Τίτλος:
Does vascular occlusion in liver resections predispose to recurrence of malignancy in the liver remnant due to ischemia/reperfusion injury? A comparative retrospective cohort study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Severe ischemic changes of the liver remnant after hepatectomy could expedite tumor recurrence on the residual liver. Our study aimed at assessing the effect of warm ischemic/reperfusion (I/R) injuries on surgery-to-local recurrence interval and patient overall survival, during major hepatectomies under inflow and outflow vascular control. Methods: One hundred and eighteen patients were subjected to liver resection under total inflow and outflow vascular clamping and were assigned as study group. These individuals were retrospectively matched to 112 counterparts, who underwent liver surgery applying inflow and outflow vascular clamping only of the segment harboring the tumor, sparing the liver remnant from any I/R injury (control group). The two cohorts were compared regarding recurrence-free survival and overall survival. Results: Reversible I/R injuries of the liver remnant subjected to vascular clamping were manifested, with increase of AST values at postoperative day 2 in the study group, as compared to the control group (603 ± 270 U/L vs. 450 ± 290 U/L, p < 0.001), reversing to normal by day 7. Recurrence-free survival and overall survival were no significantly different between the two groups (log rank statistic p = 0.298 and 0.639, respectively). Conclusion: Reversible I/R injuries of the liver remnant do not seem to be implicated in the precipitation of local malignant recurrence or in shorter long-term survival, in comparison to a technique sparing the residual liver of I/R injury. This retrospective cohort study was registered at clinicaltrials.gov under unique identifying number: NCT04257240. © 2020 IJS Publishing Group Ltd
Συγγραφείς:
Theodoraki, K.
Papadoliopoulou, M.
Petropoulou, Z.
Theodosopoulos, T.
Vassiliu, P.
Polydorou, A.
Xanthakos, P.
Fragulidis, G.
Smyrniotis, V.
Arkadopoulos, N.
Περιοδικό:
International Journal of Surgery
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
alpha fetoprotein; CA 19-9 antigen, aged; Article; blood vessel occlusion; cancer staging; cohort analysis; comorbidity; comparative study; controlled study; female; follow up; hepatic ischemia reperfusion injury; human; liver cell carcinoma; liver resection; liver vein; major clinical study; male; operation duration; overall survival; priority journal; recurrence free survival; retrospective study; survival rate; tumor recurrence; tumor volume; adult; adverse event; ligation; liver; liver resection; liver tumor; middle aged; minimal residual disease; pathology; postoperative complication; reperfusion injury; tumor recurrence; vascularization, Adult; Constriction; Female; Hepatectomy; Humans; Liver; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm, Residual; Postoperative Complications; Reperfusion Injury; Retrospective Studies
DOI:
10.1016/j.ijsu.2020.06.019
