入老鼠的鼻子对着话筒维持麻醉通风的低流量异氟醚。以约1升/分钟的流量用的1.8-2.2％的吸气部分。 </li><li>评估通过计算呼吸频率，这是理想的每分钟45到60次呼吸之间的操作期间麻醉深度。相应地调整吸气异氟烷分数，如果这不是这种情况。 注:在吸气异氟醚分数的变化需要大约60秒，直到他们成为有效的。避免迅速开展剧变。相反，逐步修改麻醉剂的应用。 </li></ol> 3.操作<ol><li>消毒胸腹部有足够的消毒和更换手套之后。 </li><li>注入的重适于体积卡洛芬（5毫克/公斤体重）到动物的大腿。 </li><li>轻轻捏住用钳子腹部皮肤以测试麻醉深度是足够的。 </li><lI&gt;沿着从用剪刀和镊子剑突到中间腹部中线执行一个切口。 </li><li>仔细解剖周围地区剑突从周围组织揭露它。 </li><li>放置一个停留缝线通过剑突（从内到外）和上面的动物脑袋使用钳两个线程连接到保持器上。 </li><li>捏牵开的四肢一起慢慢变推出了"U"形拉钩沿着动物的内部腹壁提示。 注意:这些措施暴露肝脏，以方便获得不同的瓣。肝脏的中位数和左外叶的识​​别现在应该是可能的。 </li><li>用盐水浸泡过的棉签，轻轻地向下推中叶。解剖镰状韧带的腹侧四分之三，它现在将是中叶的表面与隔膜之间可见。 </li><li>现在，使用两个盐水浸泡过的棉签位数转移叶及左外叶向上向膜。 </li><li>可视化的左外叶和尾状叶之间的薄膜，仔细解剖它。 注意:当执行从一组动物这个协议，跳跃在这一点上步骤3.18。 </li><li>放置一个大小4-0结扎斜沿左外叶的基地。 </li><li>接下来，使用棉签向左外叶返回到其原来的位置。 </li><li>仔细绑结扎尽量靠近叶的基部尽可能并在叶评估颜色变化来测试充分中断血液供应。 </li><li>由以下的叶的基部的线切除左外侧叶并注意切除叶的重量。 注意:当对从B组动物这个协议中，跳跃在这一点到步骤3.18。 </li><li>放置在左外叶的树桩和中叶的基准之间的第二结扎。 </li><li>重新定位中叶为WELL，领带结扎。再次，评估颜色变化的叶来测试中断充足的血液供应。 </li><li>切除中叶，并注意它的重量。 </li><li>的1ml注射器连接至地下30针，并使用从柔性管肿瘤细胞填充而不会在任何时候倾斜注射器。 </li><li>使用棉签移动肠襻向动物的左，以便露出下右叶。 </li><li>插入细胞加载注射器插入"三手"的设备在30°角向垂直。 </li><li>小心移到旁边的鼠标设备用针刚下肝右叶上方。 </li><li>慢慢地推进第三只手装置内的注射器，直到针的针尖是下右叶的中间部分。 </li><li>注入整个卷到耳垂的中间部分过一段30-45秒。 </li><li>压缩注射部位至少三分钟，直到出血停止。 </LI&gt; <li>除去留缝合和牵开器。 </li><li>使用一键结可吸收的缝线5-0关闭筋膜。 </li><li>使用一键结4-0，非吸收性缝合关闭皮肤。 </li><li>启动换气高流量氧气鼠标约1分钟。 </li></ol> 4.后运过程<ol><li>将动物到了下一个半小时温暖的环境（约40℃），以确保有足够的恢复。 </li><li>用5毫克/毫升安乃近的72小时的术后掺和动物的饮用水。 </li><li>仔细检查缝合线的完整性的程序后至少三天。 </li></ol> 5.观察期和安乐死<ol><li>每日测量动物的体重，共14天。他们得分就其各自的福祉和限制。 </li><li>后14天，麻醉动物以下步骤2.1和手术协议2.2ND与机构的动物安乐死的协议进行。 </li><li>如步骤3.4解释执行中位数剖腹探查术。为了方便进入腹部，延长切口1-1.5厘米尾部。插入牵开器在3.7指出。 </li><li>沿镰状韧带的其余部分解剖和切割就像它退出肝脏颅下腔静脉。 </li><li>从隔膜，通过用钳子抓住隔膜和直截了当地解剖到肝脏和肌肉组织之间的空间分离肝脏。 </li><li>提起动员肝组织过腹膜后并剖析其关闭剩余的结构它仍然附着于:腹膜后脂肪组织，下腔静脉和门静脉。 </li><li>提取为任何额外的组织，这将错误地有助于其实际尺寸和重量后检查肝脏。提取的肝脏和其肿瘤都显示在图6中 。 </li><li>解剖肿瘤关闭INFerior右叶。 </li><li>测量肿瘤和肝实质两者的尺寸和重量。 </li><li>根据需要用于组织分析保存从腹膜额外组织样品，淋巴结或其他器官</li></ol>

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The authors have nothing to disclose.

