睾丸肿瘤的影像学诊断及治疗

<正>睾丸肿瘤虽少见,却是15~35岁年轻男性中常见的恶性肿瘤。我国发病率约为1/10万,约占男性全部恶性肿瘤的1%~2%~([1-2])。睾丸肿瘤种类众多,根据2004年世界卫生组织(WHO)的分类标准,睾丸肿瘤可以分为三大类:生殖细胞肿瘤、性索/性腺间质肿瘤及其他非特异性间质肿瘤。睾丸肿瘤多以单侧发病(双侧肿瘤仅占1%~2%),且绝大部分(90%~95%)为生殖细胞肿瘤~([1])。近年来,在诊断技术的提高、联合放化疗及手术方式的改进等影响下,睾丸肿瘤     

睾丸浆细胞瘤1例报告

<正>浆细胞瘤包括孤立性浆细胞瘤、髓外浆细胞瘤(extramedullary plasmacytoma,EMP)、多发性骨髓瘤、浆细胞性白血病4类,EMP是一种罕见的发生于骨髓外软组织的恶性肿瘤,约占全部浆细胞瘤的4%,80%发生于上呼吸道和消化道~([1])。EMP好发于男性,男女发病比例为3:1,平均发病年龄60岁以上~([2])。睾丸浆细胞肿瘤可为多发性骨髓瘤侵至睾丸或EMP原发于睾丸,亦有个别浆细胞白血病进     

原发性椎管内肿瘤：（附20例报告）

原发性椎管内肿瘤指的是脊髓、神经根、硬脊膜、血管、淋巴组织、脂肪及特殊组织来源的肿瘤而言,不包括转移瘤、椎旁组织及脊柱之肿瘤。 原发性椎管内肿瘤比较少见。我院1965～1990年间共收治24例,均经病理证实,其中20例获得随访。本文就此20例作一分析讨论。1、临床资料1.1一般资料 男性12例,女性8例,为1.5:1。年龄最小7岁,最大66岁,平均34.3岁。病史最短1个月,最长5年,恶性肿瘤大多数在3个月以内,良性肿瘤大多数在半年以上。1.2部位 颈椎3例占15%,胸椎9例占45%,腰骶椎8例占40%。硬脊膜外肿瘤8例占40%,硬脊膜内脊髓外肿瘤8例占40%,脊髓内肿…     

WB-MRI与骨扫描诊断恶性肿瘤骨转移：Meta分析

目的采用Meta分析评价WB-MRI与99 Tcm-亚甲基二磷酸盐骨扫描诊断恶性肿瘤骨转移的价值。方法检索PubMed、EMbase、Web of Science、Cochrane图书馆、中国期刊全文数据库、中国科技期刊数据库(维普)、万方数字化期刊全文数据库中关于比较WB-MRI和骨扫描诊断恶性肿瘤骨转移能力的中英文文献,采用诊断性试验质量评价方法评价纳入文献质量,以Meta-Disc 1.4软件进行Meta分析。结果共纳入9篇文献、447例患者。WB-MRI诊断恶性肿瘤骨转移的合并敏感度和特异度分别为0.91(95%CI 0.86~0.95)和0.95(95%CI 0.92~0.97),SROC曲线下面积为0.9797;骨扫描诊断恶性肿瘤骨转移的合并敏感度和特异度分别为0.80(95%CI 0.73~0.85)和0.89(95%CI 0.85~0.93),SROC曲线下面积为0.9183。结论与99 Tcm-亚甲基二磷酸盐骨扫描相比,WB-MRI诊断恶性肿瘤骨转移敏感度和特异度更高。     

A single rate meta-analysis of postoperative complications in robot arm-assisted unicompartmental knee arthroplasty北大核心CSCD

