Remote ischaemic preconditioning on gene expression and circulating proteins after subacute laparoscopic cholecystectomy: randomized clinical trial.

Autor:	Wahlstrøm KL; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark., Balsevicius L; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark., Hansen HF; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark., Kvist M; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark., Burcharth J; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark., Skovsted G; Section of Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Lykkesfeldt J; Section of Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Gögenur I; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Ekeloef S; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.
Jazyk:	angličtina
Zdroj:	BJS open [BJS Open] 2024 Jul 02; Vol. 8 (4).
DOI:	10.1093/bjsopen/zrae067
Abstrakt:	Background: Surgical stress may lead to postsurgical hypercoagulability, endothelial dysfunction and systemic inflammation, which can impact on patient recovery. Remote ischaemic preconditioning is a procedure that activates the body's endogenous defences against ischaemia and reperfusion injury. Studies have suggested that remote ischaemic preconditioning has antithrombotic, antioxidative and anti-inflammatory effects. The hypothesis was that remote ischaemic preconditioning reduces surgery-induced systemic stress response. Method: During a 24-month period (2019-2021), adult patients undergoing subacute laparoscopic cholecystectomy due to acute cholecystitis were randomized to remote ischaemic preconditioning or control. Remote ischaemic preconditioning was performed less than 4 h before surgery on the upper arm. It consisted of four cycles of 5 min ischaemia and 5 min reperfusion. The gene expression of 750 genes involved in inflammatory processes, oxidative stress and endothelial function was investigated preoperatively and 2-4 h after surgery in both groups. In addition, changes in 20 inflammation- and vascular trauma-associated proteins were assessed preoperatively, 2-4 h after surgery and 24 h after surgery. Results: A total of 60 patients were randomized. There were no statistically significant differences in gene expression 2-4 h after surgery between the groups (P > 0.05). Remote ischaemic preconditioning did not affect concentrations of circulating proteins up to 24 h after surgery (P > 0.05). Conclusion: The study did not demonstrate any effect of remote ischaemic preconditioning on expression levels of the chosen genes or in circulating immunological cytokines and vascular trauma-associated proteins up to 24 h after subacute laparoscopic cholecystectomy in patients with acute cholecystitis. (© Crown copyright 2024.)
Databáze:	MEDLINE
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