Long-Term Results of Using of "Cold Plasma" Coagulation in Comparison with Suturing of the Liver


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Abstract

Relevance According to statistics, liver injuries occur with a frequency of 15-29,9% of the cases in peacetime. Postoperative mortality ranges from 4-10% to 39.3%. Quick hemostasis of hepatic vessels is a primary task for the surgeon in any kind of surgery. Innovative method of stopping the bleeding of liver is the use of "non-equilibrium plasma" (a synonym for "cold plasma").
The purpose of the study To make a comparative analysis of morphofunctional changes of liver in long-term period after atypical resection of liver and hemostasis by suturing and cold plasma.
Materials and methods Research was performed on 25 laboratory rats. There are 3 experimental groups: 5 intact animals (control group) and 5 animals in each group after liver resection and suturing and liver resection and cold plasma coagulation. Material for research was taken on the 90th and 180th day after surgery. Surgery is resection of liver left lobe, suturing or cold plasma coagulation. The biochemical control (glucose, ALT, AST, thymol test, total bilirubin, direct bilirubin, alkaline phosphatase, total protein, urea, α-amylase, CRP, fibrinogen, aPTT, PTT, INR), morphological study of rat liver were performed.
Results and their discussion Analysis of biochemical markers reveals a slight fluctuation of total protein and glucose in experimental groups relatively the control group. The most significant tendency is observed in plasma group. Analysis of morphological markers reveals, that full restoration of the liver structure is observed in plasma group on the 180th day. In suturing group destructive changes remain. This indicates that pathological effects caused by the suturing were considerably higher than the effects produced by the action of cold plasma.
Conclusion Cold plasma hemostasis leads to fast bleeding control. In this case reparation of morphological picture of the liver and restoration of the internal blood flow occur on 180-th day. Suturing of liver parenchyma leads to dystrophic and necrotic changes of hepatocytes, as well as morphological signs of microvascular thrombosis and perivascular fibrosis that remain up to 180-th day.

About the authors

Siberian State Medical University, 2 Moskovskii path, Tomsk, 634050, Russian Federation

Author for correspondence.
Email: EVSemichev@yandex.ru
Ph.D., Staff of Central Scientific Research Laboratory of State Budget Educational Institution Higher Vocational Education Siberian State Medical University, Doctoral Candidate of Chair of Hospital Surgery of the same University

Siberian State Medical University, 2 Moskovskii path, Tomsk, 634050, Russian Federation

Email: admin@vestnik-surgery.com
MD, Prof., Head of Central Scientific Research Laboratory of State Budget Educational Institution Higher Vocational Education Siberian State Medical University

Siberian State Medical University, 2 Moskovskii path, Tomsk, 634050, Russian Federation

Email: admin@vestnik-surgery.com
Clinical Ordinator of Chair of Surgical Diseases, Faculty of Pediatrics of State Budget Educational Institution Higher Vocational Education Siberian State Medical University

Siberian State Medical University, 2 Moskovskii path, Tomsk, 634050, Russian Federation

Email: admin@vestnik-surgery.com
senior research assistant, Ph.D., Asssistant Prof. of Chair of the morphology and general pathology of State Budget Educational Institution Higher Vocational Education Siberian State Medical University

Siberian State Medical University, 2 Moskovskii path, Tomsk, 634050, Russian Federation

Email: admin@vestnik-surgery.com
MD, Prof., Corresponding Member of RAMS, Head of Chair of Hospital Surgery of State Budget Educational Institution Higher Vocational Education Siberian State Medical University

Siberian State Medical University, 2 Moskovskii path, Tomsk, 634050, Russian Federation

Email: admin@vestnik-surgery.com
Ph.D., doctor-laboratory assistant of Hospital clinics behalf of the A.G Savinykh of State Budget Educational Institution Higher Vocational Education Siberian State Medical University

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