PERIOPERATIVE PREDICTORS OF MORBIDITY FOLLOWING HEPATIC RESECTION FOR NEOPLASM - A MULTIVARIATE-ANALYSIS OF A SINGLE SURGEON EXPERIENCE WITH 105 PATIENTS
PERIOPERATIVE PREDICTORS OF MORBIDITY FOLLOWING HEPATIC RESECTION FOR NEOPLASM - A MULTIVARIATE-ANALYSIS OF A SINGLE SURGEON EXPERIENCE WITH 105 PATIENTS
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DOI：
10.1097/00000658-199401000-00003
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发表时间：
1994-01-01
影响因子：
9
通讯作者：
GREENE, PS
中科院分区：
文献类型：
--
作者：
SITZMANN, JV;GREENE, PS
目的研究了预测连续肝切除术治疗肿瘤的死亡率或发病率风险的因素，并以手术技术和经验为控制变量。虽然这种程序的死亡率稳步下降，相关的发病率仍然high.Methods一百零五例进行肝切除术的恶性肿瘤在4年期间由一个单一的外科医生，以确定术前，术中，或术后预测的病态结果进行了研究。变量进行了分析，采用多元逐步回归，logistic model.Results 60天的住院死亡率为2.8%，发病率发生在33%。血清胆红素是一个重要的术前发病预测因子（p > 0.005）。值得注意的是，术前肾功能或内科疾病并不增加发病风险。结论复杂性肝切除术死亡率低，血清胆红素是预测术后并发症的最有效指标。
Objective Factors that predict mortality or morbidity risk in consecutive hepatic resections for neoplasm were examined, with controlled variables of surgical technique and experience.Summary Background Data Hepatic resection has become the therapy of choice for the management of metastatic or primary neoplasms of the liver. Although mortality for this procedure has steadily decreased, associated morbidity remains high.Methods One hundred five patients undergoing hepatic resection for malignancy over a 4-year period by a single surgeon to identify preoperative, intraoperative, or postoperative predictors of morbid outcomes were studied. Variables were analyzed using multiple regression in a stepwise, logistic model.Results Sixty-day hospital mortality was 2.8%, with morbidity occurring in 33%. A significant preoperative predictor of morbidity was serum bilirubin (p > 0.005). Notably, preoperative renal function, or medical illness, did not increase morbid risk. Operative variables increasing risk included extent of resection, blood loss, and operative time (p > 0.005).Conclusions Complex hepatic resection can be performed with low mortality, and serum bilirubin is the single most powerful predictor of postoperative complication.