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World Journal of Surgery
Published in: World Journal of Surgery 2/2008

01-02-2008

The Potential Role for Xanthine Oxidase Inhibition in Major Intra-abdominal Surgery

Authors: Anubhav Mittal, Anthony R. J. Phillips, Benjamin Loveday, John A. Windsor

Published in: World Journal of Surgery | Issue 2/2008

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Abstract

Background

Xanthine oxidase (XO) is a cytosolic metalloflavoprotein that has been implicated in the pathogenesis of a wide spectrum of diseases, and is thought to be the most important source of oxygen-free radicals and cell damage during re-oxygenation of hypoxic tissues. Clinical studies have already shown that XO inhibition is safe and effective for the treatment of gout, tumour-lysis syndrome, and to reduce complications such as post-operative arrhythmias, myocardial infarction and mortality in cardiovascular surgery. Here, we review the evidence from two decades of animal studies that have investigated the effects of XO inhibition during intra-abdominal surgery.

Materials and methods

A search of the Ovid MEDLINE database from 1950 through January 2007 was carried out using the following search terms: xanthine oxidase, allopurinol, ischemia, reperfusion, intestine, bowel, and general surgery.

Results

The inhibition of XO has been shown to reduce oxidative stress, neutrophil priming, damage to intestinal mucosa due to ischemia reperfusion injuries, intestinal anastomotic dehiscence, bacterial translocation, adhesion formation, distant organ injury and mortality.

Conclusions

Despite this evidence which very strongly suggests a likely clinically beneficial role for XO inhibition in the elective and acute operative setting, it is surprising that such an approach has not been investigated in general surgery. There is now sufficient evidence to justify dedicated studies to determine the clinical benefits, dosing and duration of XO inhibition before and after gastrointestinal surgery.
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Metadata
Title
The Potential Role for Xanthine Oxidase Inhibition in Major Intra-abdominal Surgery
Authors
Anubhav Mittal
Anthony R. J. Phillips
Benjamin Loveday
John A. Windsor
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 2/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-007-9336-4

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