Pringle maneuver induces hepatic metastasis by stimulating the tumor vasculature
Ozawa, S.; Akimoto, N.; Tawara, H.; Yamada, M.; Sato, T.; Tashiro, J.; Hosonuma, T.; Ishii, T.; Yamaguchi, S.; Husejima, Y.; Hanawa, M.; Koyama, I.
Hepato-Gastroenterology 58(105): 122-126
2011
ISSN/ISBN: 0172-6390 PMID: 21510298 Document Number: 652515
The Pringle maneuver is traditionally used to avoid hemorrhage during hepatectomy for hepatic metastasis. However, metastasis can occur under ischemic conditions due to some unknown mechanism. An orthotopic model of murine colon cancer was established in syngeneic BALB/c mice. Viable CT-26 cells were implanted into the spleen of these mice. The mice underwent a laparotomy 5 days after the implantation and the hepato-duodenal ligament was clamped for 0 or 10 minutes (Pringle maneuver). The mice were sacrificed 7 days after this maneuver and the number of hepatic metastasis were counted. The mice that underwent the maneuver developed a greater number of hepatic metastasis. An immunohistochemical analysis revealed that the expression of microvessel density, VEGF and KDR/Flk-1 were higher in the hepatic metastasis in the mice treated with the maneuver. In addition, the mice which were treated by the maneuver had a higher level VEGF in the serum. These data suggest that the Pringle maneuver induces hepatic metastasis by stimulating the overexpression of tumor vasculature.