Zero mortality in more than 300 hepatic resections: validity of preoperative volumetric analysis
Zero mortality in more than 300 hepatic resections: validity of preoperative volumetric analysis
复制标题
DOI：
10.1007/s00595-011-0108-2
复制
发表时间：
2012-05-01
期刊：
影响因子：
2.5
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Itoh, Shinji;Shirabe, Ken;Maehara, Yoshihiko
我们回顾了一系列在我们机构接受肝切除术的患者，以调查肝肿瘤切除术后并发症的危险因素，并为活体肝移植（LDLT）grafts.Between 2004年4月至2007年8月，我们进行了304例肝肿瘤切除术或为LDLT获取移植物。在肝切除术前使用三维计算机断层扫描（3D-CT）进行术前体积分析。我们比较了有无术后并发症患者的临床病理因素，无手术死亡。根据3D-CT体积测量，实际和估计的残肝体积之间的平均误差率为13.4%。术后并发症96例（31.6%）。Logistic回归分析显示，组织学肝硬化和术中出血量> 850 mL是肝切除术后并发症的重要危险因素，术前评估以容积分析为基础，结合先进的手术技术，实现了零死亡率和术中出血量最小化。其被归类为主要肝切除术后并发症的最重要预测因素之一。
We reviewed a series of patients who underwent hepatic resection at our institution, to investigate the risk factors for postoperative complications after hepatic resection of liver tumors and for procurement of living donor liver transplantation (LDLT) grafts.Between April 2004 and August 2007, we performed 304 hepatic resections for liver tumors or to procure grafts for LDLT. Preoperative volumetric analysis was done using 3-dimensional computed tomography (3D-CT) prior to major hepatic resection. We compared the clinicopathological factors between patients with and without postoperative complications.There was no operative mortality. According to the 3D-CT volumetry, the mean error ratio between the actual and the estimated remnant liver volume was 13.4%. Postoperative complications developed in 96 (31.6%) patients. According to logistic regression analysis, histological liver cirrhosis and intraoperative blood loss > 850 mL were significant risk factors of postoperative complications after hepatic resection.Meticulous preoperative evaluation based on volumetric analysis, together with sophisticated surgical techniques, achieved zero mortality and minimized intraoperative blood loss, which was classified as one of the most significant predictors of postoperative complications after major hepatic resection.