Hepatic Dearterialization for Nonresectable Liver Tumors in Five Dogs and Two Cats

IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES
Michelle T. Nguyen, Chick Weisse, Stacy Kaneko
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Abstract

Introduction

Some massive or nodular liver tumors can make surgical resection dangerous. Transarterial embolization and chemoembolization recently have been evaluated in dogs and cats, but multinodular or diffuse tumors make selective embolization difficult, impractical, and may require multiple anesthetic events. Hepatic dearterialization in humans has been shown to be safe and sometimes successful in promoting temporary tumor regression.

Materials and Methods

Retrospective review of patients with nodular, diffuse, or non-resectable massive liver tumors that underwent transarterial coil embolization of the hepatic artery from the origin of the gastroduodenal artery to the proximal hepatic artery was performed. Data recorded included patient signalment, clinical signs, serum biochemical changes, cross-sectional imaging results, complications, and response to treatment.

Results

Seven patients (five dogs and two cats) underwent transarterial hepatic dearterialization and were included. All patients had increased pretreatment hepatocellular enzyme activities 24 h after surgery. All patients survived to discharge and five were discharged within 24 h after treatment. Two patients experienced mild short-term vomiting and anorexia, one of which required repeat hospitalization. Repeat laboratory testing approximately 6 weeks after treatment indicated decreased ALT and AST activities in 5/6 and 4/5 patients, respectively. Repeat imaging identified tumor regression in 3/4 patients evaluated by computed tomography (CT). Survival time ranged from 50 to 505 days.

Conclusion

Hepatic dearterialization should be further investigated as a palliative management option for multinodular and diffuse liver tumors because it may provide a minimally invasive, safe, and palliative option based on the observation that all patients survived to discharge and tumor regression was noted in three animals.

Abstract Image

5只狗和2只猫不可切除的肝脏肿瘤的肝去动脉化
一些巨大或结节性肝肿瘤可使手术切除危险。经动脉栓塞和化学栓塞最近在狗和猫中进行了评估,但多结节或弥漫性肿瘤使得选择性栓塞困难,不切实际,并且可能需要多次麻醉事件。人类肝脏去动脉化已被证明是安全的,有时在促进肿瘤暂时消退方面是成功的。材料与方法回顾性分析从胃十二指肠动脉起源至肝近端经动脉栓塞肝动脉的结节性、弥漫性或不可切除的巨大肝肿瘤患者。记录的数据包括患者信号、临床体征、血清生化变化、横断面成像结果、并发症和对治疗的反应。结果7例患者(5只狗和2只猫)接受了经动脉肝去动脉化手术。所有患者术后24小时预处理肝细胞酶活性均升高。所有患者均存活至出院,5例在治疗后24 h内出院。2例患者出现轻度短期呕吐和厌食,其中1例需要再次住院。治疗后约6周,重复实验室检测分别显示5/6和4/5患者ALT和AST活性降低。重复成像发现3/4的患者通过计算机断层扫描(CT)评估肿瘤消退。存活时间为50 ~ 505天。结论肝去动脉化术作为多结节性和弥漫性肝肿瘤的一种姑息治疗选择值得进一步研究,因为它可以提供一种微创、安全、姑息治疗的选择,所有患者都存活到出院,并且在3只动物中发现肿瘤消退。
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来源期刊
CiteScore
4.50
自引率
11.50%
发文量
243
审稿时长
22 weeks
期刊介绍: The mission of the Journal of Veterinary Internal Medicine is to advance veterinary medical knowledge and improve the lives of animals by publication of authoritative scientific articles of animal diseases.
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