表演在啮齿类动物外科手术之前的实验已经能够确定某些变量，可以作为来源的偏见。为了获得可靠和有效的结果，请考虑以下注意事项。 常规操作前禁食可导致肝脂肪变性12，其可以抑制肝再生13,14。因此，不建议使用。肝细胞的有丝分裂最高活性在整个15天发生变化。如果可能的话，在白天所有组在一定的时间进行的程序。鼠肝再生是最有效的动?...

结直肠癌（CRC）占近9％的恶性肿瘤。它是第三大常见癌症，无论是在美国和世界各地。从30万CRC全球范围内的死亡率为50多万，每年1。患者的百分之二十在他们的大肠肿瘤的发现从肝转移苦。可切除的转移是由部分肝切除2,3通常的方式处理。改进的外科技术，新的多策略和可切除转移新的定义呈现部分肝切除可能越来越多的患者4的疗法。 继发性恶性肿瘤复发，但是，在现代胃肠外科具有挑战性的临床后遗症。 CRC患者谁接受肝转移灶切除术在其剩余肝5开发一种新的肿瘤的30〜50％的机会。因此，有必要对在进一步的研究参与肝转移复发的机制。 约70％的肝切除通常是由剩余的肝组织在几周内补偿。该再生涉及多个机制，包括象白细胞介素-6（IL-6），肿瘤坏死因子α（TNF-α），肝细胞生长因子（HGF）的细胞因子，转化生长因子β（TGF-β），血管内皮生长因子（VEGF ），基质金属蛋白酶（MMP-2和MMP-9）和CXC趋化因子6-11。这些物质支持肝再生，并且还可以通过诱导的小肿瘤细胞沉积物，其中不是由常规临床成像检测到的剩余的肝生长负责初级和次级肝恶性肿瘤的复发率较高。这种因果关系尚未迄今证实。 建立了如下假设。部分肝切除之后，增殖因子，负责活ř肥大也可能诱导以前未发现的肿瘤细胞在肝脏的生长。小鼠模型的设计相结合肝切除和肿瘤诱导的技术。第三无胸腺裸-foxn1nu / nu小鼠分为三组，每组10只动物。他们每个人都用无论是单独的剖腹手术（A组）治疗，30％的肝切除（B组）或70％肝切除术（C组）。在所有组中的动物随后收到一个肿瘤细胞注射到肝脏的定义剩余部分​​，​​以模拟休眠肿瘤细胞。其中，两个星期观察，然后动物评价肿瘤生长和肝脏肥大。 的目标是创建可用于搜索可能发挥肝切除后肿瘤形成的作用的分子和致病因素的模型。这种方法可以是在评估帮助:参与肝再生内分泌因子的来源;肝内TUM责任机制或肝切除术后的增长;和必要的肝内肿瘤生长诱导肝切除量。只是对动物，因为它们承诺向的基本生物学原理的理解，并可以预期受益通过​​改进的治疗选择人类知识的发展已经执行了下面的方法。由于涉及在这些问题的机制，它在体内被检查，如体外方法可能无法提供人类病理学的一个真实的表现。 这些调查可能导致的有关目标的发现为用于降低肿瘤复发的预防性治疗方案。

