Abstract:
OBJECTIVES:The aim of this study was to determine whether remote ischemic preconditioning (RIPC) protects aged liver against ischemia reperfusion (IR). SUMMARY OF BACKGROUND DATA:The demands for liver surgery in an aging population are growing. Clamping of vessels to prevent blood loss is integral to liver surgery, but the resulting IR injury (IRI) augments postoperative complications. More so, sensitivity to hepatic IRI increases with age; however, no strategies have been developed that specifically protect old liver. RIPC, a novel protective approach, was performed distant to the surgical site. Whether RIPC may also protect old liver from IRI is unknown. METHODS:RIPC to the femoral vascular bundle was compared against direct ischemic preconditioning (IPC) and the standard of care intermittent clamping (IC) using a model of partial hepatic ischemia in mice aged 20 to 24 months. Liver injury was measured 6 hours after reperfusion. Protective signaling (serotonin-Vegf-Il10/Mmp8 axis, Kupffer cell polarization) was assessed immediately after preconditioning. Neutralizing antibody was used to test the role of Vegf. Hepatic vasculature was examined by electron microscopy. RESULTS:RIPC was superior over other strategies in protecting old liver from IRI, with standard IPC approaches being ineffective. RIPC induced the strongest elevations in circulating Vegf, and Vegf inhibition dampened protective signaling and abrogated the protective effects. RIPC was further associated with improvements in vascular functionality. CONCLUSIONS:RIPC is highly effective in protecting old liver from ischemic insults, mainly owing to its ability to induce circulating Vegf. These findings warrant efforts toward clinical translation.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Limani P,Linecker M,Oberkofler CE,Barmettler G,Kaech A,Graf R,Humar B,Clavien PAdoi
10.1097/SLA.0000000000001765subject
Has Abstractpub_date
2016-11-01 00:00:00pages
797-803issue
5eissn
0003-4932issn
1528-1140journal_volume
264pub_type
杂志文章abstract:OBJECTIVES:To assess survival after liver resection and transplantation in patients with hepatocellular carcinoma (HCC) beyond Milan criteria. BACKGROUND:The role of liver resection and transplantation remains controversial for patients with HCC beyond Milan criteria. Resection of advanced tumors and transplantation u...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001866
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Intraductal papillary mucinous neoplasms (IPMNs) are being increasingly recognized, and often harbor cancer. Lymph node metastases are an important prognostic factor for patients with invasive intraductal papillary carcinoma (I-IPMC), but the role of lymph node ratio (LNR) in predicting survival after surg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181cf9155
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the perioperative morbidity and mortality of patients with COVID-19 who undergo urgent and emergent surgery. SUMMARY BACKGROUND DATA:Although COVID-19 infection is usually associated with mild disease, it can lead to severe respiratory complications. Little is known about the perioperative outcom...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000004420
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To determine the incidence of isolated gastrocnemius and soleal vein thrombosis (IGSVT) and the effect of anticoagulation on venous thromboembolism (VTE) events in patients with IGSVT. SUMMARY BACKGROUND DATA:Although IGSVT is diagnosed with increasing frequency, the clinical significance and optimal managem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c1ae95
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:The effects of total parenteral nutrition (TPN) administration on pulmonary macrophage function and host response to gram-negative pulmonary infection were evaluated. SUMMARY BACKGROUND DATA:Administration of TPN resulted in increased infectious complications in traumatized and perioperative patients, but un...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199403000-00009
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:To determine outcome in diabetic pancreas transplant recipients according to risk factors and the surgical techniques and immunosuppressive protocols that evolved during a 33-year period at a single institution. SUMMARY BACKGROUND DATA:Insulin-dependent diabetes mellitus is associated with a high incidence o...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-200104000-00003
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:This study aims to describe recent experience with rectal carcinoids in European and North American centers. BACKGROUND:While considered indolent, the propensity of carcinoids to metastasize can be significant. METHODS:Rectal carcinoid patients were identified from prospective databases maintained at 9 inst...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3181fb8df6
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to perform a systematic review and meta-analysis to assess the accuracy of different surgical axillary staging procedures compared with ALND. SUMMARY OF BACKGROUND DATA:Optimal axillary staging after neoadjuvant systemic therapy (NST) in node-positive breast cancer is an area of con...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000003075
更新日期:2019-03-01 00:00:00
abstract::A prospective randomized trial was conducted comparing the effect of three antibiotics: cefamandole (CM), cefazolin (CZ), and vancomycin (V), used as prophylaxis for prosthetic valve surgery, on the prothrombin (PT) response to warfarin (W) on the third day of anticoagulant therapy. Twenty patients, with normal preope...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198708000-00007
更新日期:1987-08-01 00:00:00
abstract::The postoperative function of "free" jejunal autotransplants for replacement of the pharyngoesophagus after palliative resection was evaluated in nine patients using clinical assessment, cinefluoroscopy, manometry, and electrical studies. After an initial period of adjustment, all patients swallowed solids and liquids...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198010000-00002
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:To review the literature on chest wall resection for recurrent breast cancer and evaluate overall survival (OS) and quality-of-life (QOL) outcomes. BACKGROUND:Full-thickness chest wall resection for recurrent breast cancer is controversial, as historically these recurrences have been thought of as a harbinge...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000002310
更新日期:2018-04-01 00:00:00
abstract::Patients under the age of 40 with colorectal cancer (29 females, 18 males) were compared with similar patients in our general hospital population and analyzed for patterns of presentation, stage at diagnosis, degree of tumor differentiation, and survival. There was a higher incidence of poorly differentiated tumors in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198511000-00013
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term outcome of patients with esophageal cancer after resection of the extraesophageal component of the neoplastic process en bloc with the esophageal tube. SUMMARY BACKGROUND DATA:Opinions are conflicting about the addition of extended resection of locoregional lymph nodes and soft tiss...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200107000-00005
