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Study objective The main objective of this study is to test the feasibility of the local anesthetic (LA) Mepivacaine 1% and sedation with Remifentanil as the primary anesthetic technique for the insertion of a peritoneal dialysis (PD) catheter, without the need to convert to general anesthesia. Methods We analyzed 27 consecutive end-stage renal disease (ESRD) patients who underwent the placement of a peritoneal catheter at our center between March 2015 and January 2019. The procedures were all performed by a general or vascular surgeon, and the postoperative care and follow-up were all conducted by the same peritoneal dialysis team. Results All of the 27 subjects successfully underwent the procedure without the need of conversion to general anesthesia. The catheter was deemed prone to usage in all patients and was found to be leak-proof in 100% of the patients. Conclusion This study describes a safe and successful approach for insertion of a PD catheter by combined infiltration of the local anesthetic Mepivacaine 1% and sedation with Remifentanil. Hereby, ESRD patients can be treated without general anesthesia, while ensuring functionality of the PD catheter.

Several rodent models for hepatic resection to investigate liver regeneration and repair after liver injury, as well as cell cycle dynamics, have so far been established.1–4 The availability of multiple strains of genetically engineered mice has shifted the focus from the rat toward the murine model.2 In 1931, Higgins and Anderson5 described the classic rodent model for hepatic regeneration in rats in which 2 of 4 liver lobes, about two-thirds of the rat liver, were removed. This approach, however, is not feasible in mice since the rat liver is composed of 4 lobes, whereas the murine liver contains 7 lobes.6,7 Liver resection in mice is technically more demanding than resections in rats because of liver size, tissue texture and the lack of invasive monitoring.6 Presently, extended hepatic resections in mice are generally not yet performed in a standardized fashion, and therefore such studies in mice are systematically biased. The real extent of resection with removal of functioning parenchyma is of importance because of a different regeneration stimulus and potency of the remaining liver.2,4 Nevertheless, numerous groups1,8–10 conducting murine studies still use modifications of the technique originally described by Higgins and Anderson for rats, meaning the resection of the 2 left lateral lobes of the liver, thus mistakenly implying the same amount of resected tissue as in rats. We conducted the present study to investigate the effect of different liver resection models on liver damage and regeneration parameters in mice and help establish a safe, reproducible and extended hepatectomy (70% liver weight). This facilitates standardized regeneration analysis. Furthermore, Sato and colleagues11 showed the importance of the mitogenic growth factors FGF-2 and VEGF, in hepatic regeneration.

We investigated the therapeutic efficiency of sulfonate-modified polyvinyl alcohol beads loaded with doxorubicin, irinotecan or mitoxantrone in vitro and in vivo in a model of experimental peritoneal carcinomatosis (PC). In vitro, cell proliferation was efficiently impaired by doxorubicin drug eluting bead (DEB) treatment while mitoxantrone DEBs were less effective than. Irinotecan showed little effect for both DEBs and free drug. Apoptosis was not different between free mitoxantrone and the DEB form while more apoptosis induction was observed in cells incubated with free doxorubicin and irinotecan. Experimental PC was produced in mice. The therapeutic efficiency of either mitoxantrone and doxorubicin DEB or free drugs were compared. Mice were treated either once on day 12 or by 3 repetitive applications on days 7, 10 and 12. Mice treated by DEBs showed less weight loss and mortality. Therapeutic effect was determined by measuring tumor volume and tumor load on the day 15 after tumor inoculation. For the single application on the day 12, an advantage could be observed for the free drugs. After 3 repeated injections of both free and mitoxantrone DEB no difference in tumor load or tumor volume could be observed. Least tumor load and tumor volume was observed in mice that received 3 repeated injections of doxorubicin DEB. No animal survived 3 injections of free doxorubicin. We conclude that bead encapsulation of chemotherapeutic drugs may show the advantage of less toxicity in peritoneal spread of colorectal cancer.