Skip to main content
main-content

12.06.2018 | Original Scientific Report | Ausgabe 12/2018

World Journal of Surgery 12/2018

Liver Regeneration is Preserved After At Least Four Repeated Liver Resections for Hepatocellular Carcinoma

Zeitschrift:
World Journal of Surgery > Ausgabe 12/2018
Autoren:
Takamune Yamaguchi, Takashi Kokudo, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Yoshihiro Sakamoto, Norihiro Kokudo, Kiyoshi Hasegawa
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00268-018-4714-7) contains supplementary material, which is available to authorized users.

Abstract

Introduction

Repeated resection is known to prolong survival, with an acceptable morbidity rate, in patients with hepatocellular carcinoma. However, little is known about the effect of repeated liver resection on postoperative liver regeneration and liver function. The aim of this study is to determine the impact of repeated liver resections on the postoperative liver regeneration rate and liver function.

Methods

A total of 71 patients, who had undergone more than three liver resections for hepatocellular carcinoma between May 2001 and December 2013 at a tertiary care hospital in Japan, were included in the analysis. Among them, CT-volumetric data for the first, second, third, and fourth or more resections were available for 36, 49, 53, and 24 patients. We analyzed the regeneration index (RI) defined as the postoperative TLV/preoperative TLV × 100 was calculated after each operation to measure the degree of regeneration. Liver function was evaluated using the indocyanine green retention rate at 15 min (ICG-R15).

Results

No significant differences in RI were observed among the first, second, and third or more liver resection groups. No significant difference in the ICG R15 value was seen between the first liver resection group and the second or more liver resection group (P = 0.75). However, a significant difference in the RI was observed when the 1 segmentectomy or less liver resection group (median [range] RI 98.1 [72.9–119.9]) was compared with the 2 or more segmentectomy group (median [range] RI 90.5 [62.6–113.6]) (P = 0.005).

Conclusion

The regeneration process is maintained after as many as four repeated resections. Patients with sustained liver function can safely undergo repeated liver resections for recurrences of HCC.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Supplementary material 1 (DOCX 40 kb)
268_2018_4714_MOESM1_ESM.docx
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 12/2018

World Journal of Surgery 12/2018 Zur Ausgabe
  1. Sie können e.Med Chirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise