Ischemic preconditioning versus intermittent vascular occlusion in liver resections performed under selective vascular exclusion: a prospective randomized study
| Autor: | Panagiotis Dimakakos, John Vassiliou, Nikolaos Arkadopoulos, Georgios P. Fragulidis, Agathi Condi-Pafiti, Vassilios Smyrniotis, Dionysios Voros, Kassiani Theodoraki, Matrona Plemenou-Fragou |
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| Rok vydání: | 2006 |
| Předmět: |
Time Factors
Randomization medicine.medical_treatment Ischemia Aspartate transaminase Apoptosis Postoperative Hemorrhage Vascular occlusion Hepatic Artery Liver Function Tests Occlusion medicine Hepatectomy Humans Aspartate Aminotransferases Prospective Studies Ischemic Preconditioning biology business.industry Liver Neoplasms General Medicine medicine.disease Constriction medicine.anatomical_structure Liver Reperfusion Injury Anesthesia biology.protein Ischemic preconditioning Surgery medicine.symptom business Blood vessel |
| Zdroj: | The American Journal of Surgery. 192:669-674 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2006.02.019 |
| Popis: | The aim of this study was to compare ischemic preconditioning with the intermittent vascular occlusion technique in liver resections performed under inflow and outflow occlusion.Fifty-four patients with resectable liver tumors assigned were randomly to undergo surgery with either ischemic preconditioning (IP group, n = 27) or with intermittent vascular occlusion (IVO group, n = 27). Both groups were compared regarding surgical parameters, aspartate transaminase levels, and apoptosis.For warm ischemic time less than 40 minutes, no significant difference was noticed between the 2 groups apart from caspase-3 activity, which was higher in the IVO group than in the IP group (17.2 +/- 3.4 vs. 10.3 +/- 5.2, P.05). When warm ischemia exceeded 40 minutes, the IP group showed higher levels in blood aspartate transaminase levels on day 3 (442 +/- 178 IU/L vs. 305 +/- 104 IU/L, P.05) and higher caspase-3 levels (26.5 +/- 5.7 count/high-power field [hpf] vs. 20.7 +/- 3.6 count/hpf, P.05) and apoptotic activity (28.5 +/- 7.5 count/hpf vs. 20.2 +/- 4.1 count/hpf, P.05), as compared with the IVO group.Although both techniques showed comparable efficacy for short ischemic times, intermittent vascular occlusion provided better cytoprotection when ischemia exceeded 40 minutes. |
| Databáze: | OpenAIRE |
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