目的通过Meta分析观察机器人辅助单髁置换的术后并发症发生率及翻修率。方法文献检索Cochrane Library、PubMed、EMBase、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方、维普等数据库自建库至2021年3月的文献,按照纳入和排除标准筛选文献,收集机器人辅助单髁置换术后并发症及翻修率的高质量研究,提取相关数据,使用Stata15.0软件对采集的数据进行分析。结果共纳入16项研究,包括1项随机对照研究,6项病例对照研究,9项队列研究,文献质量非随机对照试验方法学评价指标(MINORS)评分有7项为14分,3项为13分,1项为12分,4项为11分,1项为10分。Meta分析结果显示,机器人辅助单髁置换术后总并发症发生率为2%(95%CI:1%~4%)。3项研究选用NAVIO型机器人,7项研究选用MAKO型机器人,1项NAVIO型和MAKO型并用,1项选用Acrobot型机器人,由于选用Acrobot型机器人仅1项研究,所以仅按MAKO型、NAVIO型机器人进行亚组分析,结果显示:NAVIO型、MAKO型术后并发症发生率分别为4.0%(95%CI:-2%~10%)、3%(95%CI:1%~5%)。术后疼痛发生率为0.2%(95%CI:0.1%~0.3%)。术后感染发生率为0.5%(95%CI:0.3%~0.8%)。术后假体松动发生率为0.5%(95%CI:0.3%~0.7%)。翻修率为2%(95%CI:1%~2%),按NAVIO型、MAKO型机器人进行亚组分析,翻修率分别为4%(95%CI:2%~7%)、2%(95%CI:1%~2%)。结论机器人辅助单髁置换术后患者症状及假体长期生存率优良,疗效较好。     

甲状腺微小癌淋巴转移危险因素的Meta分析

目的:综合定量评价甲状腺微小癌(TMC)淋巴转移的危险因素,为TMC的治疗及转移风险评估提供依据。方法:检索相关数据库,收集国内外2005年1月―2015年7月发表的关于TMC淋巴转移危险因素的研究进行Meta分析。结果:共纳入文献12篇,共3 355例患者,发生淋巴转移1 292例(38.51%)。Meta分析结果显示,低年龄(OR=1.46,95%CI=1.20~1.78)、男性(OR=2.26,95%CI=1.65~3.09)、肿瘤直径≥0.5 cm(OR=0.46,95%CI=0.36~0.59)、原发灶多灶(OR=0.52,95%CI=0.42~0.65)、发生囊外侵袭(OR=3.22,95%CI=2.04~5.08)是TMC淋巴转移的危险因素(均P0.05)。结论:对于年龄45岁、男性、肿瘤直径≥0.5 cm、原发灶多灶、发生囊外侵袭的TMC患者应警惕淋巴转移的发生。     

脊柱转移瘤481例的流行病学分析

目的 :总结分析脊柱转移瘤的发病特点和临床特征。方法 :对国内3家医院(天津医院、河北医科大学附属第三医院、济南军区总医院)2007年1月~2016年12月所有脊柱转移瘤患者的人口学特征、原发灶来源、侵犯部位、临床症状及治疗方法进行回顾性分析。纳入标准:经临床、影像和病理检查确诊为脊柱转移瘤且医疗资料收录完整。排除标准:仅有临床、影像证据,无明确病理诊断者;不能明确排除脊柱原发肿瘤、结核、退行性病变可能的病例。对复发病例按单例计算。结果:481例脊柱转移瘤患者符合纳入标准,其中男287例(59.7%),女194例(40.3%);发病年龄18~86岁,中位年龄60.0岁,以50~69岁为高发年龄,平均59.2±11.1岁,男性平均发病年龄59.6±11.5岁,女性平均发病年龄58.5±10.5岁,差异无统计学意义(t=0.277,P0.05)。原发肿瘤为肺癌181例,肾癌40例,女性乳腺癌29例,肝癌25例,胃肠肿瘤23例,前列腺癌20例,甲状腺癌、食管癌等肿瘤病例数均小于20例(共70例),来源不明的肿瘤93例;单纯侵及颈椎37例,胸椎135例,腰椎130例,骶椎42例,跨节段(同时累及颈、胸、腰、骶两个及以上节段)的患者137例;就诊时,出现脊髓受压症状及脊柱转移部位局部疼痛的患者281例,单纯脊柱转移部位疼痛128例,只有脊髓受压症状33例,无转移部位症状而在体检中发现脊柱转移39例;有原发肿瘤病史者75例。手术治疗314例,其中266例行开放性手术,48例行经皮椎体成形术(PVP)或经皮球囊扩张椎体成形术(PKP);保守治疗167例,应用磷酸盐等抗骨质破坏药物、放射性核素治疗、放疗及止痛、全身营养支持等对症治疗。结论:脊柱转移瘤患者中男性多于女性,发病高峰为50~69岁。患者多因脊柱转移病变所致症状就诊,有明确原发肿瘤病史者较少。原发灶多为上皮或腺体来源的脏器肿瘤,尤以肺癌多见,间叶组织来源的肿瘤较少。常见侵袭部位为胸椎、腰椎,临床上以缓解症状、延缓病情发展等姑息性治疗方法为主。     

