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Risk factor in liver surgery

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https://www.readbyqxmd.com/read/28641762/laparoscopic-versus-robotic-surgery-for-hepatocellular-carcinoma-the-first-46-consecutive-cases
#1
Paolo Magistri, Giuseppe Tarantino, Cristiano Guidetti, Giacomo Assirati, Tiziana Olivieri, Roberto Ballarin, Andrea Coratti, Fabrizio Di Benedetto
BACKGROUND: Hepatocellular carcinoma has a growing incidence worldwide, and represents a leading cause of death in patients with cirrhosis. Nowadays, minimally invasive approaches are spreading in every field of surgery and in liver surgery as well. MATERIALS AND METHODS: We retrospectively reviewed demographics, clinical, and pathologic characteristics and short-term outcomes of patients who had undergone minimally invasive resections for hepatocellular carcinoma at our institution between June 2012 and May 2016...
May 8, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28636702/analysis-of-survival-after-initiation-of-continuous-renal-replacement-therapy-in-a-surgical-intensive-care-unit
#2
James M Tatum, Galinos Barmparas, Ara Ko, Navpreet Dhillon, Eric Smith, Daniel R Margulies, Eric J Ley
Importance: Continuous renal replacement therapy (CRRT) benefits patients with renal failure who are too hemodynamically unstable for intermittent hemodialysis. The duration of therapy beyond which continued use is futile, particularly in a population of patients admitted to and primarily cared for by a surgical service (hereinafter referred to as surgical patients), is unclear. Objective: To analyze proportions of and independent risk factors for survival to discharge after initiation of CRRT among patients in a surgical intensive care unit (SICU)...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28633644/risk-factors-for-pulmonary-complications-after-hepatic-resection-role-of-intraoperative-hemodynamic-instability-and-hepatic-ischemia
#3
Victoria Lepere, Antoine Vanier, Yann Loncar, Louis Lemoine, Jean Christophe Vaillant, Antoine Monsel, Eric Savier, Pierre Coriat, Daniel Eyraud
BACKGROUND: Postoperative operative pulmonary complications (PPCs) after hepatic surgery are associated with increased length of hospital stays. Intraoperative blood transfusion, extensive resection and different comorbidities have been identified. Other parameters, like time of hepatic ischemia, have neither been clinically studied, though experimental studies show that hepatic ischemia can provide lung injury. The objective of this study was to determinate the risk factors of postoperative pulmonary complications (PPCs) after hepatic resection within 7 postoperative days...
June 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28615946/treatment-and-outcome-of-intestinal-perforation-after-liver-transplant-surgery-in-adults-a-single-center-experience
#4
Jianyu Lin, Jing Wang, Peng Yue, Xingmao Zhang, Ren Lang, Yuan Wang, Chen Cui, Qiang He
OBJECTIVE: Intestinal perforation is a rare complication after liver transplantation. This study was designed to calculate the incidence and investigate the outcomes of intestinal perforation in adult liver transplant patients. MATERIALS AND METHODS: The clinical records of liver transplant recipients between January 2014 and June 2016 were obtained. The incidence of intestinal perforation was calculated, and high risk factors were analyzed. RESULTS: The mean operative time was 8...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28611523/surgical-management-of-liver-diseases-invading-the-hepatocaval-confluence-based-on-ih-classification-the-surgical-guideline-in-our-center
#5
Wei Li, Jun Han, Zhao-Ping Wu, Hong Wu
AIM: to investigate the short-term outcomes and risk factors indicating postoperative death of patients with lesions adjacent to the hepatocaval confluence. METHODS: We retrospectively analyzed 54 consecutive patients who underwent hepatectomy combined with inferior vena cava (IVC) and/or hepatic vein reconstruction (HVR) from January 2012 to January 2016 at our liver surgery center. The patients were divided into 5 groups according to the range of IVC and hepatic vein involvement...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28608014/incidence-and-risk-factors-for-postoperative-delirium-in-patients-after-hepatectomy
#6
Sung Ae Park, Yoshito Tomimaru, Asuka Shibata, Shinichi Miyagawa, Kozo Noguchi, Keizo Dono
BACKGROUNDS: Postoperative delirium is a common complication after surgery. However, the incidence and risk factors associated with delirium after liver resection have not been clarified. Thus, this study aimed to investigate the incidence and risk factors for delirium in patients that underwent liver resections. METHODS: This study included 196 consecutive patients that underwent a liver resection. Groups with and without delirium were compared to identify differential patient characteristics...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28598712/autotaxin-expression-in-hepatocellular-carcinoma
#7
Ilker Memet, Evanthia Tsalkidou, Alexandra K Tsaroucha, Maria Lambropoulou, Ekaterini Chatzaki, Gregory Trypsianis, Dimitrios Schizas, Michael Pitiakoudis, Constantinos Simopoulos
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Despite the important progress observed in liver surgery, the survival rates are discouraging. The aim of this study was to investigate the expression of autotaxin in hepatocellular carcinoma. MATERIALS AND METHODS: Liver tissues from 28 human hepatocellular carcinomas were evaluated for the expression of autotaxin by immunohistochemistry. The gender, age, histological grade, lymphovascular invasion, number of tumors, levels of serum alpha-fetoprotein (aFP), presence of liver cirrhosis, hepatitis, surgery and survival rates were recorded...
