title: Preoperative steroid administration in liver resection: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the outcome of preoperative steroid administration in patients undergoing liver resection using a systematic review and meta-analysis.
  
  
  METHODS
  Literature on prospective randomized study of preoperative steroid administration in patients undergoing liver resection published between 1966 and July 2011 was retrieved. A systematic review and meta-analysis were conducted to estimate the surgical stress, clinical benefit and safety.
  
  
  RESULTS
  The reported surgical stress markers included serum IL-6, IL-10 and CRP. Meta-analysis showed that: 1) steroid group had lower serum IL-6 level on POD 1 and POD 3 (p<0.05), and 2) steroid group had lower serum CRP level on POD 3 (p<0.05) with no significant difference on POD 1 and POD 7. After stratifying by Pringle maneuver and steroid dosage, we found that: 1) intermittent Pringle maneuver might have a better effect in suppressing releasing IL-6; 2) both 30 mg/kg and a single dose of 500 mg benefited patients in suppressing releasing IL-6. The incidences of complications were almost the same between steroid group and control group.
  
  
  CONCLUSIONS
  Preoperative steroid administration can reduce postoperative surgical stress and has a positive impact on the liver function in patients undergoing liver resection. It does not increase incidence of postoperative complication.
authors: Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu Sichuan Province, China.
authors: Hongyu
authors: H
authors: Li
authors: Yonggang
authors: Y
authors: Wei
authors: Bo
authors: B
authors: Li
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D011183:Postoperative Complications / Q000453:epidemiology; D011292:Premedication; D013312:Stress, Physiological
chemical_list: D000305:Adrenal Cortex Hormones; D015850:Interleukin-6; D002097:C-Reactive Protein