42,573 cases of hepatectomy in China: a multicenter retrospective investigation
42,573 cases of hepatectomy in China: a multicenter retrospective investigation
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DOI：
10.1007/s11427-017-9259-9
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发表时间：
2018-06-01
影响因子：
9.1
通讯作者：
Chen, Xiaoping
中科院分区：
文献类型：
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作者：
Zhang, Binhao;Zhang, Bixiang;Chen, Xiaoping
肝切除术目前在中国大多数医院常规进行。我国是世界上肝病发病人数最多、肝切除病例最多的国家。对全国112家医院进行了多中心回顾性调查，重点关注肝细胞癌（HCC）患者的肝切除术。入组42,573例肝切除病例，选取18,275例有效肝癌患者肝切除病例进行统计分析。最后分析肝癌的流行病学、肝切除术的分布、术后并发症及预后。在18，275例HCC患者中，81%患有B型肝炎病毒感染，10%患有丙型肝炎病毒感染。38%的HCC患者AFP水平正常，35%的患者AFP水平低于400 ng/mL（-1）。在研究期间，97%的肝癌切除术采用开放手术治疗，23.81%采用血管阻断技术。手术时间为（191.7 +/- 105.6）min，失血量为（546.0 +/- 562.8）mL，输血量为（543.0 +/-1，035.2）mL。HCC患者的中位生存期为631天，1年、3年和5年总生存率分别为73.2%、28.8%和19.6%。肝硬化、多发结节、肿瘤血栓形成和AFP水平升高是影响术后生存的危险因素。
Hepatectomy is currently routinely performed in most hospitals in China. China owns the largest population of liver diseases and the biggest number of liver resection cases. A nationwide multicenter retrospective investigation involving 112 hospitals was performed, and focused on liver resection for patients with hepatocellular carcinoma (HCC). 42,573 cases of hepatectomy were enrolled, and 18,275 valid cases of liver resection for HCC patients were selected for statistical analysis. The epidemiology of HCC, distribution of hepatectomy, postoperative complications and prognosis were finally analyzed. In the 18,275 HCC patients, 81% had hepatitis B virus infection and 10% had hepatitis C virus infection. 38% of the HCC patients had normal Alphafetoprotein (AFP) level, and other 35% had an AFP level lower than 400 ng mL(-1). In the study period, 97% of the hepatectomy for HCC were treated with open surgery, and 23.81% had vascular exclusion techniques. The operation time was (191.7 +/- 105.6) min, the blood loss was (546.0 +/- 562.8) mL, and blood transfusion was (543.0 +/- 1,035.2) mL. The median survival for HCC patients was 631 days, with 1-, 3-, and 5-year overall survival of 73.2%, 28.8% and 19.6%, respectively. Liver cirrhosis, multiple nodules, tumor thrombosis and high AFP level were risk factors that affect postoperative survival.