Impact of electrocautery and hyperthermic intraperitoneal chemotherapy on intestinal microvasculature in a murine model

Abstract

Background: Electrocautery (EC) is used during cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Using a murine model, we studied the effect of HIPEC on small bowel EC lesions and surrounding normal tissues. Methods: Thirty-two rats were divided into five groups: a control group with EC lesions; EC plus intraperitoneal heated 5% dextrose (D5W); EC plus oxaliplatin (OXA, 460 mg/m²); EC plus mitomycin C 10 mg/m² (MMC10); EC plus MMC 35 mg/m² (MMC35). EC lesions and surrounding tissue microvasculature were analysed after intravenous injection of fluorescein. Results: In the ileum OXA significantly reduced EC lesions microvasculature compared with the control group; MMC10 caused greater reduction than the control, D5W and MMC35 groups. Surrounding tissue microvasculature was significantly reduced by MMC35 exposure when compared to the control, OXA or MMC10 groups. In the jejunum EC injuries exposed to OXA or MMC10 had significantly reduced microvasculature compared to the control, heated D5W and MMC35 groups. Surrounding tissue microvasculature was significantly reduced by MMC35 exposure when compared to the OXA group. There was no significant microvasculature difference between the EC lesions made before or after HIPEC. Conclusion: HIPEC with OXA and MMC10 potentiates small bowel wall EC injuries. MMC35 reduces surrounding unharmed tissue microvasculature. There was no effect of hyperthermia alone on microvasculature.

Keywords:

• HIPEC
• carcinomatosis
• microvasculature
• oxaliplatin
• mitomycin

Acknowledgements

J.S.T., L.S. and P.Du. took part in the overall design of the study. J.S.T. wrote the first draft of the manuscript and conducted the experiments. J.F.T. participated in the experimental set-up. P.Dr. conducted the statistical analyses. L.L., J.F.T., L.S. and P.Du. critically revised the manuscript. All authors have read and approved the final version of the manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.