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PLoS One. 2017 Oct 18;12(10):e0185685. doi: 10.1371/journal.pone.0185685. eCollection 2017.

Inflammatory response and oxidative stress during liver resection.

Author information

1
Department of Surgery and Center for Perioperative Medicine, Medical University of Vienna, Vienna, Austria.
2
Section of Transplantation Immunology, Department of Surgery; Medical University of Vienna, Vienna, Austria.
3
Trauma Research Department, St. Anthony Hospital, Lakewood, Colorado, United States of America.
4
Trauma Research Department, Swedish Medical Center, Englewood, Colorado, United States of America.
5
Trauma Research Department, Medical Center of Plano, Plano, Texas, United States of America.
6
AYTU BioScience, Inc., Englewood, Colorado, United States of America.
7
Dept. of Anesthesiology, General Intensive Care and Pain Medicine; Medical University of Vienna, Vienna, Austria.
8
Department of Biomedical Imaging and Image Guided Therapy; Medical University of Vienna, Vienna, Austria.

Abstract

BACKGROUND:

Postoperative complications are still a major concern after liver resection (LR). Systemic inflammation and deregulated reactive oxygen species during major abdominal surgery may impair outcome after hepatectomy.

METHODS:

Patients undergoing LR were included in this study (n = 40). Oxidative stress (OS) was measured peri- and post-operatively as static oxidation-reduction potential markers (sORP) and antioxidant capacity ORP (cORP) by using the RedoxSYS Diagnostic system. Furthermore, Th1- and Th2-specific cytokines were assessed.

RESULTS:

Whereas there was no significant change in systemic sORP during LR and in the early postoperative course, there was a substantial decrease of cORP immediately post-surgery, and on postoperative days 1 and 3 (p<0.001). OS response was tightly regulated, as there was a significant correlation between sORP and cORP (p<0.0001; R2:0.457). An increase of OS (sORP) after LR of more than 3 mV was predictive for severe postoperative complications (53.8% vs. 12.5; p = 0.017). There was a significantly higher IL-2 (p = 0.006) and IL-5 (p = 0.001) increase during hepatectomy in patients who developed a severe morbidity.

CONCLUSION:

Antioxidant capacity remained stable during LR but dropped during the post-surgical period, suggesting a consumption of antioxidants to maintain OS within healthy range. Severe postoperative complications were associated with a pronounced inflammatory response during surgery.

PMID:
29045432
PMCID:
PMC5646773
DOI:
10.1371/journal.pone.0185685
[Indexed for MEDLINE]
Free PMC Article

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