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Sham remote ischemic conditioning (Sham-RIC) is applied in the perioperative using an automated Sham-RIC device.

Remote ischemic conditioning (RIC) is applied in the perioperative using an automated RIC device once daily.

Remote ischemic conditioning (RIC) is applied in the perioperative using an automated RIC device twice daily.

Sham-Remote Ischemic Conditioning (at the time points of 30 min before anesthesia, 30 min after surgery, the morning of the postoperative day 1, the afternoon of the postoperative day 1, the morning of the postoperative day 2, the afternoon of the postoperative day 2): Three cycles (30 minutes), each consisting of five minutes of cuff inflation followed by five minutes with a deflated cuff, but the cuff pressure will be 0 mmHg.

Sham-Remote Ischemic Conditioning

Remote Ischemic Conditioning (at the time points of 30 min before anesthesia, the morning of the postoperative day 1, the morning of the postoperative day 2): Three cycles (30 minutes), each consisting of five minutes of cuff inflation followed by five minutes with a deflated cuff. The cuff pressure will be 200 mmHg.

Sham-Remote Ischemic Conditioning (at the time points of 30 min after surgery, the afternoon of the postoperative day 1, the afternoon of the postoperative day 2): Three cycles (30 minutes), each consisting of five minutes of cuff inflation followed by five minutes with a deflated cuff, but the cuff pressure will be 0 mmHg.

Remote Ischemic Conditioning Once Daily

Remote Ischemic Conditioning (at the time points of 30 min before anesthesia, 30 min after surgery, the morning of the postoperative day 1, the afternoon of the postoperative day 1, the morning of the postoperative day 2, the afternoon of the postoperative day 2): Three cycles (30 minutes), each consisting of five minutes of cuff inflation followed by five minutes with a deflated cuff. The cuff pressure will be 200 mmHg.

Remote Ischemic Conditioning Twice Daily

He Huang, ph.D

Chun Tian, ph.D

Our primary aim is to investigate whether perioperative remote ischemic conditioning (PRIC) as an adjunctive treatment can improve postoperative recovery in patients undergoing hepatectomy as an adjunct to standard treatment.

Remote Ischemic Conditioning (RIC) can be applied as repeated short-lasting ischemia in a distant tissue that results in protection against subsequent long-lasting ischemic injury in the target organ. This protection can be applied prior to or during a prolonged ischemic event as remote ischemic pre-conditioning (RIPreC) and per-conditioning (RIPerC), respectively, or immediate after reperfusion as remote ischemic post-conditioning (RIPostC).

RIC is a non-pharmacologic and non-invasive treatment without noticeable discomfort, commonly achieved by inflation of a blood pressure cuff to induce 5-minute cycles of limb ischemia alternating with 5 minutes of reperfusion. However, whether perioperative remote ischemic conditioning (PRIC) can improve postoperative recovery in patients undergoing hepatectomy has never been investigated in a randomized controlled trial.

Prospective, randomized, patient-assessor blinded, sham-controlled trial

Application of Perioperative Remote Ischemic Conditioning in Patients Undergoing Hepatectomy

The individual participant data for this study is available from the sponsor on reasonable request through email.

The levels of ALT in perioperative period

The levels of AST in perioperative period

The levels of TBIL in perioperative period

The levels of INR in perioperative period

The levels of ALB in perioperative period

The levels of TNF-α in perioperative period

The levels of MDA in perioperative period

The levels of HO-1 in perioperative period

The levels of NF-κB in perioperative period

The levels of HMGB1 in perioperative period

The levels of platelet in perioperative period

The levels of WBC in perioperative period

The levels of neutrophil granulocyte percentage in perioperative period

Gastrointestinal tolerance was defined as transanal or stoma defecation and oral dietary tolerance.

Prolonged postoperative ileus was diagnosed if patients met two or more of the following conditions on or after postoperative day 4: inability to tolerate the oral diet over the past 24 h, nausea or vomiting, without flatus over the past 24 h, abdominal distension or radiological evidence of intestinal distension without mechanical intestinal obstruction.

The postoperative complications were recorded using the Clavien-Dindo classification system and included: nausea or vomiting, abdominal distension, anastomotic leakage, new pulmonary infection, poor wound healing, cognitive dysfunction, unplanned reoperation, and 30-day readmission rate.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Application of Perioperative Remote Ischemic Conditioning in Patients Undergoing Hepatectomy	NCT06130436	Hepatic Hemangi... Liver Cancer Hepatolithiasis Hepatectomy	Sham-Remote Isc... Remote Ischemic... Remote Ischemic...	25 Years - 75 Years	The Second Affiliated Hospital of Chongqing Medical University
Application of Perioperative Remote Ischemic Conditioning in Patients Undergoing Hepatectomy	NCT06130436	Hepatic Hemangi... Liver Cancer Hepatolithiasis Hepatectomy	Sham-Remote Isc... Remote Ischemic... Remote Ischemic...	25 Years - 75 Years	The Second Affiliated Hospital of Chongqing Medical University

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