Outcomes and prognostic variables associated with central division hepatic lobectomies: 61 dogs
Outcomes and prognostic variables associated with central division hepatic lobectomies: 61 dogs
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DOI：
10.1111/vsu.13164
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发表时间：
2019-04-01
影响因子：
1.8
通讯作者：
Matz, Brad M.
中科院分区：
文献类型：
--
作者：
Linden, Daniel S.;Liptak, Julius M.;Matz, Brad M.
目的探讨犬中央部肝叶切除术后的远期生存率和并发症的相关因素。研究设计多机构回顾性病例系列。动物六十一个客户拥有的狗与中央司群众。方法回顾性分析2000年1月1日至2015年1月1日行中央部肝叶切除术的犬的临床资料，包括临床体征、术前分期、术前细胞学或活检结果、手术日期、肿块位置、手术技术、是否行胆囊切除术或胆囊固定术、并发症、组织病理学诊断和切缘评价，局部复发或转移性疾病的检测日期和生存期。结果肝门切除术的术中、术后并发症增加。29只犬发生术中并发症，其中20只犬发生术中出血。19只狗需要输血。20只犬出现术后即刻并发症。围手术期死亡率为11%，2周死亡率为14.7%。未达到肝细胞癌（HCC）犬的中位生存时间。HCC犬的1年和3年截尾生存率分别为82.1%和82.1%。边缘状态不影响生存时间。结论中央部肝叶切除术后出血率约为33%，但围手术期死亡率相对较低。无论切缘状态如何，肝叶切除术治疗HCC均可获得长期生存。临床意义外科医生应预期可能需要中央部肝叶切除术的犬对血液制品的需求。无论切缘状态如何，手术治疗HCC后的长期生存是可以预期的。
Objective To determine the outcome and prognostic variables associated with long-term survival and complications in dogs undergoing hepatic lobectomy of the central division. Study design Multi-institutional retrospective case series. Animals Sixty-one client-owned dogs with central division masses. Methods Medical records of dogs undergoing hepatic lobectomy of the central division from January 1, 2000 to January 1, 2015 were reviewed for signalment, clinical signs, preoperative staging, preoperative cytology or biopsy results, date of procedure, location of mass, surgical technique, whether cholecystectomy or cholecystopexy was performed, complications, histopathologic diagnosis and margin evaluation, date of local recurrence or detection of metastatic disease, and survival. Results Hilar resection was associated with increased intraoperative and postoperative complications. Intraoperative complications occurred in 29 dogs, with 20 dogs experiencing intraoperative hemorrhage. Nineteen dogs required transfusions. Immediate postoperative complications occurred in 20 dogs. Perioperative mortality rate was 11%, and 2-week mortality rate was 14.7%. The median survival time for dogs with hepatocellular carcinoma (HCC) was not reached. The 1- and 3-year censored survival rates for dogs with HCC was 82.1% and 82.1%, respectively. Margin status did not impact survival time. Conclusion Hepatic lobectomy of the central division was associated with hemorrhage in approximately 33% of dogs, but there was a relatively low perioperative mortality rate. Hepatic lobectomy for HCC resulted in long-term survival, regardless of margin status. Clinical significance Surgeons should anticipate the requirement for blood products in dogs that may require hepatic lobectomy of the central division. Long-term survival can be expected after surgical treatment of HCC, regardless of margin status.