Impact of liver cirrhosis, the severity of cirrhosis, and portal hypertension on the outcomes of minimally invasive left lateral sectionectomies for primary liver malignancies

被引：8

作者：

Coelho, Fabricio Ferreira ^{[1
]}

Herman, Paulo ^{[1
]}

Kruger, Jaime A. P. ^{[1
]}

Wu, Andrew G. R. ^{[2
]}

Chin, Ken-Min ^{[3
,4
]}

Hasegawa, Kiyoshi ^{[5
]}

Zhang, Wanguang ^{[6
,7
]}

Alzoubi, Mohammad ^{[8
]}

Aghayan, Davit L. ^{[9
,10
]}

Siow, Tiing-Foong ^{[11
]}

Scatton, Olivier ^{[12
]}

Kingham, T. Peter ^{[13
]}

Marino, Marco, V ^{[14
,15
]}

Mazzaferro, Vincenzo ^{[16
,17
]}

Chiow, Adrian K. H. ^{[18
]}

Sucandy, Iswanto ^{[19
]}

Ivanecz, Arpad ^{[20
]}

Choi, Sung Hoon ^{[21
]}

Lee, Jae Hoon ^{[22
]}

Gastaca, Mikel ^{[23
]}

Vivarelli, Marco ^{[24
]}

Giuliante, Felice ^{[25
]}

Ruzzenente, Andrea ^{[26
]}

Yong, Chee-Chien ^{[27
]}

Dokmak, Safi ^{[28
]}

Fondevila, Constantino ^{[29
,30
]}

Efanov, Mikhail ^{[31
]}

Morise, Zenichi ^{[32
]}

Di Benedetto, Fabrizio ^{[33
]}

Brustia, Raffaele ^{[35
]}

Dalla Valle, Raffaele ^{[36
]}

Boggi, Ugo ^{[37
]}

Geller, David ^{[38
]}

Belli, Andrea ^{[39
]}

Memeo, Riccardo ^{[40
]}

Gruttadauria, Salvatore ^{[41
,42
]}

Mejia, Alejandro ^{[34
]}

Park, James O. ^{[43
]}

Rotellar, Fernando ^{[44
,45
]}

Choi, Gi Hong ^{[46
]}

Robles-Campos, Ricardo ^{[47
]}

Wang, Xiaoying ^{[48
]}

Sutcliffe, Robert P. ^{[49
]}

Pratschke, Johann ^{[50
,51
,52
,53
]}

Lai, Eric C. H. ^{[54
]}

Chong, Charing C. N. ^{[55
]}

D'Hondt, Mathieu ^{[56
]}

Monden, Kazuteru ^{[57
]}

Lopez-Ben, Santiago ^{[58
]}

Liu, Rong ^{[59
]}

机构：

[1] Univ Sao Paulo, Dept Gastroenterol, Liver Surg Unit, Sch Med, Sao Paulo, Brazil

[2] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore

[3] Singapore Gen Hosp, Dept Hepatopancreatobiliary & Transplant Surg, Singapore, Singapore

[4] Natl Canc Ctr Singapore, Singapore, Singapore

[5] Univ Tokyo, Grad Sch Med, Dept Surg, Hepatobiliary Pancreat Surg Div, Tokyo, Japan

[6] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Hepat Surg Ctr, Wuhan, Peoples R China

[7] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Hubei Key Lab Hepatobiliary Pancreat Dis, Wuhan, Peoples R China

[8] Fdn Poliambulanza, Dept Surg, Brescia, Italy

[9] Univ Oslo, Oslo Univ Hosp, Inst Clin Med, Intervent Ctr, Oslo, Norway

[10] Univ Oslo, Oslo Univ Hosp, Inst Clin Med, Dept HPB Surg, Oslo, Norway

[11] Far Eastern Mem Hosp, Dept Surg, Div Gen Surg, New Taipei City, Taiwan

[12] Sorbonne Univ, Hop Pitie Salpetriere, Dept Digest HBP & Liver Transplantat, Paris, France

[13] Mem Sloan Kettering Canc Ctr, Dept Surg, New York, NY USA

[14] Azienda Osped Osped Riuniti Villa Sofia Cervello, Gen Surg Dept, Palermo, Italy

[15] F Tappeiner Hosp, Gen Surg Dept, Merano, Italy

[16] Fdn IRCCS Ist Nazl Tumori Milano, HPB Surg & Liver Transplantat, Milan, Italy

[17] Univ Milan, Milan, Italy

[18] Changi Gen Hosp, Dept Surg, Hepatopancreatobiliary Unit, Singapore, Singapore

[19] AdventHlth Tampa, Digest Hlth Inst, Tampa, FL USA

[20] Univ Med Ctr Maribor, Dept Abdominal & Gen Surg, Maribor, Slovenia

[21] CHA Univ, CHA Bundang Med Ctr, Dept Gen Surg, Sch Med, Seongnam, South Korea

[22] Univ Ulsan, Asan Med Ctr, Dept Surg, Div Hepatobiliary & Pancreat Surg,Coll Med, Seoul, South Korea

[23] Univ Basque Country, Cruces Univ Hosp, Biocruces Bizkaia Hlth Res Inst, Hepatobiliary Surg & Liver Transplantat Unit, Bilbao, Spain

[24] Polytech Univ Marche, United Hosp Ancona, HPB Surg & Transplantat Unit, Dept Expt & Clin Med, Ancona, Italy

