ABSTRACT
PURPOSE: The purpose of this study was to evaluate whether antioxidant preconditioning with Deferoxamine can attenuate liver ischemia reperfusion injury associated with extended hepatectomy in swine. METHODS: Eighteen swine were randomly assigned to two groups: Deferoxamine (DFO) and Surgery Only (SO). The animals in both groups were subjected to laparotomy, prolonged temporary occlusion of the right and middle hepatic pedicles and subsequent left hepatectomy. The DFO group received IV deferoxamine prior to induction of liver ischemia. Monitoring was performed for 6 h and samples (Protein carbonyls, Thiobarbituric acid reactive substances, Histology, ALT, AST, Lactic acid and WBC) were drawn at 0, 60 and 360 min. RESULTS: Protein carbonyls and Thiobarbituric acid reactive substances had significantly lower concentration and higher reduction rates in serum and liver tissue of the DFO group. The histological examination of liver tissue showed less inflammation and necrosis in the DFO group. Hepatic enzymes and lactic acid measurements showed higher reduction rate in the DFO group by the end of the experiment. CONCLUSIONS: This experimental study documents an early protective effect of deferoxamine administration in major hepatectomies against liver ischemia/reperfusion injury.
Subject(s)
Antioxidants/therapeutic use , Deferoxamine/therapeutic use , Hepatectomy , Postoperative Complications/prevention & control , Premedication , Reperfusion Injury/prevention & control , Animals , Hepatectomy/adverse effects , Hepatectomy/methods , Male , Postoperative Complications/etiology , Random Allocation , Reperfusion Injury/etiology , SwineABSTRACT
The management of abdominal leiomyosarcoma is challenging. Surgical excision is considered the only effective treatment; however, this is associated with considerable morbidity. Robotic surgery has emerged during the past decades and has enhanced the general surgery armamentarium, allowing surgeons to carry out demanding operations in a safe manner. The surgical resection of retroperitoneal leiomyosarcoma (RPLM) can be associated with significant morbidity, which is primarily due to the origin or the close proximity of the tumor with important vascular structures, including the inferior vena cava and tributaries, the duodenum and the ureter. The present case describes the first case of robotic resection of RPLM in a high-volume robotic center. In the present case, a large RPLM was safely removed with respect to oncological principles with the use of the Da Vinci platform.
