Agrawal Rohit, Majeed Muhammad, Aqeel Sheeba-Ba, Wang Yuchen, Haque Zohaib, Omar Yazan Abu, Upadhyay Shristi Banskota, Gast Thomas, Attar Bashar M, Gandhi Seema
Department of Medicine (Rohit Agrawal, Muhammad Majeed, Sheeba-Ba Aqeel, Zohaib Haque, Yazan Abu Omar, Shristi Banskota Upadhyay).
Division of Gastroenterology and Hepatology, Department of Medicine (Bashar Attar, Seema Gandhi).
Ann Gastroenterol. 2021;34(2):241-246. doi: 10.20524/aog.2020.0566. Epub 2020 Dec 12.
Transarterial chemoembolization (TACE) and bland embolization (TAE), performed for hepatocellular carcinoma (HCC), are often complicated by post-embolization syndrome (PES). There are limited data regarding the incidence of PES after TAE and the role of steroids in PES. We report the incidence of PES post TACE and TAE, identify predictors, and evaluate the role of steroids in PES.
Demographic and clinical variables of patients who underwent embolization were collected and PES was identified. Risk factors for PES, TACE and TAE were derived by logistic regression. We compared patients who received dexamethasone to those who did not, regarding baseline characteristics, occurrence of PES, and hospital stay.
A total of 171 patients, average age 60.5 years, underwent the procedure, 77.8% were male, and 87.7% had cirrhosis. Of these 171, 107 underwent TACE and 64 TAE. Dexamethasone was given to 106 (61.9%) patients, of whom 85 had TACE and 21 TAE. One hundred twenty-four patients (72.5%) developed PES. PES occurred in more patients who underwent TACE, 80 (74.7%) vs. 44 (68.7%), and resulted in a longer hospital stay (1.47 vs. 1.12 days, P=0.034). Predictive factors for PES included female sex (odds ratio [OR] 2.76, 95% confidence interval [CI] 1.04-7.34; P=0.041), and alcohol-related HCC (OR 3.14, 95%CI 1.42-6.95; P=0.005). Dexamethasone did not affect the length of hospital stay (1.43 vs. 1.29 days, P=0.422) or the rate of prolonged hospitalization (18.8% vs. 15.4%, P=0.561).
There was no difference in the incidence of PES following TACE or TAE and the use of dexamethasone did not reduce the incidence of PES or the duration of hospital stay.
经动脉化疗栓塞术（TACE）和单纯栓塞术（TAE）用于治疗肝细胞癌（HCC）时，常并发栓塞后综合征（PES）。关于TAE后PES的发生率以及类固醇在PES中的作用的数据有限。我们报告了TACE和TAE后PES的发生率，确定了预测因素，并评估了类固醇在PES中的作用。
收集接受栓塞术患者的人口统计学和临床变量，并确定PES。通过逻辑回归得出PES、TACE和TAE的危险因素。我们比较了接受地塞米松治疗的患者和未接受地塞米松治疗的患者的基线特征、PES的发生情况和住院时间。
共有171例患者接受了该手术，平均年龄60.5岁，77.8%为男性，87.7%患有肝硬化。在这171例患者中，107例行TACE，64例行TAE。106例（61.9%）患者接受了地塞米松治疗，其中85例行TACE，21例行TAE。124例（72.5%）患者发生了PES。接受TACE的患者中发生PES的更多，80例（74.7%）对44例（68.7%），且住院时间更长（1.47天对1.12天，P=0.034）。PES的预测因素包括女性（比值比[OR]2.76，95%置信区间[CI]1.04-7.34；P=0.041）和酒精性HCC（OR 3.14，95%CI 1.42-6.95；P=0.005）。地塞米松并未影响住院时间（1.43天对1.29天，P=0.422）或延长住院率（18.8%对15.4%，P=0.561）。
TACE或TAE后PES的发生率无差异，使用地塞米松并未降低PES的发生率或住院时间。
