MOLECULAR MECHANISMS OF ISCHEMIC-REPERFUSION INJURY DURING LIVER RESECTION FOR COLORECTAL CANCER METASTASES- STUDY PROTOCOL

Marko Gmijović, L. Savić, M. Nestorović, V. Pecić, B. Brankovic, M. Djordjevic, T. Stoimenov, M. Stojanović, M. Radojković, M. Stojanović
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Abstract

Bleeding during liver resection is a significant threat to the clinical outcome. Portal triad occlusion with complete ischemia of the liver flow of hepatoduodenal ligament is a well-documented, safe and useful way to reduce this problem. Although the technique is efficient in limiting blood loss, there is still controversy concerning potential disadvantages and subsequent reperfusion liver injury. A prospective analysis will include at least 30 patients 18-75 years old, who are undergoing liver resection due to metastases of the colorectal carcinoma. After signing the informed consent, the parameters will be analyzed in three phases, pre-, intra- and postoperatively. During surgery (indicated by a surgical/oncological team of doctors not related to our study) liver tissue samples will be taken of the “healthy liver” (not involved in the tumor process) in which after tissue homogenization, analysis of parameters will be done responsible for the development of liver injury. This research will not affect the clinical practice, course and outcome of the treatment in patients who are included. The study may be useful for future patients who will undergo liver resections. The application of modern research methods with scientific validity of statistical processing of data and the use of appropriate literature, significant data will be obtained about the character, i.e. intensity of damage of the liver tissue in patients undergoing liver resections.
结直肠癌转移肝切除术中缺血-再灌注损伤的分子机制研究方案
肝切除术中出血是影响临床预后的重要因素。门静脉三联闭塞与肝十二指肠韧带的肝血流完全缺血是一种有充分证据的、安全有效的方法来减少这个问题。尽管该技术在限制失血量方面是有效的,但其潜在的缺点和随后的再灌注肝损伤仍存在争议。一项前瞻性分析将包括至少30名年龄在18-75岁之间,因结直肠癌转移而接受肝切除术的患者。签署知情同意书后,将分术前、术中、术后三个阶段对参数进行分析。在手术期间(由与我们研究无关的外科/肿瘤医生团队指示),将从“健康肝脏”(不参与肿瘤过程)中提取肝组织样本,在组织均质化后,将进行与肝损伤发展相关的参数分析。本研究不会影响纳入患者的临床实践、疗程和治疗结果。这项研究可能对将来接受肝切除术的患者有用。应用现代研究方法,对数据进行科学有效的统计处理,并使用适当的文献,将获得有关肝切除术患者肝组织损伤强度等特征的有意义的数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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