Systematic review of randomized controlled trials of pharmacological interventions to reduce ischaemia-reperfusion injury in elective liver resection with vascular occlusion

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dc.contributor.authorAbu-Amara, M.en
dc.contributor.authorGurusamy, K.en
dc.contributor.authorHori, S.en
dc.contributor.authorGlantzounis, G.en
dc.contributor.authorFuller, B.en
dc.contributor.authorDavidson, B. R.en
dc.date.accessioned2015-11-24T19:43:21Z
dc.date.available2015-11-24T19:43:21Z
dc.identifier.issn1477-2574-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/24747
dc.rightsDefault Licence-
dc.subjectBiological Markers/blooden
dc.subjectBlood Loss, Surgical/*prevention & controlen
dc.subjectBlood Transfusionen
dc.subjectConstrictionen
dc.subjectEvidence-Based Medicineen
dc.subjectHepatectomy/*adverse effects/mortalityen
dc.subjectHumansen
dc.subjectLength of Stayen
dc.subjectLiver Failure/diagnosis/etiology/mortality/*prevention & controlen
dc.subjectPatient Selectionen
dc.subjectProtective Agents/adverse effects/*therapeutic useen
dc.subjectRandomized Controlled Trials as Topicen
dc.subjectReperfusion Injury/diagnosis/etiology/mortality/*prevention & controlen
dc.subjectRisk Assessmenten
dc.subjectSurgical Procedures, Electiveen
dc.subjectTime Factorsen
dc.subjectTreatment Outcomeen
dc.titleSystematic review of randomized controlled trials of pharmacological interventions to reduce ischaemia-reperfusion injury in elective liver resection with vascular occlusionen
heal.abstractBACKGROUND: 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.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1111/j.1477-2574.2009.00120.x-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/20495639-
heal.identifier.secondaryhttp://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-
heal.journalNameHPB (Oxford)en
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2010-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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