Perioperative medicine & outcomes
Perioperative redox changes in patients undergoing hepato-pancreatico-biliary cancer surgery
Authors' conclusion
In patients undergoing major HPB surgery, intraoperative oxidative and nitrosative stress increased, with a concomitant increase in reductive capacity. Baseline nitrate was inversely associated with postoperative morbidity, and the hallmarks of poor postoperative outcome include changes in both oxidative stress and NO metabolism.
Study context
- Population
- Patients undergoing major hepato-pancreatico-biliary (HPB) cancer surgery
- Participants
- 56 patients
- Outcome
- Perioperative oxidative and nitrosative stress and redox status
- Follow-up
- Baseline, end of surgery (EoS), postoperative day-1
Methodological detailssingle-centre, exploratory
- Single-centre
- Exploratory
Main finding
As reported in the abstract
TBARS (oxidative stress) increase, baseline to end of surgery (EoS)
+14%
P = 0.003
Total nitroso-species (nitrosative stress) increase, baseline to EoS
+138%
P < 0.001
Overall reducing capacity increase at EoS
+9%
P = 0.03
Protein-adjusted total free thiols increase at day-1
+12%
P = 0.001
Observational data: associations, not effects.
Further findings
Association with postoperative morbidity (Clavien-Dindo: minor, moderate, severe)
- Baseline nitrate 60% higher in minor vs severe morbidity
- P = 0.003
- Intraoperative TBARS increase greater in severe vs minor morbidity
- P = 0.01
- Intraoperative nitrate decline more marked in minor vs severe morbidity
- P < 0.001
- Cyclic guanosine monophosphate (cGMP) decline greatest in severe morbidity
- P = 0.006
Original publication
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