Three Hundred and One Consecutive Extended Right Hepatectomies Evaluation of Outcome Based on Systematic Liver Volumetry
Three Hundred and One Consecutive Extended Right Hepatectomies Evaluation of Outcome Based on Systematic Liver Volumetry
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DOI：
10.1097/sla.0b013e3181b674df
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发表时间：
2009-10-01
影响因子：
9
通讯作者：
Vauthey, Jean-Nicolas
中科院分区：
文献类型：
--
作者：
Kishi, Yoji;Abdalla, Eddie K.;Vauthey, Jean-Nicolas
目的：本研究旨在确定术前肝脏容量测定对扩大右肝切除术后结果的影响 主要终点是评估未来肝残余 (FLR) 标准化肝脏体积比 (sFLR) >20% 是否足以安全进行肝切除 次要终点是评估术前门静脉栓塞 (PVE) 是否与初始 sFLR ： 20% 的患者预后改善相关背景数据： sFLR已提出 >20% 的肝脏总体积足以进行安全肝切除。但这一概念尚未在大型系列中得到验证。此外，最近的报告表明术前 PVE 适合 sFLR 7 mg/dL 通过多变量逻辑回归确定肝功能不全的预测因素结果：在接受肝容量测定的 290 名患者中，45 名患者 (15%) 发生术后肝功能不全，占死亡的 61%。 sFLR = 30%，但 sFLR 为 20% 的患者更高。多变量分析显示体重指数>25 kg/m(2)。术中输血，sFLR 20% 足以安全进行肝切除，sFLR 20 1% 至 30% 不是术前 PVE 的指征
Objective(s): This study aimed to determine the efffect of preoperative liver volumetry on postoperative outcomes after extended right hepatectomy Primary end point was to evaluate whether Future liver remnant (FLR) standardized liver volume ratio (sFLR) >20% is sufficient for a safe hepatic resection Secondary end point was to assess whether preoperative portal vein embolization (PVE) is associated with improved outcome in patients with initial sFLR : 20%Background Data: An sFLR >20% of the total liver volume has been proposed as sufficient for safe hepatic resection. but this concept has not been validated in a large series. In addition, recent reports suggest preoperative PVE is indicated for sFLR 7 mg/dL Predictors of liver insufficiency were identified by multivariate logistic regressionResults: Postoperative liver insufficiency occurred in 45 patients (15%) and accounted for 61% of deaths Among 290 patients who underwent liver volumetry. sFLR was = 30% but higher in patients with sFLR 20%. Multivariate analysis revealed that body mass index >25 kg/m(2). intraoperative blood transfusion, and sFLR 20% is sufficient For safe hepatic resection and sFLR 20 1% to 30% is not an indication for preoperative PVE