Mechanisms of Development of Hemostatic Disorders after Liver Resection

Введение. Нарушения со стороны системы гемостаза при заболеваниях кроветворных органов чрезвычайно разнообразны как по механизмам развития, так и по клиническим проявлениям. Цель исследования. Изучение причин гемостазиологических расстройств при различных патогенетических вариантах анемических состояний. Материалы и методы. Показатели коагуляционного гемостаза, липидной пероксидации и эндотелий-зависимая вазодилатация исследованы у 30 больных железодефицитной анемией, 22 больных витамин В12-дефицитной анемией и 18 больных апластической анемией. Результаты. Гемическая гипоксия, присущая анемии, сопровождается активацией свободно-радикального окисления липидов — увеличением концентрации малонового диальдегида плазмы и уменьшением антиокислительного потенциала крови. Оксидативный стресс приводит к системному поражению эндотелия, проявляющегося снижением релаксирующих свойств эндотелия сосудов и активацией системы гемостаза, представленной гипокоагуляцией по внутреннему механизму, угнетением плазминовой системы и увеличением концентрации растворимых фибрин-мономерных комплексов. Заключение. Развитие анемии, независимо от ее патогенетического механизма, сопровождается развитием метаболического дисбаланса, дисфункцией эндотелия, что в конечном итоге приводит к нарушениям со стороны коагуляционного гемостаза. Introduction. Hemostasis disturbances in diseases of hematopoietic organs are considerably varied both in mechanisms of development, and in clinical manifestations. The aim: to study the causes of hemostatic disorders at various pathogenetic types of anemias. Materials and methods. In 30 patients with iron defi ciency anemia, in 22 patients with vitamin B12-deficiency anemia and in 18 patients with aplastic anemia parameters of coagulative hemostasis, lipid peroxidation, and endothelium-dependent vasodilation were studied. Results. Attributable to anemia hemic hypoxia is accompanied by activation of free-radical lipids oxidation — increasing concentration of plasma malone dialdehyde and decreasing of blood antioxidant potential. Oxidative stress leads to systemic damage of endothelium that manifested by decreasing of vascular endothelial relaxing properties and hemostasis activation: internal mechanism of hypocoagulation, inhibition of plasmin system and increasing concentration of soluble fibrin monomer complexes. Conclusion. Anemia progression regardless of its pathogenic mechanism is associated with the development of metabolic disbalance, endothelial dysfunction that fi nally leads to disturbances of coagulative hemostasis.

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The System of Blood Coagulation in Normal and in Liver Transplantation (Review)

General Reanimatology ◽

10.15360/1813-9779-2018-5-58-84 ◽

2018 ◽

Vol 14 (5) ◽

pp. 58-84 ◽

Cited By ~ 5

Author(s):

V. I. Reshetnyak ◽

S. V. Zhuravel ◽

N. K. Kuznetsova ◽

V. М. Pisarev ◽

E. V. Klychnikova ◽

...

Keyword(s):

Liver Transplantation ◽

Blood Coagulation ◽

Liver Diseases ◽

Significant Risk ◽

Perioperative Period ◽

Coagulation System ◽

Hemostatic System ◽

Time Changes ◽

Mechanisms Of Development ◽

Hemostatic Disorders

The review dwells on the problem of hemostatic disorders in patients undergoing liver transplantation and their correction in the perioperative period. The physiology of the hemostatic system, disorders of the blood coagulation system in patients at various stages of liver transplantation, correction of hemostatic disorders during and after orthotopic liver transplantation are discussed. Liver transplantation is performed in patients with liver diseases in the terminal stage of liver failure. At the same time, changes in the hemostatic system of these patients pose a significant risk of developing bleeding and/or thrombosis during and after liver transplantation. The hypothesis is suggested that the personalized correction of hemostasis disorder in liver transplantation should be based on considerating the nosological forms of the liver damage, mechanisms of development of recipient’s hemostatic disorders, and the stage of the surgery.