<table><tbody><tr><td>&lt;strong&gt;Equipment&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Operation Microscope</td><td>Zeiss</td><td>OPMI-1 FC S21</td><td></td></tr><tr><td>Induction Cage (Plexiglas Box)</td><td>UNO BV, Netherlands</td><td>180000132</td><td></td></tr><tr><td>Flowmeter + Connection Kit</td><td>UNO BV, Netherlands</td><td>180000008</td><td></td></tr><tr><td>UNO Vaporizer Sigma Delta</td><td>UNO BV, Netherlands</td><td>180000002</td><td></td></tr><tr><td>Key Filler for Anesthetic</td><td>UNO BV, Netherlands</td><td>180000010</td><td></td></tr><tr><td>Activated Charcoal Filter Adsorber</td><td>UNO BV, Netherlands</td><td>180000140</td><td></td></tr><tr><td>Gas Exhaust Unit</td><td>UNO BV, Netherlands</td><td>180000118</td><td></td></tr><tr><td>Face Mask for mouse</td><td>UNO BV, Netherlands</td><td>180000065</td><td></td></tr><tr><td>Vaporizer Stand</td><td>UNO BV, Netherlands</td><td>180000006</td><td></td></tr><tr><td>Heat lamp</td><td>Physitemp Instruments</td><td>HL-1</td><td></td></tr><tr><td>Styrofoam Pad</td><td>RAYHER</td><td>30074000&amp;nbsp;</td><td></td></tr><tr><td>Third Hand Tool</td><td>TOOLCRAFT&amp;nbsp;</td><td>ZD-10F</td><td></td></tr><tr><td>Precision Scales</td><td>Kern</td><td>EW 220-3NM</td><td></td></tr><tr><td>Scales&amp;nbsp;</td><td>Kern</td><td>EMB 500-1</td><td></td></tr><tr><td>Sliding Caliper</td><td>MIB</td><td>MIB 82026100</td><td></td></tr><tr><td>Microdissection forceps</td><td>Braun/Aesculap</td><td>BD195R</td><td></td></tr><tr><td>Microdissection scissors</td><td>Braun/Aesculap</td><td>FD100R</td><td></td></tr><tr><td>Microdissection needle holder</td><td>Braun/Aesculap</td><td>BM563R</td><td></td></tr><tr><td>Retractor</td><td>Fine Science Tools (F.S.T.)</td><td>No. 17001-0</td><td>Type: Bowmann</td></tr><tr><td>Clamp</td><td>Braun/Aesculap</td><td>BJ002R</td><td></td></tr><tr><td>&lt;strong&gt;Name&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Catalog Number&lt;/strong&gt;</td><td>&lt;strong&gt;Comments&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;Expendable Items&lt;/strong&gt;&lt;br/&gt;(NOTE: Quantities are per animal and procedure)</td><td></td><td></td><td></td></tr><tr><td>Foliodrape sterile cover (45 cm x 75 cm)</td><td>Hartmann</td><td>2775001</td><td></td></tr><tr><td>Sterile Cotton Swabs (2x)</td><td>Hartmann</td><td>4700151</td><td>Peha</td></tr><tr><td>Sterile fluid (0.9% NaCl)</td><td>Braun</td><td>3570310</td><td>PZN=04454809</td></tr><tr><td>Disinfectant (Softasept - 250 ml)</td><td>Braun</td><td>3887138</td><td>PZN=0762008808505018</td></tr><tr><td>2 x 1 ml syringe (Injekt-F )</td><td>Braun</td><td>9166017V</td><td></td></tr><tr><td>26 G canula (Sterican) - for Carprofen injection</td><td>Braun</td><td>4665457</td><td></td></tr><tr><td>30 G canula (Sterican)&amp;nbsp; - for Tumor injection</td><td>Braun</td><td>4656300</td><td></td></tr><tr><td>Caprofen (=Rimadyl)</td><td>Pfizer</td><td>QM01AE91</td><td></td></tr><tr><td>Metamizole (= Novaminsulfon)</td><td>Ratiopharm</td><td>16543.00.00</td><td></td></tr><tr><td>4-0 Vicryl suture</td><td>Ethicon</td><td>J835G</td><td></td></tr><tr><td>5-0 Prolene suture</td><td>Ethicon</td><td>8618G</td><td></td></tr><tr><td>SafeLock Flex-Tube 1.5 ml</td><td>Eppendorf&amp;nbsp;</td><td>22363778</td><td></td></tr><tr><td>4 x 4 Gauze Sponge</td><td>Kendall/Covidien&amp;nbsp;</td><td>UPC: 728795135355&amp;nbsp;</td><td>ASIN: B005BFQTWM&amp;nbsp;</td></tr><tr><td>Large paperclip</td><td>ACCO</td><td>A7072510G</td><td></td></tr><tr><td>&lt;strong&gt;Name&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Catalog Number&lt;/strong&gt;</td><td>&lt;strong&gt;Comments&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;Animals&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Female athymic nude-foxn1nu/nu</td><td>Harlan Laboratories B.V.</td><td>Code 069</td><td></td></tr></tbody></table>

