Comparison of muscle tissue oxygenation response curves to two time-based vascular occlusion tests: evidence of diminishing returns?
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Dynamic testing of muscle tissue oxygenation (StO2) with near-infrared spectroscopy and vascular occlusion (VOT) has been used to study pathophysiological states, but there is a paucity of data for standardised techniques in normal subjects. Three-minute VOT is frequently described. We have collected StO2 data for this technique and compared them with a shorter 2-minute test.Keywords:
Vascular occlusion
Gastroduodenal artery
Vascular occlusion
Celiac artery
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Objective To investigate the intra-and postoperative course of patients undergoing laparoscopic liver resections under intermittent total pedicle occlusion (IPO),hemihepatic vascular occlusion (HVO),and selective vascular occlusion(SVO).Methods Retrospective analysis the data of 41 cases of laparoscopic liver resection were conducted in three groups of patients under different occlusion methods,including 15 cases of intermittent total pedicle occlusion (IPO),12 cases of hemihepatic vascular occlusion (HVO) and 14 cases of selective vascular occlusion (SVO).Intraoperation blood loss,operation time,conversion to open operation,changes in postoperative liver function,hospital stays and complications were compared among the three methods.Results There was no operative death in any of the 41 patients.There was no conversion to open surgery.Generally,there was no significant difference among the three groups in blood loss,clamping time or operative time.Ten patients had postoperative complication and all were cured.The effect on liver function for Gro-HVO and Gro-SVO was significantly less severe than that for Gro-IPO (P ＜ 0.05) after operation.Conclusions Both HVO and SVO are feasible and safe in laparoscopic hepatectomy(LH),and have advantage in reducing liver remnant ischemia injury and modality rate over IPO.HVO is easy to do for left lateral lobe or resection of the left half of the liver.SVO is suitable for right lobe resection.
Key words:
Laparoscopic ; Hepatotectomy ; Blood flow occlusion ; Liver neoplasms
Vascular occlusion
Liver function
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Objective To study the application and efficacy of hemihepatie vascular occlusion in HCC resection. Methods 90 ca-ses of HCC patients were roiled in and divided into two groups. Liver resection was performed with Pringle maneuver or hemihepatic vascular occhusion. Ischemia time, operative time, blood loss, postoperative liver function, the occurrence of complications and the recovery of gastro-intestinal function were recorded. The efficacy of the two occlusions was compared. Results There is no significant difference between hemibepatic vascular occlusion and Pringle maneuver in ischemia time, operative time, blood loss (P>0.05). However, there is signifi-cant difference in postoperative liver function, the occurrence of complications and intestinal function recovery time. The former is significant-ly superior to the latter (P<0.05). Conclusions The bemihepatic vascular occlusion and Pringle maneuver occlusion have no difference in ischemia time, operative time and blood loss. But bemihepatic vascular occlusion has less impact on liver function, lower rate of occur-rence of complications and faster recovery speed. Therefore, hemibepatie vascular occlusion is better than Pfingle maneuver occlusion in be-parle inflow occlusion in HCC surgery.
Key words:
Liver neoplasms/SU; Hepatectomy/MT
Vascular occlusion
Liver function
Liver Cancer
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Retinal vein occlusion is a disease that causes vision disorder due to occlusion of the retinal vein which is one kind of micro-vascular spreading to the fundus. Most of the current treatments are aimed at suppressing symptoms caused by vascular occlusion. In this study, we focused on the impact pressure of micro-jet generated by the collapse of the electrical-induced bubbles. This pressure can be worked as local and minimally invasive physical stimuli from the outside of the blood vessel to resolve the vascular occlusion itself. The electrical evaluation for electrical-induced bubbles was carried out to establish a new treatment method for retinal vein occlusion targeting vascular occlusion.
