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Title:
Electrochemotherapy with bleomycin of porcine portal vein anostomosis: evaluation of histologcal changes
Authors:
Stupan Urban, University Medical Center
?emažar Maja,
Trotovšek Blaž, University Medical Center
Petri? Miha, University Medical Center
Tomaži? Aleš, University Medical Center
Gašljevi? Gorana,
Rankovi? Branislava,
Seliškar Alenka,
Plavec Tanja,
Sredenšek Jerneja,
Plut Jan,
Štukelj Marina,
Lampreht Tratat Ursa, Institute of Oncology L
Jesenko Tanja, Institute of Oncology Ljubljana
Nemec Svete Alenka,
Serša Gregor, Institute of Oncology Ljubljana
Djoki? Mihajlo, University Medical Center
Abstract:
Electrochemotherapy (ECT) can be used to treat inoperable abdominal malignancies, including pancreatic cancer. In addition, locally advanced pancreatic cancer frequently invades portal vein that needs to be resected and thus anastomosed. To evaluated potential use of electrochemotherapy for treatment of tumors bed including anastomosis following pancreatic surgery, the aim of our study was to demonstrate that electrochemotherapy of portal anastomosis is safe and feasible. In the study, 12 pigs were treated either with electroporation only (control group) or
they were treated with ECT with bleomycin and euthanised at different time points (7, 14, and 28 days) to characterize histological changes of the treated blood vessels. During surgical procedure, the portal vein and lienal vein were transected and anastomosed. ECT was performed on the portal vein anastomosis and inferior vena cava. Histological examination of the specimens, showed
vascular smooth muscle cell loss, endotheliitis and external vasa vasorum thrombosis in the treated veins. Organisation of fibrosis in the tunica media and regeneration of the endothelium were evident on days 14 and 28 after treatment. No clear differences were observed between the samples from control group and the samples from ECT treated groups. Thus, electroporation caused irreversible damage to the VSMC in the tunica media, which could be due to the narrow irreversible electroporation zone that may occur near the electrodes or to vasa vasorum thrombosis in the tunica externa. Due to the absence of vascular complications and similar histological changes in portal vein anastomosis, we can conclude that ECT is safe and feasible in portal vein anastomosis. Thus, ECT could be safely evaluated as an adjuvant treatment in order to reduce local recidives.
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