the influence of liver resection on intrahepatic tumor growth

肿瘤复发转移切除肝脏病变后的高发病率仍然是一个未解决的问题。小的肿瘤细胞沉积物，这是不通过常规临床成像可检测的，可通过肝切除后的肝再生因子来刺激。这是不完全清楚，但是，哪些因素是肿瘤复发的关键。 所提出的小鼠模型可能是有用的，以探索肝切除后发挥复发性恶性病变的发展中的作用的机制。该模型结合了规定量的小鼠肝组织切除，肿瘤诱导（注射）中的易于执行和可重复的技术。动物用一个单剖腹手术，30％的肝切除，或70％的肝切除术。所有动物随后收到一个肿瘤细胞注射到剩余的肝组织。两周的观察后，将肝脏和肿瘤大小和重量，并进行了评价免疫组化检查。 一个70％的肝切除后，肿瘤的体积和重量比单独一个剖腹（P &lt;0.05）均显著增加。此外，免疫组织化学（Ki67的）显示切除组中增加的肿瘤增殖率（P &lt;0.05）。 这些结果表明，对肝内肿瘤生长肝再生机制的影响。像组织后处理，或RNA分析相结合的方法，所描述的小鼠模型可以作为参与肝脏内肿瘤的生长和转移复发的疾病不同因素密切审查的基础。相当多的像的术后观察的长度的变量，用于注射或注射和肝切除的时刻的细胞系探索肝切除后的转移的情况下的一个具体问题时提供多种角度。此过程的局限性是互惠thorization执行对动物的过程中，获得适当的动物试验设施，并购置某些设备。

在我们具体的实验中，我们包括30个裸鼠-foxn1nu / nu小鼠。他们接到位数剖腹500,000 MC38肿瘤细胞（溶于50μl生理盐水）的肿瘤细胞的注射，并随后用任一个70％肝切除，30％肝切除，或没有进一步的介入治疗。 后14天，剩余的肝的几乎完全再生以下30％或70％肝切除（30％肝切除组肝脏肥大指数为1.06与0.8从70％肝切除组）中观察到。...

Watch this Scientific Journal Video about The Influence of Liver Resection on Intrahepatic Tumor Growth at JoVE.com

The Influence of Liver Resection on Intrahepatic Tumor Growth

A high incidence of tumor recurrence after resection of liver metastases remains an unsolved problem. The illustrated mouse model may be useful to investigate the reasons for such recurrences. It combines a liver resection model with intrahepatic tumor cell injection for the first time.

肝切除肝内肿瘤生长的影响

The high incidence of tumor recurrence after resection of metastatic liver lesions remains an unsolved problem. Small tumor cell deposits, which are not ...

the-influence-of-liver-resection-on-intrahepatic-tumor-growth

Research

JoVE Journal

Medicine

9.4K 次观看.  Friedrich-Alexander-University Erlangen-Nürnberg (FAU). A high incidence of tumor recurrence after resection of liver metastases remains an unsolved problem. The illustrated mouse model may be useful to investigate the reasons for such recurrences. It combines a liver resection model with intrahepatic tumor cell injection for the first time. 

视频: The Influence of Liver Resection on Intrahepatic Tumor Growth

Murine Model of Metastatic Liver Tumors in the Setting of Ischemia Reperfusion Injury

Liver ischemia and reperfusion (I/R) injury, a common clinical challenge, remains an inevitable pathophysiological process that has been shown to induce multiple tissue and organ damage. Despite recent advances and therapeutic approaches, the overall morbidity has remained unsatisfactory especially in patients with underlying parenchymal abnormalities. In the context of aggressive cancer growth and metastasis, surgical I/R is suspected to be the promoter regulating tumor recurrence. This article aims to describe a clinically relevant murine model of liver I/R and colorectal liver metastasis. In doing so, we aim to assist other investigators in establishing and perfecting this model for their routine research practice to better understand the effects of liver I/R on promoting liver metastases.

We describe in detail a clinically relevant colorectal cancer liver metastases (CRLM) tumor model and the influence of liver ischemia reperfusion (I/R) in tumor growth and metastasis. This model can help to better understand the mechanisms underlying surgery-induced promotion of liver metastatic growth.

