Splenic artery ligation for severe oxaliplatin induced portal hypertension: A way to improve postoperative course and allow adjuvant chemotherapy for colorectal liver metastases.: Letter to editor: Comment about 'nodular regenerative hyperplasia (NRH) complicating oxaliplatin chemotherapy in patients undergoing resection of colorectal liver metastases'

摘要

We have read with interest the article entitled "Nodular regenerative hyperplasia (NRH) complicating oxaliplatin chemotherapy in patients undergoing resection of colo-rectal liver metastases" by Morris-Stiff et al. which was published "online first" in European Journal of surgical oncology in December 2013. In this study, the authors have explored the impact of NRH on post-operative outcome, in patients undergoing resection of colorectal liver metastases. Among the spectrum of chemotherapy-induced liver toxicity and more precisely among microvascular lesions induced by chemotherapy, NRH is defined as the presence of regenerative nodules with expanded liver cell plates not limited by fibrosis but by small atrophic hepatocytes. Increased portal blood flow in the non obstructed sinusoids leads to a regenerative response whereas the poorly supplied acini become hypotrophic.