caa a22 4500 475752538 CHVBK 20180406123528.0 cr unu---uuuuu 170329e20000901xx s 000 0 eng 10.1007/s005950070061 doi (NATIONALLICENCE)springer-10.1007/s005950070061 Does Topical Cooling Alleviate Ischemia/Reperfusion Injury During Inflow Occlusion in Hepatectomy? Results of an Experimental and Clinical Study [Elektronische Daten] [Masamichi Imakita, Naoki Yamanaka, Nobukazu Kuroda, Yoshihiro Kitayama, Eizo Okamoto] This study was undertaken to evaluate whether topical cooling can alleviate ischemia/reperfusion injury, after continuous inflow occlusion during hepatectomy. Using a canine model of 70% partial liver ischemia (60 min), alteration in the subcellular (cytoplasm, mitochondria, nucleus) elements calcium, sodium, potassium, and chloride, and liver functions following reperfusion were compared between control livers and livers subjected to topical cooling down to 23°± 4.9°C by seeding ice slush over the ischemic lobe. The elements were determined by X-ray microanalysis using liver biopsy specimens. A similar clinical study was undertaken examining ten patients with hepatocellular carcinoma and chronic liver disease who underwent right-sided segmentectomy under continuous right inflow occlusion, five of whom were given topical cooling and five of whom were not. In the experimental study, postreperfusion worsening of liver function tests was significantly suppressed in the cooling group, which was associated with the suppression of subcellular Ca, Na, and Cl increases and K decreases after reperfusion. In the clinical study, the occlusion time was significantly longer in the hypothermic patients than in the normothermic patients, but no significant differences in postoperative liver function or postischemic increases in Ca, Na, or Cl and decreases in K were observed. These experimental and clinical findings suggest that topical cooling alleviates ischemic insult and enhances safe prolonged inflow occlusion. Springer-Verlag, 2000 Key Words Hepatectomy nationallicence Ischemia/reperfusion injury nationallicence Vascular occlusion nationallicence X-Ray microanalysis nationallicence Subcellular element nationallicence Imakita Masamichi First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut Yamanaka Naoki First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut Kuroda Nobukazu First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut Kitayama Yoshihiro First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut Okamoto Eizo First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut https://doi.org/10.1007/s005950070061 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s005950070061 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Imakita Masamichi First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut NATIONALLICENCE 700 1- Yamanaka Naoki First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut NATIONALLICENCE 700 1- Kuroda Nobukazu First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut NATIONALLICENCE 700 1- Kitayama Yoshihiro First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut NATIONALLICENCE 700 1- Okamoto Eizo First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan, JP aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer