Yang Geunhyeok, Hwang Shin, Song Gi-Won, Jung Dong-Hwan
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Hepatobiliary Pancreat Surg. 2021 May 31;25(2):192-197. doi: 10.14701/ahbps.2021.25.2.192.
BACKGROUNDS/AIMS: Formula-derived standard liver volume (SLV) has been clinically used for living donor liver transplantation and hepatic resection. The majority of currently available SLV formulae are based on body surface are (BSA). However, they often show a wide range of error. Skeletal muscle index measured at the third lumbar vertebra level (L3SMI) appears to reflect lean body mass. The objective of this study was to compare the accuracy of L3SMI-based formula and BSA-based formula for calculating SLV.
The study cohort was 500 hundred living liver donors who underwent surgery between January 2010 and December 2013. Computed tomography images were used for liver volumetry and skeletal muscle area measurement.
The study cohort included 250 male and 250 female donors. Their age, BSA, L3SMI, and body mass index were 26.8±8.7 years, 1.68±0.16 m, 45.6±9.0 cm/m, and 21.7±2.5 kg/m, respectively. The BSA-based SLV formula was "SLV (ml)=-362.3+901.5×BSA (m) (r=0.71, r=0.50, <0.001)". The L3SMI-based SLV formula was "SLV (ml)=471.9+14.9×L3SMI (cm/m) (r=0.65, r=0.42, <0.001)". Correlation coefficients were similar in subgroup analyses with 250 male donors and 250 female donors. There was a crude correlation between L3SMI and body mass index (r=0.51, r=0.27, <0.001).
The results of this study suggest that SLV calculation with L3SMI-based formula does not appear to be superior to the currently available BSA-based formulae.
背景/目的:公式推导的标准肝体积(SLV)已在临床用于活体肝移植和肝切除术。目前大多数可用的SLV公式基于体表面积(BSA)。然而,它们往往显示出较大的误差范围。在第三腰椎水平测量的骨骼肌指数(L3SMI)似乎能反映瘦体重。本研究的目的是比较基于L3SMI的公式和基于BSA的公式计算SLV的准确性。
研究队列包括2010年1月至2013年12月期间接受手术的500名活体肝供者。计算机断层扫描图像用于肝脏容积测定和骨骼肌面积测量。
研究队列包括250名男性供者和250名女性供者。他们的年龄、BSA、L3SMI和体重指数分别为26.8±8.7岁、1.68±0.16 m、45.6±9.0 cm/m和21.7±2.5 kg/m。基于BSA的SLV公式为“SLV(ml)=-362.3 + 901.5×BSA(m)(r = 0.71,r = 0.50,<0.001)”。基于L3SMI的SLV公式为“SLV(ml)= 471.9 + 14.9×L3SMI(cm/m)(r = 0.65,r = 0.42 ,<0.001)”。在对250名男性供者和250名女性供者进行的亚组分析中,相关系数相似。L3SMI与体重指数之间存在粗略相关性(r = 0.51,r = 0.27,<0.001)。
本研究结果表明,基于L3SMI的公式计算SLV似乎并不优于目前可用的基于BSA的公式。