Erasto Gaertner Hospital, Centro de Projetos de Estudo E Pesquisa (CEPEP), Curitiba, PR, Brazil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia, Área de Fígado e Hipertensão Portal, São Paulo, SP, Brazil.
BMC Surg. 2020 Oct 27;20(1):254. doi: 10.1186/s12893-020-00920-7.
Hepatic metastasis are frequent and liver resection may be an option for some cases, despite the high complexity of the procedure and the possibility of postoperative complications.
This retrospective comparative descriptive study aims to evaluate a series of 86 consecutive liver resections (LRs) performed for the treatment of metastatic liver tumors, comparing the results between patients undergoing major and minor LR. All patients submitted to LR from October 2010 to July 2015 at the Erasto Gaertner Hospital in Curitiba-PR were included. Quantitative numerical variables were analyzed with the Student t-test. The nonparametric Mann-Whitney U test was used for numerical variables of non-normal distribution. Categorical variables were analyzed with the Chi-square test with Fisher's correction. The data were analyzed with the SPSS 23.0 and STATA 15 programs, being p < 0.05 considered statistically significant.
Eighty-six LR were performed, 56 cases by colorectal metastasis. The major LR corresponded to 68 cases, with 13.2% of Clavien-Dindo III-V complications and 2.9% of reoperation rate. Eighteen minor LR were performed and one patient had a postoperative complication requiring reoperation.
Preoperative elevation of transaminases and jaundice negatively influence surgical outcomes in patients undergoing LR. Tumors greater than 3 cm presented worse postoperative survival. Major LR did not significantly increase the surgical morbidity rate.
1.122.319/2015.
肝转移较为常见，尽管手术复杂性高且术后并发症的可能性较大，但对于某些病例，肝切除术可能是一种选择。
本回顾性对比描述性研究旨在评估 86 例连续接受肝切除术（LR）治疗肝转移瘤的患者系列，比较行大 LR 和小 LR 的患者结果。所有于 2010 年 10 月至 2015 年 7 月期间在库里蒂巴-巴西南里奥格兰德州的 Erasto Gaertner 医院接受 LR 的患者均被纳入研究。对定量数值变量采用学生 t 检验进行分析。非正态分布的数值变量采用非参数 Mann-Whitney U 检验。分类变量采用带有 Fisher 校正的卡方检验进行分析。采用 SPSS 23.0 和 STATA 15 程序进行数据分析，p 值<0.05 被认为具有统计学意义。
共进行了 86 例 LR，其中 56 例为结直肠转移。大 LR 对应 68 例，Clavien-Dindo III-V 级并发症发生率为 13.2%，再次手术率为 2.9%。行 18 例小 LR，其中 1 例术后并发症需要再次手术。
术前转氨酶和黄疸升高会对行 LR 的患者的手术结果产生负面影响。肿瘤大于 3cm 的患者术后生存情况较差。大 LR 并未显著增加手术发病率。
1.122.319/2015。