单中心170 例足踝部肿瘤及瘤样病变临床分析

 目的 探讨足踝部肿瘤和瘤样病变的流行病学特点、临床表现以及恶性肿瘤的预后。方法 通过对25年间170例足踝部肿瘤及瘤样病变的临床资料进行回顾性分析,并对恶性肿瘤进行随访,分析其年龄和性别分布、临床表现、肿瘤组织类型、解剖学部位分布、肿瘤大小与良恶性的关系以及恶性肿瘤的预后。结果 170例足踝部肿瘤及瘤样病变中,男91例,女79例。骨肿瘤51例,软组织肿瘤119例。良性126例,恶性44例。年龄7个月~76岁,中位年龄32岁,平均年龄33.1岁。良性肿瘤以10~19岁和20~29岁最多,平均年龄29.54岁;恶性肿瘤以40~49岁和50~59岁最多,平均年龄为43.73岁。临床出现皮损往往提示恶性肿瘤。足踝部肿瘤主要以软组织肿瘤和良性肿瘤为主。软组织良性肿瘤以腱鞘巨细胞瘤最为多见;骨的良性肿瘤以甲下外生骨疣和内生软骨瘤最为多见。软组织恶性肿瘤以黑色素瘤和滑膜肉瘤最为常见。骨的原发恶性肿瘤和转移瘤均非常罕见。前足是肿瘤好发的解剖学部位。软组织肿瘤的大小与良恶性没有相关性,骨肿瘤的肿瘤大小与良恶性显著相关。44例恶性肿瘤中16例采用保肢术,28例截肢(趾)。平均随访时间32.4月,6例无瘤存活,5年无瘤生存率16.13%。结论足踝部肿瘤和瘤样病变以软组织肿瘤和良性肿瘤最为常见,恶性肿瘤发病年龄较高,出现皮损提示恶性肿瘤可能,前足是肿瘤的好发部位,骨肿瘤大小与良恶性相关,恶性肿瘤的预后较差。     

脾脏肿瘤的诊治进展

正1脾肿瘤的流行病学脾肿瘤可发生于各个年龄段且无性别差异,同时在肿瘤的诊治中,较其它脏器的肿瘤具有类型少见、发病率低的特点,脾肿瘤发病率仅占全部肿瘤的0. 03%~([1])。根据Kli~([2])等报道,脾脏良性肿瘤发病率约为0. 14%,脾恶性肿瘤占全部恶性肿瘤的比例不到0. 64%,分析原因如下:(1)脾脏的免疫效应:脾     

MR扩散加权成像鉴别诊断卵巢良恶性肿瘤：Meta分析

目的系统评价MR弥散加权成像(DWI)鉴别诊断卵巢良恶性肿瘤的价值。方法检索PubMed、Embase、Cochrane Library、CBM、中国知网、万方医学网、维普数据库,检索时间自建库至2019年10月31日,获取DWI鉴别诊断卵巢良恶性肿瘤研究,以QUADAS-2量表评估文献质量。采用Review Manager 5.2双变量模型及Meta-Disc l.4软件进行Meta分析,最终结果以合并敏感度、特异度、阳性似然比(PLR)、阴性似然比(NLR)及其95%CI表示。采用综合受试者工作特征(SROC)曲线计算曲线下面积(AUC)。结果依据纳入及排除标准,最终选取11篇文献,包括313例良性肿瘤和587例恶性肿瘤。Meta分析结果显示,DWI鉴别诊断卵巢良恶性肿瘤的合并敏感度和特异度分别为0.86[95%CI(0.82,0.90)]和0.83[95%CI(0.80,0.86)],合并PLR和NLR为4.93[95%CI(3.01,8.08)]和0.19[95%CI(0.10,0.39)]。SROC曲线的AUC为0.9093(P=0.433),未检测到阈值效应。结论MR DWI对卵巢癌良恶性肿瘤具有较好的鉴别诊断能力。     

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 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.     

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.     

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.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

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.