The Effect of Trimetazidine on Diathermy-related Thermic Injury of the Rat Liver.

Background/aim: Owing to new oncotherapy modalities, the importance of an R0 resection decreased in the last decade; however, liver metastasis of colorectal cancer significantly decreases survival. Furthermore, to prevent cardiovascular disease, more and more patients are treated with anti-ischemic drugs, which may influence oncologic treatments in such patients. This study aimed to examine the effect of Trimetazidine on liver surface injury after spray diathermy.

Materials And Methods: We performed standard liver resections with resection-margin spray coagulation in 36 rats on both liver lobes. In all procedures, a Pringle maneuver was performed on the right lobe, while on the left lobe, no vessel occlusion was applied. Half of the animals were on Trimetazidine therapy. In 12 animals, histologic samples were taken immediately after operation, while 12 animals were terminated 1 week later, and the remaining 12 animals 3 weeks later. After standard HE staining, histologic analysis was performed.

Results: When diathermy was used, a coagulation zone appeared. Destruction was slightly wider in case of Trimetazidine therapy (745.75 vs. 680.04 μm). In cases of 1-week-surviving animals, a necrotic zone was observed under the coagulated tissue, and a fibrotic zone appeared after 3 weeks. In TMZ medicated animals, the destruction zone was significantly thinner (645.08 vs. 893.76 μm; p<0.001) and the necrosis zone showed the same difference (2,430.05 vs. 3,238.45 μm; p<0.001).

Conclusion: Administration of Trimetazidine can reduce the extent of thermic necrosis. Furthermore, a great effort should be applied to achieve R0 resection in patients on anti-ischemic therapy.