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Liver Resection for Liver Metastasis - the Bernese Results

Swiss Surgery ◽

10.1024/1023-9332.6.4.164 ◽

2000 ◽

Vol 6 (4) ◽

pp. 164-168 ◽

Cited By ~ 3

Author(s):

Seiler ◽

Redaelli ◽

Schmied ◽

Baer ◽

Büchler

Keyword(s):

Liver Resection ◽

Liver Metastasis ◽

Chirurgische Resektion ◽

Kurative Therapie

Neue Erkenntnisse über die Anatomie und Funktion der Leber haben dazu geführt, dass heute die chirurgische Resektion die Therapie der Wahl bei Lebermetastasen geworden ist. Obschon Lebermetastasen ein fortgeschrittenes Tumorstadium bedeuten, werden infolge besserer Kenntnisse der Karzinogenese (Mikrometastasen etc.) sowie der prognostischen Risikofaktoren erwiesenermassen die besten Langzeitresultate durch die chirurgische Resektion erzielt. In dieser Studie wurden die Ergebnisse von 109 Resektionen von kolorektalen sowie nicht kolorektalen Lebermetastasen an unserer Klinik während eines Zeitraumes von 59 Monaten zusammengefasst. Vier verschiedene Operationsverfahren (formelle Hemihepatektomie vs Segmentresektion vs atypische Resektion vs Biopsie) wurden untersucht. Die Einhaltung eines Resektionsabstandes von mindestens 10 mm wurde bei Resektionen immer angestrebt. Die kumulierte Morbidität aller Operationsverfahren zusammen betrug 23%. Obwohl die Morbidität bei ausgedehnten Resektionen höher war (Encephalopathie 16% vs 2.3% bei der Segmentresektion, Leberinsuffizienz 23% vs 4.7%), war das Langzeitüberleben gegenüber den limitierten Resektionsverfahren verbessert. Die 60-Tage Mortalität lag bei 2.7%. Patienten nach Resektion von kolorektalen Lebermetastasen hatten eine höhere Ueberlebensrate als diejenigen nach Resektion nicht kolorektaler Metastasen. Unsere Resultate zeigen, dass die Leberresektion heutzutage unter Einhaltung der anatomischen sowie funktionellen Grenzen (inkl. eines adäquaten Resektionsrandes) die einzige, potentiell kurative Therapie von Lebermetastasen darstellt. Trotz erhöhter perioperativer Morbidität ist die ausgedehnte formelle Resektion den limitierten Operationsverfahren bezüglich Langzeitüberleben überlegen. Ein Grund dafür ist die erhöhte Wahrscheinlichkeit einer Mitresektion von präoperativ nicht detektierbaren lokalen Mikrometastasen.

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The Animal Models for Hemorrhage and Thrombosis in the Neonate

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651075 ◽

1987 ◽

Vol 57 (01) ◽

pp. 118-122 ◽

Cited By ~ 3

Author(s):

C Thomas Kisker

Keyword(s):

Animal Models ◽

Normal Development ◽

Relevant Information ◽

Relevant Model ◽

Current Information ◽

Single Animal ◽

Hemostatic Disorders ◽

Thrombotic Diseases

SummaryAnimal models have added significantly to our understanding of adult hemorrhagic and thrombotic diseases. Few models, however, have been developed for studies of the hemostatic disorders in the fetus and newborn. This report reviews the current information on animal models of fetal and neonatal hemostasis. The requirements of a relevant model are addressed and previous studies using fetal and neonatal animal models are reviewed. A recommendation of a single animal for all studies of fetal and neonatal hemostasis is not possible. However, the lamb has been the most frequently studied and appears to provide relevant information regarding normal development and the factors which may adversely influence hemostasis in the fetus and newborn.

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Impairment of Platelet Aggregation by Echis colorata Venom Mediated by L-Amino Acid Oxidase or H2O2

Thrombosis and Haemostasis ◽

10.1055/s-0038-1657280 ◽

1982 ◽

Vol 48 (03) ◽

pp. 277-282 ◽

Cited By ~ 22

Author(s):

I Nathan ◽

A Dvilansky ◽

T Yirmiyahu ◽

M Aharon ◽

A Livne

Keyword(s):

Hydrogen Peroxide ◽

Amino Acid ◽

Platelet Aggregation ◽

Snake Venom ◽

Oxidase Activity ◽

Enzyme Preparation ◽

Acid Oxidase ◽

Crude Venom ◽

Amino Acid Oxidase ◽

Hemostatic Disorders

SummaryEchis colorata bites cause impairment of platelet aggregation and hemostatic disorders. The mechanism by which the snake venom inhibits platelet aggregation was studied. Upon fractionation, aggregation impairment activity and L-amino acid oxidase activity were similarly separated from the crude venom, unlike other venom enzymes. Preparations of L-amino acid oxidase from E.colorata and from Crotalus adamanteus replaced effectively the crude E.colorata venom in impairment of platelet aggregation. Furthermore, different treatments known to inhibit L-amino acid oxidase reduced in parallel the oxidase activity and the impairment potency of both the venom and the enzyme preparation. H2O2 mimicked characteristically the impairment effects of L-amino acid oxidase and the venom. Catalase completely abolished the impairment effects of the enzyme and the venom. It is concluded that hydrogen peroxide formed by the venom L-amino acid oxidase plays a role in affecting platelet aggregation and thus could contribute to the extended bleeding typical to persons bitten by E.colorata.

