Decreased blood loss reduces postoperative complications in resection for hepatocellular carcinoma

Aramaki, Osamu; Takayama, Tadatoshi; Higaki, Tokio; Nakayama, Hisashi; Ohkubo, Takao; Midorikawa, Yutaka; Moriguchi, Masamichi; Matsuyama, Yutaka

doi:10.1002/jhbp.101

Cited by 41 publications

(35 citation statements)

References 32 publications

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“…The morbidity rate was significantly better with laparoscopic liver resection than with open liver resection for both minor (13.5% vs 30.5%) or major liver resection (22.4% vs 45.6%) . However, blood loss with open liver resection in these studies seemed extraordinarily high in high‐volume hepatobiliary centers …”

Section: Laparoscopic Liver Resectionmentioning

confidence: 72%

Current topics in liver surgery

Yamazaki

Takayama

2019

Annals of Gastroent Surgery

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Liver resection is one of the main treatment strategies for liver malignancies. Mortality and morbidity of liver surgery has improved significantly with progress in selection criteria, development of operative procedures and improvements in perioperative management. Safe liver resection has thus become more available worldwide. We have identified four current topics related to liver resection (anatomical liver resection, laparoscopic liver resection, staged liver resection and chemotherapy‐induced liver injury). The balance between treatment effect and patient safety needs to be considered when planning liver resection. Progress in this area has been rapid thanks to the efforts of many surgeons, and outcomes have improved significantly as a result. These topics remain to be solved and more robust evidence is needed. Precise selection of the optimal procedure and risk evaluation should be standardized with further development of each topic. The present article reviews these four current topics with a focus on safety and efficacy in recent series.

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Section: Laparoscopic Liver Resectionmentioning

confidence: 72%

Current topics in liver surgery

Yamazaki

Takayama

2019

Annals of Gastroent Surgery

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“…Postoperative complications were stratified according to the Clavien–Dindo classification, which defines morbidities as complications with a score of 3 or higher. Complications specific to liver resection were defined as described previously …”

Section: Methodsmentioning

confidence: 99%

“…Complications specific to liver resection were defined as described previously. 25 Two consultant surgeons (T.T. and T.H.)…”

Section: Treatmentmentioning

confidence: 99%

Diabetes mellitus not an unfavorable factor on the prognosis of hepatitis C virus‐related hepatocellular carcinoma

Yoshida

Midorikawa

Higaki

et al. 2017

Hepatology Research

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Aim: Diabetes mellitus (DM) is a potential risk factor for hepatocarcinogenesis, especially in patients with hepatitis C virus (HCV) infection. We aimed to elucidate whether DM influences the surgical outcomes of patients with hepatocellular carcinoma (HCC).Methods: Our patients were routinely controlled to keep urinary glucose excretion to less than 3.0 g/day before surgery, and the serum glucose level under 200 mg/dL after surgery. The surgical outcomes and postoperative complications of 112 patients with HCV-related HCC with DM (DM group) were compared to those of 112 propensity-matched patients without DM (non-DM group).Results: After a median follow-up of 3.2 years (range, 0.2-11.3 years), the median overall (5.2 years; 95% confidence interval, 3.8-6.5 years) and recurrence-free survival (2.2 years; 1.7-2.9 years) in the DM group were not significantly different from those (6.3 years; 5.4-7.1 years, P = 0.337; and 2.2 years; 1.7-3.6 years, P = 0.613) in the non-DM group. The independent factors related to overall survival were the background liver (hazard ratio, 2.06; 95% confidence interval, 1.27-3.39, P = 0.014) and tumor differentiation grade (2.07; 1.14-4.05, P = 0.015). Thirty-two patients (28.5%) in the DM group and 32 patients (28.5%) in the non-DM group had morbidities after operation, with no significant difference between the groups (P = 1.000). Furthermore, postoperative control status of DM did not affect the prognostic outcome.Conclusion: Diabetes mellitus does not affect the surgical outcomes of patients with HCV-related HCC, and it is not an unfavorable factor when selecting candidates for liver resection of HCC.

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“…Surgical resection is the primary treatment of OSCC and can involve both complex resection and reconstruction. Surgical blood loss and prolonged operating time adversely impact treatment outcomes in a variety of surgical procedures including major head and neck surgery [2–5]. Neck dissection, either uni or bilateral is usually part of the treatment of advanced OSCC.…”

Section: Introductionmentioning

confidence: 99%

Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: A randomized clinical trial

Fritz

Matthews

Chandarana

et al. 2016

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundLong operating time and high blood loss contribute to post-surgical morbidity. Therefore, strategies to reduce these factors should to be tested using robust methods.The purpose of this study was to evaluate the impact of using the harmonic scalpel on operating time and blood loss in patients undergoing resection for advanced oral cancer (OSCC).MethodsThirty-six adult head and neck cancer patients with advanced OSCC requiring primary tumor resection with uni- or bi- lateral selective neck dissection from July 2012 to September 2014 were randomized to either the control group (traditional surgery) or the experimental group (harmonic surgery). Patients older than 18 years who were able to provide informed consent were eligible. Primary outcomes of interest were: intraoperative blood loss (mL) and operative time (minutes) for the ablative part of the surgery.ResultsMean blood loss in the experimental group was 260 mL versus 403 mL in the control group (p = 0.08). Mean operative time was 140 min in the experimental group and 159 min in the control group (p = 0.2).ConclusionsIn this randomized controlled trial, use of the harmonic scalpel did not effect intraoperative blood loss or OR time in patients undergoing surgery for advanced OSCC.Trial registrationClinicalTrials.gov, NCT02017834.

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Decreased blood loss reduces postoperative complications in resection for hepatocellular carcinoma

Abstract: Decrease in blood loss in resection of HCC is accompanied by reduced risk of complications. Surgeons need to minimize blood loss as less as 820 ml.

Cited by 41 publications

References 32 publications

Current topics in liver surgery

Current topics in liver surgery

Diabetes mellitus not an unfavorable factor on the prognosis of hepatitis C virus‐related hepatocellular carcinoma

Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: A randomized clinical trial

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