Measuring intraoperative anesthetic parameters during hepatectomy with inferior vena cava clamping

Nanashima, Atsushi; Hiyoshi, Masahide; Imamura, Naoya; Hamada, Takeomi; Tsuchimochi, Yuuki; Shimizu, Ikko; Ota, Yusuke; Furukawa, Koji; Tsuneyoshi, Isao

doi:10.1007/s00423-023-03172-0

Cited by 1 publication

(1 citation statement)

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“…Although the mechanism underlying poor prognosis following blood transfusion has not been fully elucidated, increased blood loss may be a cause for transfusion. Various attempt to reduce blood loss by using hemostatic devices, IVC half-clamping, or Trendelenburg position and so on have been our long-term policy and, therefore, prediction of liver fibrosis is one of important parameter before hepatectomy ( 42 , 43 ). Thus, to achieve no blood transfusion is always aiming in our proposition.…”

Section: Discussionmentioning

confidence: 99%

Clinical significances of several fibrotic markers for prognosis in hepatocellular carcinoma patients who underwent hepatectomy

Nanashima,

Hiyoshi,

Imamura

et al. 2024

Transl Cancer Res

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Background Progression of chronic liver fibrosis and related increased fibrotic markers are associated with functional liver reserves or patient prognosis as well as tumor factors in hepatocellular carcinoma (HCC) patients. The aim of this study was to newly clarify the relationship between fibrotic markers and HCC malignant behaviors or its long-term postoperative prognosis by the retrospective cohort study. Methods We examined the relationship between tumor-related factors or six liver fibrosis-associated parameters, including platelet count, hyaluronic acid (HA), Mac-2 binding protein glycosylation isomer (M2BPGi), type IV collagen 7S (T4C7), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (Fib-4) index, and clinicopathological parameters, surgical records, and postoperative prognosis in 130 HCC who underwent curative hepatectomy. Results Histological fibrosis stage 4 as cirrhosis was in 31%. The platelet count significantly decreased in stage 4 fibrosis and correlated with grade B liver damage (P<0.01). HA levels were significantly increased in multiple HCC, stage 4 fibrosis, and grade B liver damage (P<0.01). T4C7 was significantly increased in patients with post-hepatectomy tumor recurrence compared to those without (P<0.01). Additionally, M2BPGi was significantly higher in stage 4 fibrosis and liver damage grade B, and was significantly associated with poor prognosis (P<0.05). Fib-4 index was significantly higher in patients with liver damage B (P<0.05), and T4C7 alone did not correlate with other five fibrosis markers. Stage 4 fibrosis, higher T4C7, higher M2BPGi, and increased tumor size were significantly associated with shorter cancer-free, overall, and cancer-specific survivals. Higher T4C7, non-met Milan criteria, liver damage B, blood transfusion, and curability C were independently associated with cancer-specific survivals (P<0.05). Conclusions Type IV collagen 7S (T4C7) may reflect not only impaired liver function but also HCC malignant behaviors and patient survivals.

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Section: Discussionmentioning

confidence: 99%