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Radiofrequency ablation of colorectal liver metastases

Perspectives in Surgery ◽

10.33699/pis.2019.98.10.399-403 ◽

2019 ◽

Vol 98 (10) ◽

Keyword(s):

Radiofrequency Ablation ◽

Liver Resection ◽

Liver Metastases ◽

Colorectal Liver Metastases ◽

Survival Rates ◽

Postoperative Mortality ◽

Disease Free Survival ◽

Female Ratio ◽

Liver Resections ◽

Multi Stage

Introduction: Radical liver resection is the only method for the treatment of patients with colorectal liver metastases (CLM); however, only 20–30% of patients with CLMs can be radically treated. Radiofrequency ablation (RFA) is one of the possible methods of palliative treatment in such patients. Methods: RFA was performed in 381 patients with CLMs between 01 Jan 2001 and 31 Dec 2018. The mean age of the patients was 65.2±8.7 years. The male to female ratio was 2:1. Open laparotomy was done in 238 (62.5%) patients and the CT-navigated transcutaneous approach was used in 143 (37.5%) patients. CLMs <5 cm (usually <3 cm) in diameter were the indication for RFA. We used RFA as the only method in 334 (87.6%) patients; RFA in combination with resection was used in 36 (9.4%), and with multi-stage resection in 11 (3%) patients. We performed RFA in a solitary CLM in 170 (44.6%) patients, and in 2−5 CLMs in 211 (55.6%) patients. We performed computed tomography in each patient 48 hours after procedure. Results: The 30-day postoperative mortality was zero. Complications were present in 4.8% of transcutaneous and in 14.2% of open procedures, respectively, in the 30-day postoperative period. One-, 3-, 5- and 10-year overall survival rates were 94.8, 66.8, 43.9 and 16.6%, respectively, in patients undergoing RFA, and 90.6, 69.1, 52.8 and 39.2%, respectively, in patients with liver resections. Disease free survival was 63.2, 30.1, 18.4 and 13.1%, respectively, in the same patients after RFA, and 71.1, 33.3, 22.8 and 15.5%, respectively, after liver resections. Conclusion: RFA is a palliative thermal ablation method, which is one of therapeutic options in patients with radically non-resectable CLMs. RFA is useful especially in a non-resectable, or resectable (but for the price of large liver resection) solitary CLM <3 cm in diameter and in CLM relapses. RFA is also part of multi-stage liver procedures.

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The comparison of efficacy in 3 different types of pre-coagulation method for endoscopic liver resection of hepatocellular carcinoma

Journal of Microwave Surgery ◽

10.3380/jmicrowavesurg.28.47 ◽

2010 ◽

Vol 28 ◽

pp. 47-51 ◽

Cited By ~ 1

Author(s):

Takatoshi Ishiko ◽

Toru Beppu ◽

Akira Chikamoto ◽

Toshiro Masuda ◽

Hirohisa Okabe ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Different Types

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Endometrial hyperplasia (Clinical lecture)

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.10 ◽

2016 ◽

pp. 10-18 ◽

Cited By ~ 2

Author(s):

I.B. Vovk ◽

◽

N.Е. Gorban ◽

O.Ju. Borysiuk ◽

◽

...

Keyword(s):

Key Words ◽

Hormonal Therapy ◽

Endometrial Hyperplasia ◽

Intraepithelial Neoplasia ◽

Diagnosis And Treatment ◽

Pathogenetic Mechanisms ◽

Endometrial Intraepithelial Neoplasia ◽

Mechanisms Of Development ◽

Clinical Lecture

In clinical lecture presents modern views of endometrial hyperplasia in terms of practitioner gynecologist. The problems of classification, pathogenetic mechanisms of development of endometrial hyperplasia. Particular attention is paid to modern approaches to diagnosis and treatment of endometrial hyperplasia. Key words: hyperplasia, endometrium, classification, endometrial hyperplasia, endometrial intraepithelial neoplasia, hormonal therapy.

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