腹腔镜下疝内容物复位加疝环充填式无张力疝修补术治疗成人腹股沟嵌顿疝的临床应用

目的探讨腹腔镜下疝内容物复位加疝环充填式无张力疝修补术治疗成人腹股沟嵌顿疝的可行性及临床价值。方法回顾性分析我院2012年6月至2016年6月应用腹腔镜下疝内容物复位加疝环充填式无张力疝修补术治疗46例嵌顿性腹股沟疝患者的临床资料。结果全麻后有11例疝内容物自行回纳,腹腔镜下探查疝内容物均为小肠,其中1例小肠坏死,行部分小肠切除术。余35例患者成功行腹腔镜下疝内容物复位,其中2例大网膜坏死行部分大网膜切除术。所有患者腹腔渗出液WBC为1.32×10~9/L~78.81×10~9/L,平均(25.34±11.03)×10~9/L,疝囊周围渗液WBC为0.18×10~9/L~2.31×10~9/L,平均(0.42±0.28)×10~9/L。所有患者疝囊外周渗液涂片未找到脓细胞。术中腹腔镜探查发现合并对侧隐匿疝(斜疝)5例,予行疝环缝扎术,脂肪肝7例,肝囊肿14例,空肠憩室1例。全部病例顺利行疝环充填式无张力疝修补术。手术时间75~110 min,平均87.4 min。住院时间5~7 d,平均6.7 d。术后肠功能恢复时间15~36 h,平均20.4 h。术后5例出现血清肿、3例出现暂时性神经感觉异常。1例出现腹股沟区伤口脂肪液化坏死,加强伤口消毒、换药后伤口逐渐愈合。余病例无并发症。随访时间4个月至40个月,平均22.8个月,无术后疝复发。结论腹腔镜下疝内容物复位加疝环充填式无张力疝修补术治疗腹股沟嵌顿疝具有探查全面、及时复位、一期修补的优点,安全可行。     

开放式腹膜前间隙无张力疝修补术在老年腹股沟嵌顿疝中的应用

探讨开放式腹膜前间隙无张力疝修补治疗老年腹股沟嵌顿疝的临床效果。189例老年腹股沟嵌顿疝分为传统修补法(传统组,142例)及开放式腹膜前间隙无张力疝修补(腹膜前组,47例),比较两组基础疾病、术后恢复情况及并发症发生率。结果显示,两组术后切口血清肿、血肿、阴囊血肿差异无统计学意义(P0.05)。腹膜前组卧床时间(12.95±1.65)h明显短于传统组(72.33±3.72)h(P0.05)。腹膜前组未出现疝复发,传统组有12例疝复发,复发率为8.5%,差异有统计学意义(P0.05)。腹膜前组术后早期(24 h、48 h)疼痛情况明显好于传统组(P0.05)。两组切口感染率差异无统计学意义(P0.05)。开放式腹膜前间隙无张力疝修补术治疗老年腹股沟嵌顿疝效果确切,能有效防止疝复发,术后疼痛较轻。     

腹腔镜经腹腹膜前疝修补术联合腹壁小切口“杂交手术”治疗大网膜嵌顿腹股沟疝的临床体会

目的:探讨腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)联合腹壁小切口治疗大网膜嵌顿性腹股沟疝的临床价值。方法:回顾分析2012年1月至2016年4月明确诊断为大网膜嵌顿疝的13例患者的临床资料,疝囊内网膜组织均不能完全回纳,手术方式为保留远端疝囊内不能回纳的网膜组织,完成TAPP修补,再于腹壁外环处行小切口切除残留疝囊内网膜。结果:13例患者顺利完成手术,手术时间50~120 min,平均(65.9±14.0)min;出血量10~50 ml,平均(13.1±8.2)ml;住院时间4~10 d,平均(6.1±1.1)d。术后1例发生腹股沟血清肿,经保守治疗自行吸收;1例发生阴囊积液,经穿刺后消失;无腹腔出血、腹腔感染、补片感染、肠梗阻及腹股沟区慢性疼痛等并发症。术后随访3~36个月,无复发病例。结论:TAPP联合腹壁小切口的"杂交手术"处理无法回纳的大网膜嵌顿性疝是安全、可行的,可避免不必要的手术中转。     

