Comparative study of Nd-YAG laser versus electrocautery for liver metastatic resection in the rat

The thermal, hemostatic and lymphostatic effects of the Nd-YAG laser suggest a benefit in the treatment of multiple liver metastases. The aim of this work was to evaluate experimentally this hypothesis in a comparative study with conventional electrocautery resection of liver metastases. The original animal model was represented by syngeneic BDIX rats inoculated under the liver capsule with 1.5×10⁶ DHD/K12 tumour cells originating from a clone of a 1,2 dimethyl hydrazine induced rat colon cancer. One hundred and ten rats bearing three liver metastases were randomly treated by laser volatilization or electrocautery enucleation. The first group of 60 rats was used as a survival group: the laser treated rats survived significantly longer than rats treated by cautery (49.9 days vs 28.9 days) (mean values;p<0.015). In this group, the temperature elevation during operation at the edge of the treated lesion was found higher in the laser group than in the cautery group (56±4.6°C vs 8±3°C) (mean values±s.d.;p<0.001). Nd-YAG laser was also a faster procedure than cautery resection (21±4.2 s vs 57±6.1 s) (mean values±s.d.;p<0.001). At the time of autopsy, the infection rate with laser was found lower than in the cautery group (p<0.025) while no bile leakage was evident. A peritoneal tumour dissemination with ascites was noted in the majority of dead rats. In the second group of 50 rats, the metastatic recurrence was assessed. At day 7, no metastases were found in the laser treated rats while a mean number of 6.5 was found in the cautery group (p<0.001). At the 15th day, more metastases were present in the cautery group. There was a significant correlation between the total number of metastases and the time of death. Those findings suggest that the Nd-YAG laser destruction of experimental liver metastases by its specific effects on tumour cells delayed the recurrence of metastases when compared to the electrocautery resection, contributing to a longer survival of the laser treated rats.