Impact of intraoperative blood loss on postoperative morbidity after liver resection for primary and secondary liver cancer.

• Tác giả: Miho Akabane, Luca Aldrighetti, Abdullah Altaf, Federico Aucejo, Todd W Bauer, François Cauchy, Itaru Endo, Ana Gleisner, Tom Hugh, Jun Kawashima, Mujtaba Khalil, Minoru Kitago, Bas G Koerkamp, Vincent Lam, Shishir K Maithel, Hugo P Marques, Guillaume Martel, Timothy M Pawlik, Irinel Popescu, George Poultsides, Carlo Pulitano, Zayed Rashid, Andrea Ruzzenente, Kazunari Sasaki, Feng Shen, Mathew J Weiss, Shahzaib Zindani
• Ngôn ngữ: eng
• Ký hiệu phân loại: 615.367 Liver extracts
• Thông tin xuất bản: England : HPB : the official journal of the International Hepato Pancreato Biliary Association , 2025
• Bộ sưu tập: NCBI
• ID: 166738

Tóm tắt

 BACKGROUND: We sought to determine the association between intraoperative blood loss (IBL) and postoperative morbidity among patients undergoing surgery for liver cancer. METHODS: Patients undergoing surgery for primary and secondary liver cancer were identified from a multi-institutional database. Adjusted blood loss (aBL) was calculated by normalizing IBL to body weight
  the comprehensive complication index (CCI) was used to evaluate postoperative complications. RESULTS: A total of 2491 patients were included. Mean CCI was 10.6 (±5.2) for patients with aBL <
 10 mL/kg versus 15.2 (±7.2) for individuals with aBL ≥10 mL/kg (p <
  0.001). On cubic spline regression, a nonlinear correlation between aBL and CCI was observed. CCI increased exponentially for aBL ranging from 5 to 10 mL/kg, then reached a plateau between an aBL of 10-30 mL/kg before dramatically increasing for aBL >
 30 mL/kg. Recursive partitioning technique demonstrated that an aBL threshold of 8.5 mL/kg best distinguished CCI (p <
  0.001). Additionally, patients with an aBL ≥8.5 mL/kg had worse recurrence-free and overall survival versus patients with an aBL <
 8.5 mL/kg. CONCLUSION: A nonlinear incremental correlation between aBL and CCI was identified among patients undergoing surgery for liver cancer. Maintaining an aBL <
 8.5 mL/kg during LR may help reduce postoperative morbidity.