腹腔镜探查联合Lichtenstein或经腹腹膜前疝修补术治疗腹股沟嵌顿疝的临床对比研究

目的:探讨腹腔镜探查联合Lichtenstein或经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)治疗腹股沟嵌顿疝的手术方法,评估发生绞窄且行肠切除时放置合成补片的安全性。方法:回顾分析2013年9月至2015年12月因腹股沟嵌顿疝就诊且经手术治疗的71例患者的临床资料,其中35例腹腔镜探查后行Lichtenstein手术(Lichtenstein组),36例行TAPP(TAPP组)。71例患者中60岁以上占64.8%,男性占78.9%,嵌顿时间平均(17.2±22.6)h;术后随访25~52个月,平均(39.1±8.3)个月。比较两组术后近远期并发症发生率及临床疗效。结果:7例因发生绞窄而行肠切除术。TAPP组住院时间、恢复日常活动时间与工作时间均优于Lichtenstein组,两组差异有统计学意义。两组并发症发生率差异无统计学意义。结论:在腹股沟嵌顿/绞窄疝的治疗中,如腹腔镜下探查判断肠管失活,先于镜下完成肠切除肠吻合术,联合Lichtenstein放置大孔聚丙烯补片是安全、有效的。     

传统、疝环充填式及经前入路腹膜前间隙腹股沟疝修补术的对比研究

目的研究比较传统、疝环充填式及腹膜前间隙疝修补术的临床效果。方法1997年至2005年采用传统方法修补腹股沟疝325例,2001年后采用疝环充填式疝修补术128例及2007年后腹膜前间隙疝修补术50例。结果传统疝修补术组平均手术时间为(65±25)min,疝环充填式组为(45±20)min,腹膜前间隙组为(40±20)min。随访1～4年,复发率分别为5.02%,1.92%,0%。结论同传统腹股沟疝修补术比较,疝环充填式无张力修补术和腹膜前间隙疝修补术具有手术时间短、痛苦小、恢复快、复发率低的特点,腹膜前间隙疝修补术更符合工程力学原理,术后疼痛更轻、恢复更快,具有免缝合,微创手术的特点。腹膜前间隙疝修补术是一种具有良好发展潜力的无张力疝修补术。     

腹腔镜TAPP和TEP治疗腹股沟嵌顿疝的临床应用研究

目的探讨腹腔镜腹膜前修补术(TAPP)和腹腔镜完全腹膜外修补术(TEP)治疗腹股沟嵌顿疝的安全性及临床效果。方法各选择2017年7月至2019年7月两年间采用TAPP和TEP术式治疗的腹股沟嵌顿疝病人50例,分为TAPP组(25例)和TEP组(25例),对比两组手术时间、出血量、膀胱损伤、精索血管损伤、输精管损伤情况,对比术后血清肿、术野感染、术后慢性疼痛、复发、术后尿潴留情况。结果两组在手术时间、术中出血量、术后血清肿发生相当,组间差异没有统计学意义(P0.05)。两组均无膀胱、精索及其血管损伤,无感染发生。平均随访10.4月无复发。结论相对于开放腹股沟嵌顿疝手术腹腔镜手术在探查嵌顿内容物血运情况可能更有优势,TAPP相对于TEP在游离腹膜前间隙,处理腹膜更有优势,适合初学者采用。     

