Systematic review of randomized controlled trials of pharmacological interventions to reduce ischaemia-reperfusion injury in elective liver resection with vascular occlusion
Φόρτωση...
Ημερομηνία
Συγγραφείς
Abu-Amara, M.
Gurusamy, K.
Hori, S.
Glantzounis, G.
Fuller, B.
Davidson, B. R.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
HPB (Oxford)
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
BACKGROUND: Vascular occlusion during liver resection results in ischaemia-reperfusion (IR) injury, which can lead to liver dysfunction. We performed a systematic review and meta-analysis to assess the benefits and harms of using various pharmacological agents to decrease IR injury during liver resection with vascular occlusion. METHODS: Randomized clinical trials (RCTs) evaluating pharmacological agents in liver resections conducted under vascular occlusion were identified. Two independent reviewers extracted data on population characteristics and risk of bias in the trials, and on outcomes such as postoperative morbidity, hospital stay and liver function. RESULTS: A total of 18 RCTs evaluating 17 different pharmacological interventions were identified. There was no significant difference in perioperative mortality, liver failure or postoperative morbidity between the intervention and control groups in any of the comparisons. A significant improvement in liver function was seen with methylprednisolone use. Hospital and intensive therapy unit stay were significantly shortened with trimetazidine and vitamin E use, respectively. Markers of liver parenchymal injury were significantly lower in the methylprednisolone, trimetazidine, dextrose and ulinastatin groups compared with their respective controls (placebo or no intervention). DISCUSSION: Methylprednisolone, trimetazidine, dextrose and ulinastatin may have protective roles against IR injury in liver resection. However, based on the current evidence, they cannot be recommended for routine use and their application should be restricted to RCTs.
Περιγραφή
Λέξεις-κλειδιά
Biological Markers/blood, Blood Loss, Surgical/*prevention & control, Blood Transfusion, Constriction, Evidence-Based Medicine, Hepatectomy/*adverse effects/mortality, Humans, Length of Stay, Liver Failure/diagnosis/etiology/mortality/*prevention & control, Patient Selection, Protective Agents/adverse effects/*therapeutic use, Randomized Controlled Trials as Topic, Reperfusion Injury/diagnosis/etiology/mortality/*prevention & control, Risk Assessment, Surgical Procedures, Elective, Time Factors, Treatment Outcome
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/20495639
http://onlinelibrary.wiley.com/store/10.1111/j.1477-2574.2009.00120.x/asset/j.1477-2574.2009.00120.x.pdf?v=1&t=h0nqk5b2&s=35ebc1af9d083afb8a70dc6a64e4d4b9ed7b065b
http://onlinelibrary.wiley.com/store/10.1111/j.1477-2574.2009.00120.x/asset/j.1477-2574.2009.00120.x.pdf?v=1&t=h0nqk5b2&s=35ebc1af9d083afb8a70dc6a64e4d4b9ed7b065b
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής