Prediction of perioperative outcome after hepatic resection for pediatric patients

Liu, Jianxia; Zhang, Yunfei; Zhu, Hai-Dong; Qiu, Lin; Guo, Chunbao

doi:10.1186/s12876-019-1109-7

Cited by 13 publications

(20 citation statements)

References 27 publications

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“…To compare our results with existing evidence, an overview of studies reporting surgical outcomes of pediatric liver resection is given in Table 6 ( 2 – 4 , 10 , 12 , 13 , 16 – 19 , 40 – 44 ). Eleven single-center trials were found, with a median number of 27 reported cases in a median observation period of 15 year (1.8 cases per year on average).…”

Section: Resultsmentioning

confidence: 99%

“…Pediatric patients are particularly susceptible to blood loss and low circulating blood volume. Strong negative effects on the patients' outcome have been reported previously (10,36,37). Adverse effects of blood transfusions, such as lung injury, transfusion-related acute circulatory overload and hemolytic transfusion reactions, occur more often in pediatric patients than in the adult population, with associated mortality rates as high as 15-30% (36).…”

Section: Discussionmentioning

confidence: 99%

“…Liver resection in children is still associated with substantial morbidity and mortality ( 2 – 4 , 10 , 17 ). Interpretation of data is difficult due to the low level of evidence of the heterogenous, retrospective observational studies ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…Only few publications on liver resection and surgery specific outcomes in pediatric patients from Western countries exist, with reported study populations ranging from 9 to 128 patients (3,(12)(13)(14). Complication rates vary considerably, with surgery-related mortality ranging from 0 to 6% and morbidity rates from 14 to 69% (2,3,10,(14)(15)(16)(17)(18)(19). Most of these studies apply different, often incomplete outcome measures and varying definitions of surgical quality, ensuing poor comparability, and lowering the quality of conclusions from these results.…”

Section: Introductionmentioning

confidence: 99%

“…Evidence of surgical treatment in pediatric patients with surgical liver disease is often based on small case series with low patient numbers. Investigations on surgical aspects in large cohorts are primarily reported by East Asian centers ( 10 , 11 ). Only few publications on liver resection and surgery specific outcomes in pediatric patients from Western countries exist, with reported study populations ranging from 9 to 128 patients ( 3 , 12 – 14 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Establishing a Standardized Measure of Quality in Pediatric Liver Surgery: Definition and Validation of Textbook Outcome With Associated Predictors

et al. 2021

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Purpose: To establish comparable reporting of surgical results in pediatric liver surgery, the recently introduced composite outcome measures Textbook Outcome (TO) and Comprehensive Complication Index (CCI) are applied and validated in a pediatric surgery context for the first time. In a representative cohort of pediatric patients undergoing liver resection, predictive factors for TO and CCI are investigated, and outcomes are compared to available literature on surgical outcomes of pediatric liver resection.Methods: All liver resections for patients under 21 years of age performed at the Department of General, Visceral, Transplantation and Pediatric Surgery of the University of Heidelberg between 2009 and 2020 were included in the analysis. Criteria for TO were defined prior to the analysis. Univariate and Multivariate regression was applied to identify factors associated with TO and CCI.Results: Fifty-three pediatric patients underwent liver resections during the observation period. No 30- or 90-day mortality occurred. Twenty-three patients (43.4%) had a TO. CCI and TO showed highly significant correlation (b = −30.33, 95% CI [−37.44; −23.22], p < 0.001). Multivariate analyses revealed significant association between intraoperative blood loss (adjusted for circulating blood volume) and CCI (b = 0.70, 95%CI [0.22; 1.32], p = 0.008) and failure to achieve TO (OR = 0.85, 95%CI [0.69; 0.97], p = 0.048).Conclusion: TO and CCI are suited outcome measures in pediatric surgical studies and offer objective comparability of results. Their application in clinical studies will be a major step forward to establish evidence-based therapies in pediatric surgery. Systematic utilization of TO and CCI can aid in generating comparable studies on surgical techniques and outcomes in pediatric liver resection.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Establishing a Standardized Measure of Quality in Pediatric Liver Surgery: Definition and Validation of Textbook Outcome With Associated Predictors

et al. 2021

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Ultrasound-guided No Touch liver pedicle microwave ablation in hepatocellular carcinoma treatment

