Rakić, Mislav and Patrlj, Leonardo and Amić, Fedor and Aralica, Gorana and Grgurević, Ivica (2018) Comparison of hepatoprotective effect from ischemia-reperfusion injury of remote ischemic preconditioning of the liver vs local ischemic preconditioning of the liver during human liver resections. International Journal of Surgery, 54 (Pt A). pp. 248-253. ISSN 1743-9191
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Abstract
AIM: To compare and evaluate the hepatoprotective effect of remote ischemic preconditioning (RIPC) with local ischemic preconditioning (LIPC) of the liver during human liver resections. ----- METHODS: A prospective, single-centre, randomised control trial was conducted in the Clinical Hospital "***" from April 2017 to January 2018. A total of 60 patients, who underwent liver resection due to colorectal cancer liver metastasis, were randomised to one of three study arms: 1) a RIPC group, 2) an LIPC group and 3) a control group (CG) in which no ischemic preconditioning was done before liver resection. The hepatoprotective effect was evaluated by comparing serum transaminase levels, bilirubin levels, albumin, and protein levels, coagulograms and through pathohistological analysis. The trial was registered on ClinicalTrials.gov (NCT****). ----- RESULTS: Significant differences were found in serum levels of liver transaminases and bilirubin levels between the groups, the highest level in the CG and the lowest level in the LIPC group. Levels of cholinesterase were also significantly higher in the LIPC group. Pathohistological findings graded by the Rodriguez score showed favourable changes in the LIPC and RIPC groups versus the CG. ----- CONCLUSION: Strong evidence supports the hepatoprotective effect of RIPC and LIPC preconditioning from an ischemia-reperfusion injury of the liver. Better synthetic liver function preservation in these two groups supports this conclusion.
| Item Type: | Article | ||||||||||||
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| MeSH: | Aged ; Bilirubin/blood ; Cholinesterases/blood ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Female ; Hepatectomy/adverse effects ; Hepatectomy/methods ; Humans ; Ischemic Preconditioning/methods ; Liver/blood supply ; Liver/pathology ; Liver Neoplasms/blood ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Prospective Studies ; Reperfusion Injury/etiology ; Reperfusion Injury/prevention & control ; Serum Albumin/analysis ; Transaminases/blood | ||||||||||||
| Departments: | Katedra za kirurgiju | ||||||||||||
| Depositing User: | Kristina Berketa | ||||||||||||
| Status: | Published | ||||||||||||
| Creators: |
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| Date: | June 2018 | ||||||||||||
| Date Deposited: | 01 Oct 2019 11:29 | ||||||||||||
| Last Modified: | 01 Oct 2019 11:29 | ||||||||||||
| Subjects: | / | ||||||||||||
| Related URLs: | |||||||||||||
| URI: | http://medlib.mef.hr/id/eprint/3419 |
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