Preoperative high-dose steroid administration attenuates the surgical stress response following liver resection: results of a prospective randomized study

Abstract

Intravenous methylprednisolone administration before hepatic resection significantly reduced systemic inflammatory cytokine release. No adverse effect on immunity was noted due to the methylprednisolone. We found no significant difference in the convalescence score, but a significantly shorter hospital stay in the steroid group. Further studies with more patients are needed to elucidate the clinical impact of preoperative steroid bolus therapy in liver surgery.

The impact of carbon dioxide pneumoperitoneum on liver regeneration after liver resection in a rat model

“…Steroids to prevent the ischemia/reperfusion injury also have been suggested [43,44]. In experimental laparoscopic settings, findings have shown that ischemic preconditioning with sequential periods of pneumoperitoneum followed by deflation effectively decreases oxidative stress-induced tissue injury [37,45,46].…”

Fast-track surgery—an update on physiological care principles to enhance recovery

“…Administration of glucocorticoids in a single preoperative dose has promising effects based on several randomised trials first of all as an anti-emetic in relatively small doses (4-8 mg dexamethasone) but also in higher doses (about 125 mg methylprednisolone) to reduce pain and facilitate early recovery [19,20]. In abdominal surgery the antiinflammatory effects of 8 mg dexamethasone is controversial [21,22] while larger doses may have both antiinflammatory and enhanced recovery effects [23,24]. Based on these initial promising results and since there may be no safety aspects [19], further procedure-specific studies on the recovery effects of perioperative glucocorticoids are required.…”

The role of serum interleukin-8 in hepatic resections

“…1,2 Interleukin-8 is not synthesized under physiological conditions, but following stimulation by lipopolysaccharide and cytokines such as IL-1 and tumor necrosis factor, 3 IL-8 is synthesized in monocytes, macrophages, neutrophils, vascular endothelial cells, hepatocytes, etc. 2,4,5 Therefore, IL-8 is implicated in several infl ammatory diseases, [6][7][8][9] surgical stress, [10][11][12][13][14][15] and organ ischemic reperfusion. [16][17][18][19][20] On the other hand, the liver is composed of hepatocytes, endothelial cells, Kupffer cells, etc., and is one of the most important organs associated with vital reactions against surgical stress and changes in the glucose and protein metabolism under surgical stress.…”