[25] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli, Hepatobiliary Surg Unit, IRCCS, Rome, Italy

[26] Univ Verona, GB Rossi Hosp, Dept Surg Dent Gynecol & Pediat, Gen & Hepatobiliary Surg, Verona, Italy

[27] Chang Gung Mem Hosp, Dept Surg, Kaohsiung, Taiwan

[28] Univ Paris Cite, Beaujon Hosp, Dept HPB Surg & Liver Transplantat, Clichy, France

[29] Univ Barcelona, Hosp Clin, Gen & Digest Surg, IDIBAPS,CIBERehd, Barcelona, Spain

[30] Hosp Univ La Paz, Gen & Digest Surg, IdiPAZ, CIBERehd, Madrid, Spain

[31] Moscow Clin Sci Ctr, Dept Hepatopancreato Biliary Surg, Moscow, Russia

[32] Fujita Hlth Univ, Okazaki Med Ctr, Dept Surg, Sch Med, Okazaki, Japan

[33] Univ Modena & Reggio Emilia, HPB Surg & Liver Transplant Unit, Modena, Italy

[34] Methodist Dallas Med Ctr, Liver Inst, Houston, TX USA

[35] Henri Mondor Hosp, AP HP, Dept Digest & Hepatobiliary & Pancreat Surg, Creteil, France

[36] Univ Parma, Dept Med & Surg, Hepatobiliary Surg Unit, Parma, Italy

[37] Univ Pisa, Div Gen & Transplant Surg, Pisa, Italy

[38] Univ Pittsburgh, Dept Surg, Div Hepatobiliary & Pancreat Surg, Med Ctr, Pittsburgh, PA USA

[39] Natl Canc Ctr IRCCS G Pascale, Dept Abdominal Oncol, Div Hepatopancreatobiliary Surg Oncol, Naples, Italy

[40] F Miulli Gen Reg Hosp, Unit Hepatopancreatc Biliary Surg, Acquaviva Delle Fonti, Bari, Italy

[41] Univ Pittsburgh Med Ctr Italy, Ist Ricovero & Cura Carattere Sci Ist Mediterraneo, Dept Treatment & Study Abdominal Dis & Abdominal T, Palermo, Italy

[42] Univ Catania, Dept Gen Surg & Med Surg Specialties, Catania, Italy

[43] Univ Washington, Dept Surg, Med Ctr, Seattle, WA USA

[44] Univ Navarra, Clin Univ Navarra, Dept Gen Surg, HPB & Liver Transplant Unit, Pamplona, Spain

[45] Inst Hlth Res Navarra IdisNA, Pamplona, Spain

[46] Yonsei Univ, Severance Hosp, Dept Surg, Div Hepatopancreatobiliary Surg,Coll Med, Seoul, South Korea

[47] Clin & Univ Hosp Virgen de la Arrixaca, Dept Gen Visceral & Transplantat Surg, IMIB ARRIXACA, Murcia, Spain

[48] Fudan Univ, Zhongshan Hosp, Liver Canc Inst, Dept Liver Surg & Transplantat, Shanghai, Peoples R China

[49] Univ Hosp Birmingham NHS Fdn Trust, Dept Hepatopancreatobiliary & Liver Transplant Sur, Birmingham, England

[50] Campus Charite Mitt, Dept Surg, Berlin, Germany

来源：

SURGERY | 2023年 / 174卷 / 03期

关键词：

LEARNING-CURVE; HEPATOCELLULAR-CARCINOMA; MAJOR HEPATECTOMY; RESECTION; DIFFICULTY; PATHOPHYSIOLOGY; RECOMMENDATIONS; SEGMENTECTOMY; EXPERIENCE; PROPOSAL;

D O I：

10.1016/j.surg.2023.04.057

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: The impact of cirrhosis and portal hypertension on perioperative outcomes of minimally invasive left lateral sectionectomies remains unclear. We aimed to compare the perioperative outcomes between patients with preserved and compromised liver function (noncirrhotics versus Child-Pugh A) when undergoing minimally invasive left lateral sectionectomies. In addition, we aimed to determine if the extent of cirrhosis (Child-Pugh A versus B) and the presence of portal hypertension had a significant impact on perioperative outcomes. Methods: This was an international multicenter retrospective analysis of 1,526 patients who underwent minimally invasive left lateral sectionectomies for primary liver malignancies at 60 centers worldwide between 2004 and 2021. In the study, 1,370 patients met the inclusion criteria and formed the final study group. Baseline clinicopathological characteristics and perioperative outcomes of these patients were compared. To minimize confounding factors, 1:1 propensity score matching and coarsened exact matching were performed. Results: The study group comprised 559, 753, and 58 patients who did not have cirrhosis, Child-Pugh A, and Child-Pugh B cirrhosis, respectively. Six-hundred and thirty patients with cirrhosis had portal hy-pertension, and 170 did not.After propensity score matching and coarsened exact matching, Child-Pugh A patients with cirrhosis undergoing minimally invasive left lateral sectionectomies had longer operative time, higher intraoperative blood loss, higher transfusion rate, and longer hospital stay than patients without cirrhosis. The extent of cirrhosis did not significantly impact perioperative outcomes except for a longer duration of hospital stay. Conclusion: Liver cirrhosis adversely affected the intraoperative technical difficulty and perioperative outcomes of minimally invasive left lateral sectionectomies. & COPY; 2023 Elsevier Inc. All rights reserved.

引用

页码：581 / 592

页数：12

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