P Rossi

Bloodless hepatic resection with automatic bipolar radiofrequency generator and multielectrode device

Liver resection is a standard treatment for liver tumours. Intra‐operative blood loss remains a major concern during liver resection due to its association with higher postoperative complications and shorter long‐term survival. To perform bloodless hepatic resection we realized an apparatus consisting of an incremental, bipolar radiofrequency generator and a probe with six in‐line needles (SURTRON SB). Several ex‐vivo and in‐vivo pig liver experiments and a first‐phase clinical study allowed the realization of a prototype radiofrequency (RF) generator that works at 470u2005kHz, 150 watts maximum power delivered. The probe consists of six needle electrodes of 1.5u2005mm diameter, with 4.5u2005mm free space, 6.0u2005mm centre to centre, between each. We obtained a coagulation of 35u2005mm length and 12u2005mm width. The transection was performed with a common scalpel after coagulation of liver parenchyma. We observed good healing of the liver edge both in animal model and in ongoing pilot clinical study. Coagulation with SURTRON SB allows a feasible, easy and safe bloodless liver resection. This method is tolerated with no systemic complication or adverse reaction. This technique offers a method for a bloodless hepatic transection without the need for sutures, ties, staples or tissue glue.

HLA‐DRB1*13:01 allele in the genetic susceptibility to colorectal carcinoma

Increasing evidence suggests that HLA‐DRB1 alleles reduce or increase the risk of developing ulcerative colitis‐associated colorectal carcinoma (CRC) tumors. However, the role of HLA‐DRB1 locus on the susceptibility to develop CRC tumor, in the absence of a history of inflammatory bowel diseases (IBDs), is unclear. The aim of our study was to determine whether HLA‐DRB1 alleles are associated with IBD‐independent CRC tumor. HLA‐DRB1 allele polymorphisms were identified by sequence‐based typing method in 53 CRC patients and 57 sex‐ and age‐matched healthy Caucasian controls. Pearsons chi‐squared analysis with Yates correction or Fishers exact test with Bonferronis correction, as appropriate, were used to compare the allele frequency (AF) differences of HLA‐DRB1 in patients and controls. A total of 29 HLA‐DRB1 alleles were recognized. A detailed study of these alleles allowed to identify DRB1*13:01 and DRB1*11:01 alleles that were significantly associated with an increased and reduced risk to develop CRC tumor, respectively. AF of DRB1*13:01, in CRC patients, was significantly higher than that of healthy controls, even following Bonferronis correction (pu2009=u20090.029). In contrast, the presence of the DRB1*11:01 allele was negatively associated with CRC tumor as evidenced by the significantly lower AF in CRC patients than that of healthy controls (pu2009=u20090.005). However, following Bonferronis correction, the AF of DRB*11:01 lost its statistical significance. These results suggest that HLA‐DRB1*13:01 allele could be a potential marker for predicting genetic susceptibility to CRC tumor. In contrast, the protective role of DRB1*11:01 remains unclear.