Khan Adel H, Mahmud Omar, Fatimi Asad Saulat, Ahmed Shaheer, Wiener Alyssa A, Nishtala Madhuri V, Stahl Christopher C, Christensen Leslie, Khan Muhammad Rizwan, Schwartz Patrick B, Zafar Syed Nabeel
Khyber Medical College, Peshawar, Pakistan.
Medical College, Aga Khan University, Karachi, Pakistan.
J Surg Oncol. 2025 Apr;131(5):865-878. doi: 10.1002/jso.27928. Epub 2024 Nov 21.
Patients in low- and middle-income countries (LMICs) are disproportionately affected by liver cancers but there is a lack of understanding of their postoperative outcomes. This study aimed to review the current status of research in LMICs regarding outcomes after oncologic hepatectomy and synthesize the data reported in the literature.
The PubMed, Scopus, Embase, Web of Science, and World Health Organization (WHO) Global Index Medicus databases were searched from database inception to May 26th, 2022. Studies that reported outcomes after oncologic hepatectomy in LMIC settings were eligible for inclusion. Two independent reviewers performed record screening and data extraction. Risk of bias assessment was performed using the National Institutes of Health Study Quality Assessment tools. Pooled results with 95% confidence intervals (95% CIs) were calculated using a random effects model.
One hundred and thirty-five studies and 16 985 patients were included. Most studies were of a "fair" quality. Two studies described pediatric patients. Only one study was from a low-income country and most African regions were not represented. The rates of major and minor complications were 11% and 27%, respectively, while 30- and 90-day mortality rates were 2% and 3% each. Postoperative liver failure (8%), surgical site infections (6%), and bile leaks (6%) were common complications.
This review indicates a dearth of data from LMICs on outcomes after hepatectomy, particularly from African regions and low-income countries.
中低收入国家（LMICs）的患者受肝癌影响的比例过高，但人们对其术后结果缺乏了解。本研究旨在回顾中低收入国家关于肿瘤性肝切除术后结果的研究现状，并综合文献中报道的数据。
检索了PubMed、Scopus、Embase、Web of Science和世界卫生组织（WHO）全球医学索引数据库，检索时间从数据库建立至2022年5月26日。报告中低收入国家肿瘤性肝切除术后结果的研究符合纳入标准。两名独立审阅者进行记录筛选和数据提取。使用美国国立卫生研究院研究质量评估工具进行偏倚风险评估。采用随机效应模型计算95%置信区间（95%CI）的合并结果。
纳入了135项研究和16985名患者。大多数研究质量为“中等”。两项研究描述了儿科患者。只有一项研究来自低收入国家，大多数非洲地区未被纳入。主要和次要并发症的发生率分别为11%和27%，30天和90天死亡率均为2%和3%。术后肝衰竭（8%）、手术部位感染（6%）和胆漏（6%）是常见并发症。
本综述表明，中低收入国家尤其是非洲地区和低收入国家缺乏肝切除术后结果的数据。