June 9, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28597349/perioperative-allogenic-blood-transfusion-is-a-poor-prognostic-factor-after-hepatocellular-carcinoma-surgery-a-multi-center-analysis
#8
Hiroshi Wada, Hidetoshi Eguchi, Hiroaki Nagano, Shoji Kubo, Takuya Nakai, Masaki Kaibori, Michihiro Hayashi, Shigekazu Takemura, Shogo Tanaka, Yasuyuki Nakata, Kosuke Matsui, Morihiko Ishizaki, Fumitoshi Hirokawa, Koji Komeda, Kazuhisa Uchiyama, Masanori Kon, Yuichiro Doki, Masaki Mori
PURPOSE: The influence of allogenic blood transfusion on the postoperative outcomes of hepatocellular carcinoma (HCC) surgery remains controversial. This study aims to clarify the clinical impacts of perioperative allogenic blood transfusion on liver resection outcome in HCC patients. METHODS: We analyzed data collected over 5 years for 642 patients who underwent hepatectomy for HCC at one of the five university hospitals. We investigated the impact of allogenic blood transfusion on postoperative outcome after surgery in all patients and in 74 matched pairs, using a propensity score...
June 8, 2017: Surgery Today
https://www.readbyqxmd.com/read/28595819/risk-factors-and-prediction-model-for-inpatient-surgical-site-infection-after-major-abdominal-surgery
#9
Aslam Ejaz, Carl Schmidt, Fabian M Johnston, Steve M Frank, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSIs) are a common source of postoperative morbidity and a marker of surgical quality. The ability to predict the incidence of SSIs is limited and most models have poor predictive value. We sought to identify risk factors associated with SSIs and develop a prediction model for SSIs after major abdominal surgery. METHODS: A total of 1744 patients undergoing pancreatic, hepatobiliary, and colorectal resections between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital were identified...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28593406/laparoscopic-liver-surgery-towards-a-day-case-management
#10
Hadrien Tranchart, David Fuks, Panagiotis Lainas, Martin Gaillard, Ibrahim Dagher, Brice Gayet
BACKGROUND: Ambulatory surgery (AS) is a contemporary subject of interest. The feasibility and safety of AS for solid abdominal organs are still dubious. In the present study, we aimed at defining potential surgical criteria for AS by analyzing a large database of patients who underwent laparoscopic liver surgery (LLS) in two French expert centers. METHODS: This study was performed using prospectively filled databases including patients that underwent pure LLS between 1998 and 2015...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28583534/pretransplant-resting-heart-rate-and-its-association-with-all-cause-mortality-in-liver-transplant-recipients
#11
H-M Kwon, I-G Jun, K-W Jung, Y-J Moon, W-J Shin, J-G Song, G-S Hwang
BACKGROUND: The importance of heart rate (HR) measurement as a prognostic factor has been recognized in many clinical conditions, such as hypertension, coronary artery disease, or heart failure. Patients with liver cirrhosis tend to have increased resting HR as consequence of hyperdynamic circulation. In the current study, we examined whether pretransplant resting increased HR is associated with overall mortality in cirrhotic patients following liver transplantation (LT). PATIENTS AND METHODS: We retrospectively collected and analyzed the data of 881 liver recipients who underwent LT surgery between October 2009 and September 2012...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28582270/conversion-for-unfavorable-intraoperative-events-results-in-significantly-worst-outcomes-during-laparoscopic-liver-resection-lessons-learned-from-a-multicenter-review-of-2861-cases
#12
Mark C Halls, Federica Cipriani, Giammauro Berardi, Leonid Barkhatov, Panagiotis Lainas, Mohammed Alzoubi, Mathieu D'Hondt, Fernando Rotellar, Ibrahim Dagher, Luca Aldrighetti, Roberto I Troisi, Bjorn Edwin, Mohammed Abu Hilal
OBJECTIVE: To investigate the risk factors for conversion during laparoscopic liver resection and its effect on patient outcome in a large cohort of patients. Additional analysis of outcomes in patients who required conversion for unfavorable intraoperative findings and conversion for unfavorable intraoperative events will be performed to establish if the cause of conversion effects outcome. SUMMARY BACKGROUND DATA: Multiple previous studies demonstrate that laparoscopic liver surgery reduces intraoperative blood loss, hospital stay, and morbidity while maintaining comparable oncological and survival outcomes when compared with open liver resections...
