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Duration of hepatic vascular inflow clamping and survival after liver resection for hepatocellular carcinoma
British journal of surgery, 2011-09, Vol.98 (9), p.1284-1290
Ishizuka, M.
Kubota, K.
Kita, J.
Shimoda, M.
Kato, M.
Sawada, T.
2011
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Ishizuka, M.
Kubota, K.
Kita, J.
Shimoda, M.
Kato, M.
Sawada, T.
Titel
Duration of hepatic vascular inflow clamping and survival after liver resection for hepatocellular carcinoma
Ist Teil von
British journal of surgery, 2011-09, Vol.98 (9), p.1284-1290
Ort / Verlag
Chichester, UK: John Wiley & Sons, Ltd
Erscheinungsjahr
2011
Quelle
MEDLINE
Beschreibungen/Notizen
Background: The aim of this study was to evaluate the influence of the duration of hepatic vascular inflow clamping (Pringle time) on the survival of patients with any type of liver background (not only cirrhosis) undergoing liver resection for hepatocellular carcinoma (HCC). Methods: Patients who underwent liver resection between April 2000 and December 2008 for HCC using the Pringle manoeuvre were identified retrospectively from an institutional database and divided into two groups: group 1 had a Pringle time of 60 min or less, and group 2 a Pringle time of more than 60 min. Univariable and multivariable analyses were performed to identify predictors of postoperative survival. Kaplan–Meier analysis was used to compare overall survival between the groups. Results: A total of 357 patients were enrolled; 242 patients had a Pringle time of 60 min or less (group 1), and 115 patients had a Pringle time of more than 60 min (group 2). Patients in group 2 had a shorter overall survival than those in group 1 (P = 0·010). Univariable analyses showed that type of HCC (primary versus recurrent), maximum tumour diameter, hepatic venous infiltration, platelet count, serum protein induced by vitamin K absence or antagonist II level, blood loss (700 ml or less versus more than 700 ml), duration of operation (300 min or less versus more than 300 min) and Pringle time (60 min or less versus more than 60 min) were predictive of postoperative survival. Multivariable analysis indicated that only Pringle time was associated with postoperative survival (odds ratio 1·83, 95 per cent confidence interval 1·08 to 3·10; P = 0·024). Conclusion: Longer Pringle time is an important predictor of shorter postoperative survival in patients undergoing liver resection for HCC. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Longer Pringle is bad news
Sprache
Englisch
Identifikatoren
ISSN: 0007-1323
eISSN: 1365-2168
DOI: 10.1002/bjs.7567
Titel-ID: cdi_proquest_miscellaneous_879680027
Format
–
Schlagworte
Adult
,
Aged
,
Aged, 80 and over
,
Biological and medical sciences
,
Blood Loss, Surgical - mortality
,
Carcinoma, Hepatocellular - mortality
,
Carcinoma, Hepatocellular - pathology
,
Carcinoma, Hepatocellular - surgery
,
Constriction
,
Female
,
Gastroenterology. Liver. Pancreas. Abdomen
,
General aspects
,
Humans
,
Kaplan-Meier Estimate
,
Length of Stay
,
Liver - blood supply
,
Liver Neoplasms - mortality
,
Liver Neoplasms - pathology
,
Liver Neoplasms - surgery
,
Liver, biliary tract, pancreas, portal circulation, spleen
,
Liver. Biliary tract. Portal circulation. Exocrine pancreas
,
Male
,
Medical sciences
,
Middle Aged
,
Retrospective Studies
,
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
,
Surgery of the digestive system
,
Treatment Outcome
,
Tumors
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