缺血再灌注损伤中转移性肝肿瘤的模样

Liver ischemia and reperfusion (I/R) injury, a common clinical challenge, remains an inevitable pathophysiological process that has been shown to induce ...

科研

癌症研究

Application of Hemostatic Devices in Laparoscopic Hepatectomy

Laparoscopic hepatectomy is considered a conventional method for treating benign and malignant liver diseases because it is a minimally invasive method. Despite its non-invasive aspect, bleeding and bile leakage occur in liver parenchyma tissue resection during the operation or in the post-operation period, indicating the requirement for high-grade hemostatic devices, such as ultrasonic surgical aspiration, bipolar electrocoagulation, etc. The lack of availability of these high-grade hemostatic devices prevents laparoscopic hepatectomy from becoming a generalized procedure in basic medical organizations. In view of the situation mentioned above, a suite of simple and easy hemostatic devices is developed in this protocol, which includes a harmonic scalpel, monopole electrocoagulation, and a single lumen catheter, to innovatively perform liver parenchyma tissue resection. First of all, the porta hepatis or hepatic pedicle is occluded intermittently by a single lumen catheter, followed by clamping for 15 min and releasing for 5 min. Subsequently, using the harmonic scalpel, clamping and crushing of the liver are done to cut off the hepatic parenchyma tissue and to reveal the intrahepatic arteries, veins, and bile ducts. Lastly, the bleeding spots are coagulated by using monopole electrocoagulation at each spot. Intrahepatic pipeline structures are then visible by using these methods, which could stop bleeding easily, reduce the incidence rate of bile leakage, and improve the safety and feasibility of laparoscopic hepatectomy. Therefore, the simple and easy hemostatic devices shown here are suitable for conducting procedures in primary medical institutions.

High-grade hemostatic devices are essential for laparoscopic hepatectomy. However, these devices are not generalized in basic medical organizations. Therefore, a suite of simple and easy hemostatic devices is shown in this article, which can make the laparoscopic hepatectomy easier to perform.

止血装置在腹腔镜肝切除术中的应用

Laparoscopic hepatectomy is considered a conventional method for treating benign and malignant liver diseases because it is a minimally invasive method. ...

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

Laparoscopic hepatectomy has been reported in many studies, and it is the mainstream method of liver resection. In some particular cases, such as when there are tumors adjacent to the cystic bed, surgeons cannot palpate the surgical margins through the laparoscopic approach, which leads to uncertainty about R0 resection. Conventionally, the gallbladder is resected first, and the hepatic lobes or segments are resected second. However, tumor tissues can be disseminated in the above cases. To address this issue, based on the recognition of the porta hepatis and intrahepatic anatomy, we propose a unique approach to hepatectomy combined with gallbladder resection by en bloc anatomic resection in situ. Firstly, after dissecting the cystic duct, without cutting the gallbladder primarily, the porta hepatis is pre-occluded by the single lumen ureter; secondly, the left hepatic pedicle is made free by the gap of the Laennec membrane and Hilar plate; thirdly, the assistant is asked to drag the fundus of the gallbladder, and the liver parenchyma tissue is resected using a harmonic scalpel along the ischemia line on the liver surface and intraoperative ultrasound. The whole middle hepatic vein (MHV) and its tributaries appear completely; lastly, the left hepatic vein (LHV) is disconnected, and the specimen is taken out from the abdominal cavity. The tumor, gallbladder, and other surrounding tissues are resected en bloc, which meets the tumor-free criterion, and a wide incisal margin and R0 resection are achieved. Therefore, the laparoscopic hepatectomy with the combination of the en bloc concept and anatomic resection is a safe, effective, and radical method with low postoperative recurrence and metastasis.

Numerous studies have demonstrated the advantages of anatomic resection. Nonetheless, whether anatomic resection can increase R0 resection rates remains controversial. Consequently, the present study describes an innovative procedure involving the en bloc concept combined with anatomic resection in laparoscopic hepatectomy, which can reduce postoperative recurrence and metastasis.

整体概念联合解剖切除在腹腔镜肝切除术中的应用

Laparoscopic hepatectomy has been reported in many studies, and it is the mainstream method of liver resection. In some particular cases, such as when ...

