Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma

Kabir, Tousif; Tan, Zoe; Chua, Denise Qian Ling; Syn, Nicholas; Goh, Brian K. P.

doi:10.4103/jmas.jmas_47_19

Cited by 6 publications

(1 citation statement)

References 29 publications

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“…Rupture and hemorrhage of primary liver cancer nodules is a serious complication of primary liver cancer nodules with a high mortality rate [ 13 , 14 ]. Our patient has an acute onset, which is sudden and fierce.…”

Section: Discussionmentioning

confidence: 99%

Emergency Nursing Countermeasures and Experience of Patients with Primary Liver Cancer Nodule Rupture and Hemorrhage

Qing

Yang

2022

Emergency Medicine International

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Objective. To explore the emergency nursing countermeasures and nursing experience of patients with primary liver cancer nodule rupture and hemorrhage. Methods. 30 patients with primary liver cancer nodule rupture and hemorrhage treated in our hospital since January 2020 after the implementation of emergency nursing countermeasures were selected as the observation group, and another 30 patients with primary liver cancer nodule rupture and hemorrhage treated in our hospital before January 2020 were selected as the control group. The control group received basic nursing intervention, while the observation group received emergency nursing measures. The hemoglobin level, blood oxygen saturation monitoring value, and partial pressure of oxygen of patients with hemorrhagic shock due to nodular rupture of primary liver cancer were compared between the two groups at admission and after nursing care. All indexes of patients during the perioperative period were recorded. The incidence of complications, mortality, and nursing satisfaction rates of the patients’ families were compared between the two groups. Results. After nursing care, the observation group’s patients’ hemoglobin level, blood oxygen saturation monitoring value, and partial pressure of oxygen were higher than those of the control group’s patients ( P < 0.05 ). The intraoperative bleeding volume, shock correction time, and discharge time of patients in the observation group were lower than those of patients in the control group ( P < 0.05 ). The incidence of complications and mortality in the observation group was significantly lower than those in the control group ( P < 0.05 ). The nursing satisfaction rate of patients in the observation group was higher than that of the control group ( P < 0.05 ). Conclusion. The results of emergency nursing intervention in patients with primary liver cancer rupture and hemorrhage are reliable, which can significantly improve perioperative indicators of patients, reduce complications and mortality, improve nursing satisfaction, and effectively shorten the hospital stay of patients.

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Section: Discussionmentioning

confidence: 99%

Emergency Nursing Countermeasures and Experience of Patients with Primary Liver Cancer Nodule Rupture and Hemorrhage

Qing

Yang

2022

Emergency Medicine International

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Laparoscopic versus open resection of hepatocellular carcinoma in patients with cirrhosis: meta-analysis

Kabir

Tan

Syn

et al. 2021

British Journal of Surgery

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Background The exact role of laparoscopic liver resection (LLR) in patients with hepatocellular carcinoma (HCC) and underlying liver cirrhosis (LC) is not well defined. In this meta-analysis, both long- and short-term outcomes following LLR versus open liver resection (OLR) were analysed. Methods PubMed, EMBASE, Scopus and Web of Science databases were searched systematically for randomised controlled trials (RCTs) and propensity-score matched (PSM) studies reporting outcomes of LLR versus OLR of HCC in patients with cirrhosis. Primary outcome was overall survival (OS). This was analysed using one-stage (individual participant data meta-analysis) and two-stage (aggregate data meta-analysis) approaches. Secondary outcomes were operation duration, blood loss, blood transfusion, Pringle manoeuvre utilization, overall and major complications, length of hospital stay (LOHS), 90-day mortality and R0 resection rates. Results Eleven studies comprising 1618 patients (690 LLR versus 928 OLR) were included for analysis. In the one-stage meta-analysis, an approximately 18.7 per cent lower hazard rate (HR) of death in the LLR group (random effects: HR 0.81, 95 per cent confidence interval [C.I.] 0.68 to 0.96; P = 0.018) was observed. Two-stage meta-analysis resulted in a pooled HR of 0.84 (95 per cent C.I. 0.74 to 0.96; P = 0.01) in the overall LLR cohort. This indicated a 16–26 per cent reduction in the HR of death for patients with HCC and cirrhosis who underwent LLR. For secondary outcomes, LLR was associated with less blood loss (mean difference [MD] −99 ml, 95 per cent C.I. −182 to −16 ml), reduced overall complications (odds ratio 0.49, 95 per cent C.I. 0.37 to 0.66) and major complications (odds ratio 0.45, 95 per cent C.I. 0.26 to 0.79), and shorter LOHS (MD −3.22 days, 95 per cent C.I. −4.38 to −2.06 days). Conclusion Laparoscopic resection of HCC in patients with cirrhosis is associated with improved survival and perioperative outcomes.

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Alpha-Fetoprotein+Alkaline Phosphatase (A-A) Score Can Predict the Prognosis of Patients with Ruptured Hepatocellular Carcinoma Underwent Hepatectomy

et al. 2022

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Background. This research is aimed at establishing a scoring system alpha-fetoprotein+alkaline phosphatase (A-A score) based on preoperative serum alpha-fetoprotein (AFP) and alkaline phosphatase (ALP) levels and to investigate its clinical significance in patients with ruptured hepatocellular carcinoma (rHCC) after hepatectomy. Methods. 175 ruptured hepatocellular carcinoma (HCC) patients treated with hepatectomy were included. Survival analysis was assessed by the Kaplan-Meier method. Prognostic factors were analyzed in a multivariate model. Preoperative serum AFP and ALP values are assigned a score of 1 if they exceed the threshold value and 0 if they are below the threshold value, A-A score is obtained by summing the scores of two variables (AFP, ALP), and the predictive values of AFP, ALP, and A-A score were compared by receiver operating characteristic curve (ROC) analysis, and subgroup analyses were performed to further evaluate the power of A-A scores. Results. Of the 175 patients, 67 (38.3%) had an A-A score of 0, 72 (41.1%) had an A-A score of 1, and 36 (20.6%) had an A-A score of 2. In multivariate analysis, the A-A score, the BCLC stage, and the extent of resection were independent predictors of OS in patients with rHCC. The 1-, 3-, and 5-year OS and RFS in patients with an A-A score of 1 were better than those with an A-A score of 0 and worse than those with an A-A score of 1 (all p < 0.05 ). Based on the results of ROC analysis, the A-A score is superior to AFP or ALP alone in predicting the prognosis of patients with ruptured HCC. In subgroup analysis, A-A score could accurately predict the prognosis of patients with or without microvascular invasion (MVI) and with different Child-Pugh grades or gender. Conclusions. The A-A score can effectively predict the prognosis of patients after hepatectomy of ruptured hepatocellular carcinoma. At the same time, it also has good evaluation ability in different subgroups.

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Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma

Cited by 6 publications

References 29 publications

Emergency Nursing Countermeasures and Experience of Patients with Primary Liver Cancer Nodule Rupture and Hemorrhage

Emergency Nursing Countermeasures and Experience of Patients with Primary Liver Cancer Nodule Rupture and Hemorrhage

Laparoscopic versus open resection of hepatocellular carcinoma in patients with cirrhosis: meta-analysis

Alpha-Fetoprotein+Alkaline Phosphatase (A-A) Score Can Predict the Prognosis of Patients with Ruptured Hepatocellular Carcinoma Underwent Hepatectomy

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