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Br J Surg：左肝切除术后结局分析

2016-02-17 Mechront 译 MedSci原创

左肝切除术癌症死亡率
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左肝三叶切除术（LHT）是十分具有挑战的解剖性肝切除术，全球范围内该手术的经验有限，术后并发症发生率尤其高。研究者对1993-2013年间进行了LHT的113名患者进行了一项队列研究，分析这些患者的预后，以及识别与术后长期和短期结局相关的因素。纳入研究的113名患者中有57名为结直肠癌肝转移，22名为肝门部胆管癌，12名为肝内胆管癌，11名为肝细胞性肝癌，还有11名患者有其他各种手术指征。整体上这

左肝三叶切除术（LHT）是十分具有挑战的解剖性肝切除术，全球范围内该手术的经验有限，术后并发症发生率尤其高。研究者对1993-2013年间进行了LHT的113名患者进行了一项队列研究，分析这些患者的预后，以及识别与术后长期和短期结局相关的因素。

纳入研究的113名患者中有57名为结直肠癌肝转移，22名为肝门部胆管癌，12名为肝内胆管癌，11名为肝细胞性肝癌，还有11名患者有其他各种手术指征。

整体上这113名患者术后的发病率和90天死亡率分别为46.0%和9.7%，术后1年和3年的生存率分别为71.3%和44.4%。分析后发现，全肝血流阻断和术中输血是术后并发症的独立预测因子，而输血是预测住院死亡率的唯一因素。时间段分析显示，在过去5年时间里，输血、住院时间、术后并发症和死亡率呈下降趋势。

研究结果表明，具有显著肿瘤负担的患者，LHT术后的发病率、死亡率和长期生存率支持LHT治疗方式的选择。

原始出处：

Farid SG, White A,et al.Clinical outcomes of left hepatic trisectionectomy for hepatobiliary malignancy.Br J Surg. 2016 Feb;103(3):249-56. doi: 10.1002/bjs.10059.


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    2016-12-08 doctorzheng

    #切除术#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1876758, encodeId=091b18e6758f1, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu Dec 08 03:16:00 CST 2016, time=2016-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=68808, encodeId=4205688086d, content=挺新颖的观点, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=109f1616069, createdName=DoctorTao1991, createdTime=Sun Mar 13 16:20:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1926392, encodeId=8920192639282, content=<a href='/topic/show?id=a6ba8118009' target=_blank style='color:#2F92EE;'>#肝切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81180, encryptionId=a6ba8118009, topicName=肝切除)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Fri Aug 05 07:16:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417874, encodeId=dcc9141e87455, content=<a href='/topic/show?id=bcb081181dc' target=_blank style='color:#2F92EE;'>#肝切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81181, encryptionId=bcb081181dc, topicName=肝切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bcb3304824, createdName=zexyw02, createdTime=Fri Feb 19 09:16:00 CST 2016, time=2016-02-19, status=1, ipAttribution=)]
    2016-03-13 DoctorTao1991

    挺新颖的观点

    0

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    2016-08-05 changfy

    #肝切除#

    0

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    2016-02-19 zexyw02

    #肝切除术#

    0