<meta charset="utf8"></head><body>用于肝再生研究的患者来源肝癌细胞类器官

A Hepatocellular Cancer Patient&#45;Derived Organoid Xenograft Model to Investigate Impact of Liver Regeneration on Tumor Growth

Recurrence poses a notable challenge after hepatocellular carcinoma (HCC) treatment, impacting more than 70% of patients who undergo surgical resection. Recurrence stems from undetected micro-metastasis or de novo cancer, potentially triggered by postsurgical liver regeneration. Prior research employed HCC cell lines in orthotopic models to study the impact of liver regeneration, but their limited validity prompted the need for a more representative model. Here, we introduce a novel approach utilizing patient-derived HCC organoids to investigate the influence of liver regeneration on HCC.
Patient tumor tissues are processed to create tumor organoids, embedded in a three-dimensional basement membrane matrix, and cultured in a liver-specific medium. One million organoids are injected into the right superior lobe (RSL) of immunodeficient mice, confirming macroscopic tumor growth through sonography. The intervention group undergoes resection of the left lateral lobe (LLL) (30% of total liver volume) or additionally, the middle lobe (ML) (65% of total liver volume) to induce liver regeneration within the tumor site. The control group experiences re-laparotomy without liver tissue resection. After 2 weeks, both groups undergo tumor and normal tissue explantation.
In conclusion, this patient-derived HCC organoid model offers a robust platform to investigate the impact of liver regeneration post-cancer resection. Its multi-cellular composition, genetic diversity, and prolonged culture capabilities make it an invaluable tool for studying HCC recurrence mechanisms and potential interventions.

<meta charset="utf8"></head><body>肝细胞癌患者来源的类器官异种移植模型，用于研究肝脏再生对肿瘤生长的影响

Organoids generated from patient tumors are orthotopically injected into the mouse liver. The resection of non-tumorous liver tissue leads to a regenerative environment in the liver tissue where the tumor is located.

肝细胞癌患者来源的类器官异种移植模型，用于研究肝脏再生对肿瘤生长的影响

Recurrence poses a notable challenge after hepatocellular carcinoma (HCC) treatment, impacting more than 70% of patients who undergo surgical resection. ...

Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience

Laparoscopic anterior right hepatectomy (LARH) has been used in some hospitals. However, data on the feasibility and safety of this procedure are still limited, due to the demanding technical requirements. The primary objective of this study was to compare the clinical outcomes of LARH with those of laparoscopic conventional right hepatectomy (LCRH) in patients with large right hepatocellular carcinoma, as well as to confirm the safety and feasibility of LARH. Furthermore, the article presents a step-by-step description of the surgical procedures for LARH to help perform this surgery in the clinic. The principle of LARH is to first prioritize the hepatic inlet duct separation while separating the right hepatic perihepatic ligament after transecting the liver. From December 2015 to June 2022, 82 patients with large right hepatocellular carcinoma (maximum tumor diameter &#8805; 5 cm), were recruited for the study. In this cohort, 54 and 28 patients underwent LARH and LCRH, respectively. The perioperative clinical data and survival outcomes of the two groups were compared. Compared with LCRH, LARH exhibited the advantages of less contact and extrusion, thereby leading to the achievement of superior results. Thus, we propose that LARH is the optimal choice for patients with large right hepatocellular carcinoma.

Here we present a step-by-step protocol for conducting laparoscopic anterior right hepatectomy and compare its clinical effects and postoperative outcomes with those of conventional hepatectomies. Analysis of the data of 82 patients with hepatocellular carcinoma revealed that laparoscopic anterior right hepatectomy had better clinical outcomes and survival rates than the conventional hepatectomy.

腹腔镜右前肝切除术:单中心体验

Laparoscopic anterior right hepatectomy (LARH) has been used in some hospitals. However, data on the feasibility and safety of this procedure are still ...

行为学

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Procedure

Recent clinical data support an aggressive surgical approach to both primary and metastatic liver tumors. For some indications, like colorectal liver metastases, the amount of liver tissue left behind after liver resection has become the main limiting factor of resectability of large or multiple liver tumors. A minimal amount of functional tissue is required to avoid the severe complication of post-hepatectomy liver failure, which has high morbidity and mortality. Inducing liver growth of the prospective remnant prior to resection has become more established in liver surgery, either in the form of portal vein embolization by interventional radiologists or in the form of portal vein ligation several weeks prior to resection. Recently, it was shown that liver regeneration is more extensive and rapid, when the parenchymal transection is added to portal vein ligation in a first stage and then, after only one week of waiting, resection performed in a second stage (Associating Liver Partition and Portal vein ligation for Staged hepatectomy = ALPPS). ALPPS has rapidly become popular across the world, but has been criticized for its high perioperative mortality. The mechanism of accelerated and extensive growth induced by this procedure has not been well understood. Animal models have been developed to explore both the physiological and molecular mechanisms of accelerated liver regeneration in ALPPS. This protocol presents a rat model that allows mechanistic exploration of accelerated regeneration.