Wang

Shu

Zhu

et al. 2021

Oncology and Translational Medicine

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ObjectiveThis study aimed to investigate the feasibility, safety, and clinical effect of No Touch liver pedicle microwave ablation (NTLP-MWA).MethodsThe outcomes of 118 patients diagnosed with hepatocellular carcinoma (HCC) between 2014 and 2015 were retrospectively analyzed. Patients were divided into three groups. In group A, 35 patients underwent ultrasound-guided NTLP-MWA, 27 in Group B were treated with routine microwave ablation (RMWA), and 56 in group C underwent anatomic hepatectomy (AH). The preoperative basic data, intraoperative data, and postoperative data were analyzed among the three groups.ResultsThe treatment time, intraoperative blood loss, and postoperative liver function (alanine transaminase) in the NTLP-MWA and RMWA groups were significantly different from those in the AH group(all P < 0.005). There was no difference in the complete elimination rate and local recurrence within 1 year among the three groups. Treatment was not an independent risk factor for early postoperative recurrence. There was no significant difference in the 5-year overall survival rates among the three groups.ConclusionNTLP-MWA is safe and reliable, in accordance with the principles of oncology treatment, and worth further promotion in clinical practice.

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Hemorrhage in pheochromocytoma surgery: evaluation of preoperative risk factors

Guo

Xie

et al. 2022

Endocrine

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Objective Pheochromocytoma surgery carries a higher risk of hemorrhage. Our objective was to identify preoperative risk factors for hemorrhage during pheochromocytoma surgery. Methods Patients who underwent surgery and with postoperative pathological confirmation were enrolled. A total of 251 patients from our center were included in the investigation, and 120 patients from the First Affiliated Hospital, Sun Yat-sen University were included as an external validation dataset. Family and medical history, demographics, hemodynamics, biochemical parameters, image data, anesthesia and operation records, postoperative outcomes were collected. Postoperative complications were graded by the Clavien–Dindo classification. Correlation between intraoperative hemorrhage volume and postoperative outcomes was assessed. The features associated with intraoperative hemorrhage were identified by linear regression. All features that were statistically significant in the multiple linear regression were then used to construct models and nomograms for predicting intraoperative hemorrhage. The constructed models were evaluated by Akaike Information Criterion. Finally, internal and external validations were carried out by tenfold cross-validation. Results Intraoperative hemorrhage volume was positively correlated with the postoperative hospitalization time (R = 0.454, P < 0.001) and the Clavien–Dindo grades (R = 0.664, P < 0.001). Features associated with intraoperative hemorrhage were male gender (β = 0.533, OR = 1.722, P = 0.002), tumor diameter (β = 0.027, OR = 1.027, P < 0.001), preoperative CCB use (β = 0.318, OR = 1.308, P = 0.123) and open surgery (β = 1.175, OR = 3.234, P < 0.001). Validations showed reliable results (internal (R = 0.612, RMSE = 1.355, MAE = 1.111); external (R = 0.585, RMSE = 1.398, MAE = 0.964)). Conclusion More intraoperative hemorrhage is correlated with longer postoperative hospitalization time and more severe postoperative complications. Male gender, larger tumor, preoperative CCB use and open surgery are preoperative risk factors for hemorrhage in PCC surgery.

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Prediction of perioperative outcome after hepatic resection for pediatric patients

Cited by 13 publications

References 27 publications

Establishing a Standardized Measure of Quality in Pediatric Liver Surgery: Definition and Validation of Textbook Outcome With Associated Predictors

Establishing a Standardized Measure of Quality in Pediatric Liver Surgery: Definition and Validation of Textbook Outcome With Associated Predictors

Ultrasound-guided No Touch liver pedicle microwave ablation in hepatocellular carcinoma treatment

Hemorrhage in pheochromocytoma surgery: evaluation of preoperative risk factors

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