传统、疝环充填式及经前入路腹膜前间隙腹股沟疝修补术的对比研究

目的比较传统张力性疝修补术、疝环充填式及腹膜前间隙无张力性疝修补术的临床效果。方法采用病例对照研究,其中传统方法修补腹股沟疝325例,疝环充填式疝修补术128例,经前路腹膜前间隙疝修补术50例。结果传统疝修补术组平均手术时间为(65.1±24.2)min,疝环充填式组为(48.3±20.2)min,腹膜前间隙组为(40.5±19.3)min,传统组明显长于其他两组(P0.05)。传统组并发症发生率明显高于其他两组(P0.05),传统组、充填组和前路组分别随访287、114和49例,复发率分别为4.9%,1.8%和0,三组间无统计学差异(P0.05)。结论同传统腹股沟疝修补术比较,疝环充填式无张力修补术和腹膜前间隙疝修补术具有手术时间短、痛苦小、恢复快、复发率低的特点,而腹膜前间隙疝修补术更符合人体工程力学原理,有良好的发展潜力。     

腹股沟疝内容物含骨性异物一例

患者男,59岁,左侧腹股沟区可复性肿块3年,不能回纳3个月.体检:肿块轻压痛,入阴囊.B超及CT:左腹股沟内侧混合性块物(疝?).术前诊断:左侧腹股沟斜疝嵌顿.行腹股沟斜疝修补术,术中见疝囊6 cm×4 cm×3 cm,内容物为大网膜及20 ml黄褐色液体,大网膜与疝囊颈部3/4圈粘连固定,疝囊颈内侧大网膜粘连成团约5 cm×5 cm,与耻骨后腹膜及其外侧腹膜粘连固定,大网膜团块中有一直径约0.2 cm,长约1.5 cm断骨.     

腹股沟直疝经内环口无张力修补术式探讨

目的探讨经内环口进入腹膜前间隙腹股沟直疝腹膜前间隙无张修补术的临床意义。方法回顾性分析2012年1月至2015年7月,成都市第三人民医院180例腹股沟直疝患者的临床资料,本组患者均自愿行经内环口进入腹膜前间隙腹股沟直疝腹膜前间隙无张修补术。结果 180例患者手术时间54~125 min,平均(75±18)min,术中探查直疝合并隐匿性斜疝者有9例;术后随访1~3年,失访6例,其余患者均无复发、腹股沟区硬化、皮下脓肿及补片周围深部脓肿等发生,慢性疼痛3例,腹股沟区麻木感10例,均获得较满意的临床疗效。结论内环口进入腹膜前间隙腹股沟直疝腹膜前间隙无张修补术是避免腹股沟直疝修补时遗漏隐匿性斜疝。     

腹膜前间隙与疝环填补式无张力疝修补术的临床效果比较

目的比较腹膜前间隙和疝环填补式无张力疝修补术的临床疗效,探讨一种有效术式,以提高疗效。方法选取本院2018年7月至2020年1月的78例腹股沟疝患者,均行手术治疗,根据不同术式分成对照组与观察组各39例。两组分别行疝环填补式与腹膜前间隙无张力疝修补术。对比其手术指标(手术历时、出血量、下床时间、住院时间)、术后疼痛程度(VAS评分)、血清基质金属蛋白酶(MMP-2、MMP-9)以及并发症(切口感染、血肿、尿潴留)。结果观察组的出血量、下床时间、住院时间(23.59±6.70)ml、(3.21±1.12)小时、(6.22±1.30)天均少于对照组(42.76±8.96)ml、(6.86±2.78)小时、(8.74±2.69)天,P0.05;观察组术后2、6、12、24小时的VAS评分(3.41±1.01)分、(3.05±0.92)分、(2.83±0.81)分、(2.70±0.67)分、均低于对照组(4.70±1.26)分、(4.12±1.19)分、(3.86±1.08)分、(3.38±1.01)分,P0.05;观察组术后的MMP-2、MMP-9 (141.83±16.84)μg/L、(127.16±11.94)g/L均低于对照组(166.16±15.07)μg/L、(144.41±17.36)μg/L,P0.05;观察组的并发症发生率(5.13%)低于对照组(20.51%),P0.05。结论腹膜前间隙无张力疝修补术的运用效果优于疝环填补式无张力疝修补术,可改善手术指标与血清基质金属蛋白酶水平。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.