Major liver resection reduces nonprotein respiratory quotient and increases nonesterified fatty acid at postoperative day 14 in patients with hepatocellular carcinoma
Major liver resection reduces nonprotein respiratory quotient and increases nonesterified fatty acid at postoperative day 14 in patients with hepatocellular carcinoma
复制标题
肝细胞癌患者术后第 14 天的主要肝切除术降低了非蛋白呼吸商并增加了非酯化脂肪酸
DOI：
10.1016/j.clnesp.2017.10.001
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发表时间：
2018
影响因子：
3
通讯作者：
Shimada Mitsuo
中科院分区：
文献类型：
--
作者：
Wada Shoko;Yamanaka-Okumura Hisami;Katayama Takafumi;Morine Yuji;Imura Satoru;Shimada Mitsuo
背景与目的我们报道了肝细胞癌（HCC）患者肝切除后非蛋白质呼吸商（npRQ）降低;然而，肝切除量是否影响这些患者的能量代谢尚不清楚。我们的目的是研究肝切除和能量代谢indics.MethodsNpRQ之间的关系进行了测定，在53例肝癌和7在术前和术后天。患者分为4组：小-低ICG组（n = 17）：小（亚段或更少）切除和15 min时低吲哚菁绿色留存率（ICGR 15）（<15%）;小-高ICG组（n = 18）：小切除和高ICGR 15（≥15%）;大-低ICG组（n = 18）：大（肺叶）切除和低ICGR 15（<15%）。我们调查了膳食摄入量和血液生化能量测量。结果与术前相比，术后第14天Minor-highICG组和Major-lowICG组npRQ显著降低，而Major-lowICG组NEFA显著升高。在单因素回归分析中，ΔnpRQ与HCV感染显著相关，ΔNEFA与切除体积、HCV感染和ICGR 15显著相关。经年龄、病因和ICGR 15校正后，ΔNEFA与手术切除量呈显著正相关。结论大切除术患者术后营养恢复慢于小切除术患者。因此，营养护理，以防止饥饿是必要的，在重大切除患者。
Background & aimsWe reported decreased nonprotein respiratory quotient (npRQ) after liver resection in patients with hepatocellular carcinoma (HCC); however, whether liver resection volume affects energy metabolism in these patients is unclear. We aimed to examine the relationship between liver resection and energy metabolism indices.MethodsNpRQ was measured in 53 patients with HCC and seven with at the pre- and postoperative days. Patients were classified into four groups: Minor-lowICG group (n = 17): minor (subsegment or less) resection and low indocyanine green retention rate at 15 min (ICGR15) (<15%); Minor-highICG group (n = 18): minor resection and high ICGR15 (≥15%) and Major-lowICG group (n = 18): major (lobe) resection and low ICGR15 (<15%). We investigated dietary intake and blood biochemistry at energy measurement. The difference in npRQ and nonesterified fatty acid (NEFA) pre- and post-hepatectomy was shown as ΔnpRQ and ΔNEFA, respectively.ResultsCompared with the preoperative values, npRQ significantly decreased in the Minor-highICG and Major-lowICG groups and NEFA significantly increased in the Major-lowICG group at postoperative day 14. In single regression analysis, ΔnpRQ significantly correlated with HCV infection and ΔNEFA with resection volume, HCV infection, and ICGR15. In multiple regression analysis, ΔNEFA significantly correlated with resection volume after adjusting for age, etiology, and ICGR15.ConclusionsThese results suggest that postoperative nutritional recovery is slower in major resection than in minor resection patients. Hence, nutritional care to prevent starvation is needed in major resection patients.