June 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28573420/identifying-independent-risk-factors-for-graft-loss-after-primary-liver-transplantation
#13
Jill Gwiasda, Harald Schrem, Jürgen Klempnauer, Alexander Kaltenborn
PURPOSE: The aim of the study is the identification of independent risk factors for re-transplantation after primary liver transplantation beyond the occurrence of hepatic artery thrombosis. METHODS: Eight hundred thirty-four adult patients undergoing primary liver transplantation were analyzed. A propensity score was developed using multivariable binary logistic regression with hepatic artery thrombosis as the dependent variable. The logit link function of the propensity score was included into multivariable Cox regression analysis for graft survival to adjust the study population...
June 1, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28562348/actual-over-10-year-survival-after-liver-resection-for-patients-with-intrahepatic-cholangiocarcinoma
#14
Anfeng Si, Jun Li, Hongjun Xiang, Shichao Zhang, Shilei Bai, Pinghua Yang, Xiaofeng Zhang, Yong Xia, Kui Wang, Zhenlin Yan, Wan Yee Lau, Lehua Shi, Feng Shen
Partial hepatectomy is a potentially curative therapy for intrahepatic cholangiocarcinoma (ICC). Unfortunately, the overall surgical prognosis remains dismal and the actual 10-year survival has not been reported. This study aimed to document 10-year actual survival rates, identify the prognostic factors associated with 10-year survival rate, and analyze the characteristics of patients who survived ≥ 10 years. Among 251 patients who underwent curative liver resection for ICC between 2003 and 2006 at the Eastern Hepatobiliary Surgery Hospital, 21 patients (8...
May 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28558845/metformin-is-not-associated-with-lactic-acidosis-in-patients-with-diabetes-undergoing-coronary-artery-bypass-graft-surgery-a-case-control-study
#15
Rakan I Nazer, Khalid A Alburikan
BACKGROUND: Metformin associated lactic acidosis (MALA) is a rare but lethal complication. There is no consensus regarding when to stop and resume metformin in patients who undergo coronary artery bypass grafting (CABG). This study aimed to determine if uninterrupted metformin administration in patients with diabetes undergoing CABG increases the risk of lactic acidosis. METHODS: Over a span of 12 months (2015-2016), 127 patients with type 2 diabetes underwent isolated CABG...
May 30, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28550439/baseline-anthropometric-and-metabolic-parameters-correlate-with-weight-loss-in-women-1-year-after-laparoscopic-roux-en-y-gastric-bypass
#16
Sans Arnaud, Bailly Laurent, Anty Rodolphe, Sielezenef Igor, Gugenheim Jean, Tran Albert, Gual Philippe, Iannelli Antonio
BACKGROUND: In this study, we explored in a prospective cohort of morbidly obese women undergoing laparoscopic Roux-en-Y gastric bypass (LRYGP) correlations between baseline anthropometrics, metabolic parameters, resting energy expenditure (REE), body composition, and 1-year % excess body mass index loss (%EBMIL). We also investigated risk factors for insufficient %EBMIL. METHODS: One hundred three consecutive women were prospectively evaluated at baseline (age 40...
May 26, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28521464/integration-of-child-pugh-score-with-future-liver-remnant-yields-improved-prediction-of-liver-dysfunction-risk-for-hbv-related-hepatocellular-carcinoma-following-hepatic-resection
#17
Heng Zou, Yiming Tao, Zhi-Ming Wang
Assessment of hepatic functional reserve is important to enable the selection of appropriate treatment methods and safe hepatic resection in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). In the present study, an evaluation was made of the clinical value of combining the Child-Pugh score (CPS) with the standardized future liver remnant (sFLR) measurement to predict postoperative liver dysfunction (PLD). A total of 61 HBV-related HCC patients undergoing liver volumetry prior to hepatectomy were enrolled in the study...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28514317/impact-of-age-on-short-term-outcomes-of-liver-surgery-lessons-learned-in-10-years-experience-in-a-tertiary-referral-hepato-pancreato-biliary-center
#18
Andrea Ruzzenente, Simone Conci, Andrea Ciangherotti, Tommaso Campagnaro, Alessandro Valdegamberi, Francesca Bertuzzo, Fabio Bagante, Guido Mantovani, Michela De Angelis, Adriano E Dorna, Marco Piccino, Corrado Pedrazzani, Alfredo Guglielmi, Calogero Iacono
We investigate the surgical outcomes of patients undergoing hepatectomy according to different age intervals, identify the clinical factors related to surgical outcomes, and propose clinical risk scores for severe morbidity and mortality based on the clinical factors.Eight hundred three patients undergoing liver resection were divided into 3 groups: young patients (YP), <65 years (n = 387), elderly patients (EP), from 65 to 74 years (n = 279); very-elderly patients (VEP), ≥75 years (n = 137)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#19
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#20
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
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