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy ALPPS Procedure

Inducing rapid liver hypertrophy using Associating Liver Partition and Portal vein ligation for a Staged hepatectomy (ALPPS) has been proposed for resection of borderline resectable liver tumors. This model may elucidate mechanisms involved in rapid hypertrophy and allows testing of drugs that promote or block the acceleration of regeneration.

肝分型与门静脉结扎大鼠分期肝切除 (ALPPS) 手术模型的建立

Recent clinical data support an aggressive surgical approach to both primary and metastatic liver tumors. For some indications, like colorectal liver ...

医学

Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis

Laparoscopic hepatectomy is a common treatment for colorectal cancer liver metastasis. Previously, a sufficient number of functional liver masses had to be maintained during laparoscopic hepatectomy, with a residual liver volume of &gt;40% in cirrhotic patients and &gt;30% in non-cirrhotic patients. The high incidence of complications such as bleeding, bile leakage, or liver failure due to the exposure and difficulty of the resection of specific liver segments such as S2 and S7 reduces the success rate of liver resection. At present, microwave ablation is mainly applied in the treatment of liver metastasis using a percutaneous approach, which makes it difficult to identify hidden parts or small lesions. For some liver segments, the percutaneous puncture of liver segment 7 (S7) is likely to pass through the thoracic cavity, and the percutaneous puncture of liver segment 2 (S2) adjacent to the diaphragm is likely to injure the diaphragm and heart; these issues restrict the application of percutaneous ablation in colorectal cancer liver metastasis. Considering multiple lesions, laparoscopic microwave ablation combined with hepatectomy was performed in this study. The location of the lesions was determined by contrast-enhanced ultrasound under laparoscopy, and small lesions that were difficult to detect before the operation were identified. For the scattered lesions, which had diameters less than 3 cm and were difficult to resect, ablation was adopted to substitute hepatectomy. This technique helped to more explicitly locate the tumors, simplified the operation procedures, reduced the risk of complications such as bleeding and bile leakage, shortened the operation time, accelerated the postoperative recovery, significantly improved the success rate of operation, and enhanced the clinical prognosis of colorectal cancer liver metastasis by surgical resection.

This protocol describes the laparoscopic resection of colorectal cancer liver metastases combined with ultrasound-guided microwave ablation. This technique can safely, effectively, and accurately treat refractory liver metastases &lt;3 cm, reduce postoperative complications, and accelerate the postoperative rehabilitation of patients.

腹腔镜肝切除术联合术中微波消融术在结直肠癌肝转移中的应用

Laparoscopic hepatectomy is a common treatment for colorectal cancer liver metastasis. Previously, a sufficient number of functional liver masses had to ...

Laparoscopic Left Approach Resection of the Caudate Lobe

Laparoscopic caudate lobectomy (LCL) is one of the most challenging types of laparoscopic liver resections. The main difficulty lies in the deep anatomical position of the caudate lobe, which is closely adjacent to the first and second hepatic ports and the inferior vena cava, increasing the risk of major bleeding during surgery. In addition to a thorough understanding of the anatomy of the caudate lobe tumor, comprehensive imaging assessment, and three-dimensional reconstruction, the flexible choice of surgical approach is also key to reducing surgical difficulty and improving safety. We perform laparoscopic caudate lobectomy using a left-sided approach, especially when the tumor is located in the area of the caudate lobe close to the inferior vena cava. This method avoids the step of splitting the liver substance to expose the field of view required by the traditional anterior approach, with the advantages of larger operating space and shorter operation time. At the same time, combined with preoperative three-dimensional reconstruction technology, we have significantly reduced the risk of damaging important blood vessels and increased the success rate of resection of tumors in the caudate lobe.

Here, we present a surgical protocol describing the laparoscopic resection of a tumor situated near the paracaval portion within the caudate lobe, utilizing a left-sided approach.

肝切除肝内肿瘤生长的影响

摘要

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此视频中的章节

缺血再灌注损伤中转移性肝肿瘤的模样

止血装置在腹腔镜肝切除术中的应用

整体概念联合解剖切除在腹腔镜肝切除术中的应用

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