Vascular occlusion
Retinal Vein
Fundus (uterus)
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Objective To compare the clinical results between hepatectomy with vascular occlusion and using Tissue-Link Cusa without vascular occlusion in the treatment of hepatocellular carcinoma(HCC). Methods From January 2003 to September 2006, 105 patients of HCC underwent hepatectomy with vascular occlusion (control group,n =50) and using TissueLing Cusa without vascular occlusion (non-occlusion group,n=55)were analyzed rerto-spectively. Results Compared with control group, the incisional margin were significantly wider in non-occlusion group [(1.1±0.3) cm vs. (0.7 ±0.5)cm, P 0.05], both the edge positive rate and local recurrence rate were significantly lower than that non-occlusion group (0% vs. 4%, P0.05; 0% vs. 6%, P0.05), but no significant difference were seen in the out of incional margin recurrence rate (13% vs. 14%, P= 0.112). The duration of hepatectomy was significantly longer in non-occlusion group than in control group. However,in the amount of operative bleeding were significantly lower in non-occlusion group. Serum total bilirubin levels on 7th day after operation, and the supplement of albumin were significantly lower in non-occlusion group than in control group. Whereas, there were no significant differences in 1-, 2-, and 3-year tumor-free survival rates (90.9% 、87.3% and 80.0% vs. 90.0% 、 74.0% and 66.0% respectively,between the two groups (P=0.134). Conclusion Heppatectomy with Tissue-Link and cusa non occlusion technigue is superior to the hilar occlusion method in the curative effects for the treatment of hepato-cellular carcinoma. It has a clear operative field, less operative bleeding, few damage of liver funetion and a lower cancer residual rate of incisional margin and recurrence rate.
Vascular occlusion
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Objective To review the advances in techniques of hepatic blood occlusion in hepatectomy.Methods The related literatures were reviewed and analysed.Results There were many techniques of hepatic blood occlusion.The most frequently used and studied techniques were hemihepatic vascular occlusion and intermittent hepatic inflow occlusion.Hepatic vascular exclusion was employed when hepatic veins and/or vena cava would be damaged.Total vascular exclusion and other techniques were rarely used.Conclusion To reduce blood loss in hepatectomy and make patient safe,based on the situation of the patient,the technique should be ingeniously selected.
Vascular occlusion
Hepatic veins
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Vascular occlusion
Spark plug
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Hepatectomy is still the main method for treatment of liver tumor,and hepatic blood occlusion techniques have been the research focus in the field of hepatobiliary surgery.The related literatures of hepatic blood occlusion was studied and hepatic blood occlusion methods were summarized.There were many hepatic blood occlusion methods,the most frequently used and studied techniques were hemihepatic vascular occlusion and intermittent hepatic inflow occlusion.Selecting suitable hepatic blood occlusion methods based on the situation of the patient can reduce blood loss in hepatectomy and ensure the patient′s safety.
Vascular occlusion
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Objective— To provide a comprehensive review of the experimental and clinical data related to gradual vascular occlusion of congenital portosystemic shunts (CPS) in dogs. Study Design— Literature review. Methods— PubMed literature search (1966–2004). Results— Surgical intervention and complete vascular occlusion have been recommended for CPS therapy in dogs; however, acute complete ligation of CPS is often associated with life‐threatening portal hypertension. Recently, several investigators have attempted to reduce the risk of postoperative portal hypertension by using gradual vascular occlusion. Successful vascular occlusion has been achieved using partial ligation with silk suture, ameroid constrictors, cellophane bands, thrombogenic coils and hydraulic vascular occluders. Objective comparisons of the reliability and rate of vascular occlusion produced by each of these methods have been limited by differences in experimental models and a lack of definitive follow up evaluation in some clinical studies. Conclusions— Gradual vascular occlusion is widely used in the clinical treatment of CPS in dogs. Objective evaluation of the experimental and clinical data on each of the techniques for gradual vascular occlusion is necessary for informed clinical practice and for the planning of future research into this important area. Clinical Relevance— Even from the limited data available, it is clear that the ideal method for gradual vascular occlusion of CPS has yet to be identified.
Vascular occlusion
Portosystemic shunt
Clinical Significance
Collateral circulation
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The influences of intermittent hemihepatic vascular occlusion in rats were investigated. The restoration of tissue energy level during 10 min of reperfusion after more than 40 min of occlusion was significantly lower than after occlusion within 30 min. over 40 min of occlusion which resulted in a significant increase of tissue free fatty acids during occlusion showed marked decrease of total adenine nucleotides (TAN) in the liver and marked increase of serum TAN in the hepatic vein after reperfusion. It was presumed that these findings were caused by wash-out of adenine-nucleotides from liver cell to the hepatic vein after reperfusion correlated with degradation of cell membrane. Thus, less than 30 min of occlusion was safe in hemihepatic vascular occlusion. Three times intermittent occlusion--repeats of 30 min of occlusion and 10 min of reperfusion--resulted in a same tissue energy level as once 40 min of occlusion. Furthermore, there was no difference in serum ornithine carbamoyltransferase, tissue oxygen consumption and ICG test during 48 hrs after reperfusion between three times intermittent occlusion and once 40 min of occlusion. These findings indicated that repetition of short time occlusion was useful in order to safely prolong total ischemic time in hemihepatic vascular occlusion.
Vascular occlusion
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