Preoperative peripheral blood neutrophil count predicts long-term outcomes following hepatic resection for colorectal liver metastases

Haruki, Koichiro; Shiba, Hiroaki; Fujiwara, Yuki; Furukawa, Kenei; Iida, Takuya; Ohkuma, Masahisa; Ogawa, Masaichi; Ishida, Yuichi; Misawa, Takeyuki; Yanaga, Katsuhiko

doi:10.3892/ol.2017.5873

Cited by 16 publications

(16 citation statements)

References 30 publications

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“…Buettner et al showed a deterioration of recurrence-free survival and overall survival after curative-intended resections of extrahepatic bile duct malignancies [ 9 ]. Furthermore, similar results have been shown in cases of hepatic resection of colorectal liver metastases [ 10 ]. It has also been shown that important therapies such as adjuvant chemotherapy begin at delayed course due to iSSI occurrence [ 44 ].…”

Section: Discussionsupporting

confidence: 83%

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Negative pressure wound therapy (NPWT) on closed incisions to prevent surgical site infection in high-risk patients in hepatopancreatobiliary surgery: study protocol for a randomized controlled trial—the NP-SSI trial

Brennfleck

Linsenmeier

Junger

et al. 2020

Trials

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Background Incisional surgical site infections (iSSI) in hepatopancreatobiliary (HPB) surgery usually lead to prolonged hospital stays, consume valuable resources, and impact on patients’ outcome. Prophylactic closed incision negative pressure wound therapy (ciNPWT) to decrease wound complications has become available. Owing to an increasing number of studies, evidence for superiority in many indication areas has accumulated; however, in general surgery, there are a few data and those have shown contradictory results. Methods In this monocentric, prospective, randomized, controlled, two-armed study, the influence of ciNPWT on incisional surgical site infection rates after HPB operations will be investigated. A total of 222 patients will be randomized 1:1 to an interventional group (7-day treatment with ciNPWT) or a control group (treated with gauze dressing). The primary parameter to evaluate efficacy is the rate of incisional SSIs within 30 days after surgery. Additionally, several clinically relevant secondary outcomes will be assessed. Discussion A reduction in the rate of incisional SSIs would not only lead to a significant cost reduction and shorter postoperative length of stay, but may also improve postoperative quality of life for patients. While earlier publications have shown advantages for ciNPWT, recent studies did not confirm a positive effect regarding iSSI rate. Even if iSSI rate is not reduced, findings obtained from the secondary endpoints may be of clinical relevance, such as reduction of wound complication rates. Trial registration This trial has been registered in the German Clinical Trials Register, DRKS 00015136. Registered on 19 February 2019 and has been approved by the local ethics committee of the University of Regensburg: 18-1225-101.

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Section: Discussionsupporting

confidence: 83%

“…SSIs account for a large proportion of nosocomial infections [ 3 , 4 ] and often lead to revision operations [ 5 ], prolonged hospital stays, increased costs [ 6 , 7 ], and a reduction in patient quality of life [ 8 ]. In addition, they have been shown to worsen the overall outcome in oncological patients [ 9 , 10 ].…”

Section: Rationalementioning

confidence: 99%

Negative pressure wound therapy (NPWT) on closed incisions to prevent surgical site infection in high-risk patients in hepatopancreatobiliary surgery: study protocol for a randomized controlled trial—the NP-SSI trial

Brennfleck

Linsenmeier

Junger

et al. 2020

Trials

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“…(20) Furthermore, development of a surgical site infection is associated with decreased administration of adjuvant chemotherapy and worse oncologic outcomes after HPB surgery. (6, 7, 21, 22)…”

Section: Discussionmentioning

confidence: 99%

Evaluating the American College of Surgeons National Surgical Quality Improvement project risk calculator: results from the U.S. Extrahepatic Biliary Malignancy Consortium

Beal

Lyon

Kearney

et al. 2017

HPB

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Background The objective of this study is to evaluate use of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) online risk calculator for estimating common outcomes after operations for gallbladder cancer and extrahepatic cholangiocarcinoma. Methods Subjects from the United States Extrahepatic Biliary Malignancy Consortium (USE-BMC) who underwent operation between January 1, 2000 and December 31, 2014 at 10 academic medical centers were included in this study. Calculator estimates of risk were compared to actual outcomes. Results The majority of patients underwent partial or major hepatectomy, Whipple procedures or extrahepatic bile duct resection. For the entire cohort, c-statistics for surgical site infection (0.635), reoperation (0.680) and readmission (0.565) were less than 0.7. The c-statistic for death was 0.740. For all outcomes the actual proportion of patients experiencing an event was much higher than the median predicted risk of that event. Similarly, the group of patients who experienced an outcome did have higher median predicted risk than those who did not. Conclusions The ACS NSQIP risk calculator is easy to use butrequires further modifications to more accurately estimate outcomes for some patient populations and operations for which validation studies show suboptimal performance.

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“…Nosocomial infections remain a major cause of morbidity among patients undergoing liver resection, and surgical site infections (SSI) reportedly account for > 50% of infectious complications after surgery[3-7]. In particular, in patients undergoing hepatectomy for hepatocellular carcinoma (HCC), SSI have a significant impact on morbidity, mortality, prolonged hospitalization, costs, and long-term oncology outcomes[8]. Hence, SSI prevention has been considered a top priority for improving perioperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

Predicting surgical site infections using a novel nomogram in patients with hepatocelluar carcinoma undergoing hepatectomy

Tang

Zong

Shen

et al. 2019

WJCC

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BACKGROUND Surgical site infections (SSI) remain a major cause of morbidity after hepatectomy for hepatocellular carcinoma (HCC). AIM To identify the risk factors associated with SSI, and develop a nomogram to predict SSI among patients undergoing hepatectomy. METHODS We retrospectively reviewed the data of patients diagnosed with HCC undergoing hepatectomy at two academic institutions in China, and evaluated the occurrence of SSI. Independent risk factors for SSI were identified using univariate and multivariate analyses. Based on these independent risk factors, a nomogram was established using the data of patients in the first institution, and was validated using data from an external independent cohort from the second institution. RESULTS The nomogram was established using data from 309 patients, whereas the validation cohort used data from 331 patients. The operation duration, serum albumin level, repeat hepatectomy, and ASA score were identified as independent risk factors. The concordance index (C-index) of the nomogram for SSI prediction in the training cohort was 0.86; this nomogram also performed well in the external validation cohort, with a C-index of 0.84. Accordingly, we stratified patients into three groups, with a distinct risk range based on the nomogram prediction, to guide clinical practice. CONCLUSION Our novel nomogram offers good preoperative prediction for SSIs in patients undergoing hepatectomy.

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Preoperative peripheral blood neutrophil count predicts long-term outcomes following hepatic resection for colorectal liver metastases

Cited by 16 publications

References 30 publications

Negative pressure wound therapy (NPWT) on closed incisions to prevent surgical site infection in high-risk patients in hepatopancreatobiliary surgery: study protocol for a randomized controlled trial—the NP-SSI trial

Negative pressure wound therapy (NPWT) on closed incisions to prevent surgical site infection in high-risk patients in hepatopancreatobiliary surgery: study protocol for a randomized controlled trial—the NP-SSI trial

Evaluating the American College of Surgeons National Surgical Quality Improvement project risk calculator: results from the U.S. Extrahepatic Biliary Malignancy Consortium

Predicting surgical site infections using a novel nomogram in patients with hepatocelluar carcinoma undergoing hepatectomy

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