更新日期:2001-07-01 00:00:00
abstract::Resting energy expenditure (REE), nutritional parameters, and substrate levels were measured using a technique to minimize artifacts in 11 control patients, nine patients with localized, and four patients with diffuse neoplastic disease. Patients with diffuse disease had significantly increased percentage preillness w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198403000-00008
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the results of liver resection for patients with bilateral hepatic metastases from colorectal cancer. We aimed to assess the evolution of the technical approach over time and correlations with morbidity, mortality, and oncologic outcome. SUMMARY BACKGROUND DATA:Although...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181557e47
更新日期:2008-01-01 00:00:00
abstract::In a series of 112 patients who underwent reoperation for primary hyperparathyroidism at the Massachusetts General Hospital between 1930 and 1975, all but 10 were treated successfully. Seventy-five initial explorations had been performed elsewhere, and 37 in our hospital. A total of 110 diseased parathyroids were unco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197708000-00004
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of clinically significant decision conflict (CSDC) among patients undergoing cancer surgery and associations with postoperative physical activity, as measured through smartphone accelerometer data. BACKGROUND:Patients with cancer face challenging treatment decisions, which may lea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004487
更新日期:2020-09-15 00:00:00
abstract::Fibronectin exists in a soluble form in plasma and in an insoluble form in tissues. Plasma fibronectin can modulate phagocytic function as well as incorporate into the tissue matrix where it is believed to influence microvascular integrity and tissue repair. The temporal alterations in plasma and lung lymph fibronecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198508000-00016
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVES:To determine the influence of patient depression (and anxiety) on postoperative outcome and surgeons' consideration of it. BACKGROUND:Patients' mental state influences the course of nonpsychiatric diseases. Evidence in the surgical setting comes mainly from cardiac-surgery patients and no predictive-model o...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001448
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To analyze the feasibility and safety of Natural Orifice Transluminal Endoscopic Surgery (NOTES) appendectomy, and to analyze separately the transvaginal appendectomy (TVAE) and the transgastric appendectomy (TGAE) procedures. BACKGROUND:Laparoscopic appendectomy has rare but relevant complications, namely i...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001742
更新日期:2017-03-01 00:00:00
abstract::Forty-nine patients undergoing elective or emergent gastric surgery have been included in this study. Gastric needle aspiration was performed at the time of surgery in each case, followed by qualitative aerobic and anaerobic bacteriologic analysis. In 18 patients undergoing elective operation for chronic nonobstructin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197511000-00004
更新日期:1975-11-01 00:00:00
abstract::This paper reports the experience of three general surgeons performing 304 laparoscopic cholecystectomies in three private hospitals between October 1989 and November 1990. Laparoscopic cholecystectomy boasts two major advantages over the conventional procedure: the remarkable reduction in postoperative pain and econo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199106000-00017
更新日期:1991-06-01 00:00:00
abstract::In the absence of a prospective randomized study of patients treated conservatively or with thymectomy, a computer-assisted retrospective matches study was devised. Of 563 patients treated for myasthenia gravis without thymoma up to 1965, 104 had thymectomy. With computer assistance, each surgical patient was matched ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197610000-00008
更新日期:1976-10-01 00:00:00
abstract::The costs for elective cholecystectomies were measured 1955, 1965 and 1975. The average length of stay decreased by 25% between 1955 and 1965 and with the same amount between 1965 and 1975. In spite of these marked reductions in the average length of stay there was only a significant decrease in costs between 1955 and...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract::Many advances have occurred in recent years in the diagnosis, localization, and treatment of primary hyperparathyroidism. Several different operative choices for primary hyperparathyroidism also have been proposed--a unilateral approach versus the standard bilateral parathyroid exploration. The unilateral approach is ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199204000-00002
更新日期:1992-04-01 00:00:00
abstract::Spectral analysis was used to examine 257 carotid arteries in 227 patients who had undergone carotid endarterectomy at 1, 3, 6, and 12 months after surgery and annually thereafter. Routine intraoperative completion angiography ensured that the operations were technically satisfactory. Postoperative restenoses were ide...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198407000-00013
更新日期:1984-07-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to investigate whether patients who undergo surgery in hospitals experiencing significant length of stay (LOS) reductions over time are exposed to a higher risk of severe adverse events in the postoperative period. SUMMARY BACKGROUND DATA:Surgical care innovation has encouraged hospi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003206
更新日期:2020-07-01 00:00:00
abstract::A sterile Doppler probe was used for intraoperative monitoring of the integrity of carotid endarterectomy of 125 vessels of 107 patients. Our objective was to reduce the contribution of residual carotid lesions to recurrent stenosis, which was evaluated by Doppler spectrum analysis in the early (less than 3 months, 66...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198606000-00010
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:We sought to quantitate the course of specific cytokine mRNA expression in tissues that exhibit increasing histopathological changes in time in an animal model for the multiple organ dysfunction syndrome (MODS). SUMMARY BACKGROUND DATA:The development of treatment protocols for MODS requires elucidation of t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000130725.52373.e7
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To determine whether glutamine (GLN)-supplemented parenteral nutrition (PN) improves clinical outcomes in surgical intensive care unit (SICU) patients. SUMMARY BACKGROUND DATA:GLN requirements may increase with critical illness. GLN-supplemented PN may improve clinical outcomes in SICU patients. METHODS:A p...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000001487
更新日期:2016-04-01 00:00:00