Liver resection: 10-year experience from a single Institution

Coelho, Júlio Cézar Uili; Claus, Christiano Marlo Paggi; Machuca, Tiago; Sobottka, Wagner Herbert; Gonçalves, Cláudio Ubiratan

doi:10.1590/s0004-28032004000400006

Cited by 17 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results showed that the rates of mortality and morbidity after trisectionectomies were comparable to those of major resections performed in our department in the same period. Besides, our results were similar to mortality and morbidity rates quoted in patients undergoing liver resection in literature, even for less extensive hepatectomies [6,9,26,27]. Liver failure was the cause of death in both patients of TR group; besides, liver failure represented the only morbidity significantly higher in TR group compared with MH group.…”

Section: Discussionsupporting

confidence: 88%

Liver trisectionectomies for primary and secondary liver cancer in the modern era: results of a single tertiary center

et al. 2010

View full text Add to dashboard Cite

Recent advances in patient selection and surgical technique have resulted in low mortality and morbidity rates after liver resections. The aim of this study was to evaluate the operative risks of liver trisectionectomies in comparison with major resections. The data prospectively collected of patients who underwent trisectionectomies (TR Group, n = 54) and major hepatectomies (MH Group, n = 175) without biliary reconstruction were compared. Besides, the early results of patients who underwent right trisectionectomies (RTR Group, n = 36) and left trisectionectomies (LTR Group, n = 18) were compared. There was no significant difference in patient characteristics of MH and TR groups excluded for a high portal vein embolization (PVE) in TR group. Mortality (1% in MH group and 3.7% in TR group, p = 0.206) and overall morbidity rates (39% in MH group and 48% in TR group, p = 0.225) were similar between two groups. A higher proportion of patients in TR group developed liver failure (p = 0.024) and required blood transfusion (30 vs. 11%, p < 0.001). The median hospital stay after trisectionectomies was higher in TR group than MH group (p = 0.053). There was no significant difference in patient characteristics of LTR and RTR groups excluded for lymphadenectomy which was higher in LTR group (p = 0.008) and PVE rate higher in RTR group (p = 0.01). The overall morbidity (44 vs. 55%) and mortality (2.7 vs. 5.5%) were comparable between two groups. A higher proportion of patients in RTR group required blood transfusion (39 vs. 11%, p = 0.032). At multivariate analysis, age was the only positive predictor for morbidity after trisectionectomies (p = 0.010). Trisectionectomies can be performed safely. Left trisectionectomies are as safe as right trisectionectomies. The accurate preoperative selection is necessary to reduce operative risks.

show abstract

Section: Discussionsupporting

confidence: 88%

Liver trisectionectomies for primary and secondary liver cancer in the modern era: results of a single tertiary center

et al. 2010

View full text Add to dashboard Cite

show abstract

“…8 Diseased livers such as steatotic or fibrotic livers may be the most vulnerable to temporary interruption of blood flow. [9][10][11] Surgical techniques are known to protect liver cells against subsequent sustained ischemia in cases of ischemic-reperfusion injury in animal models 12 as well as in humans. 11,13 Currently, ischemic preconditioning with continuous clamping, but also intermittent portal triad clamping (cycles of 15 minutes of ischemia followed by 5 minutes of reperfusion) are the only clinically established protective strategies against liver injury due to prolonged ischemia.…”

Section: Miniabstractmentioning

confidence: 99%

A Randomized Controlled Trial on Pharmacological Preconditioning in Liver Surgery Using a Volatile Anesthetic

Beck‐Schimmer¹,

Breitenstein²,

Urech³

et al. 2008

Annals of Surgery

226

186

View full text Add to dashboard Cite

; Clavien, P A (2008). A randomized controlled trial on pharmacological preconditioning in liver surgery using a volatile anesthetic. Annals of Surgery, 248(6) A randomized controlled trial on pharmacological preconditioning in liver surgery using a volatile anesthetic Abstract OBJECTIVE: To evaluate the effects of pharmacological preconditioning with a volatile anesthetic in patients undergoing liver resection with inflow occlusion. BACKGROUND: In liver surgery, ischemic preconditioning and intermittent clamping are the only established protective strategies to reduce tissue damage due to ischemia during inflow occlusion. Preconditioning with volatile anesthetics has provided protection against cardiac and renal ischemic injury in several animal models through NO and HO-1 pathways. But pharmacological preconditioning has never been tested in patients undergoing liver surgery in a randomized trial. METHODS: Sixty-four patients undergoing liver surgery with inflow occlusion were randomized intraoperatively for preconditioning with sevoflurane or not (ClinicalTrials.gov NCT00516711). Anesthesia was performed intravenously with propofol. Thirty minutes before inflow occlusion propofol was replaced by sevoflurane in the preconditioning group. Primary endpoint was postoperative liver injury assessed by peak values of liver transaminases. Postoperative complications were recorded according to an established scoring system. RESULTS: Sevoflurane preconditioning significantly limited the postoperative increase of serum transaminase levels by 261 U/L (95% CI, 65 to 458; P = 0.01) for the ALT and by 239 (95% CI, -2 to 480; P = 0.05) for the AST corresponding to decreases of baseline levels of 35% and 31%, respectively. Patients with steatosis had an even better benefit than patients without steatosis. The rates of any complication (risk ratio 0.46; 95% CI, 0.25 to 0.85; P = 0.006) and of severe complications requiring invasive procedures (risk ratio 0.25; 95% CI, 0.06 to 1.08; P = 0.05) were also lowered by preconditioning. CONCLUSION: This first randomized trial of pharmacological preconditioning in liver surgery in humans showed a protective effect of preconditioning with volatile anesthetics. This strategy may provide a new and easily applicable therapeutic option to protect the liver and to lower complication rates. Background: In liver surgery, ischemic preconditioning and intermittent clamping are the A Randomized Controlled Trial on Pharmacological Preconditioning in Liver Surgery using a Volatile Anesthetic

show abstract

“…However, the first successful liver resection was performed in 1888 by Langenbuch and the technique of vascular control, with great improvement on the procedure, was introduced by Pringle in 1908 1 . In the last decades, the surgical safety increased considerably because of new techniques, new equipment and materials, reducing the morbidity and mortality of patients submitted to hepatectomy 2 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Evaluation of liver regeneration diet supplemented with omega-3 fatty acids: experimental study in rats

Silva

Malafaia

Torres

et al. 2015

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

Evaluation of liver regeneration diet supplemented with omega-3 fatty acids: experimental study in rats 393Rev. Col. Bras. Cir. 2015; 42(6): [393][394][395][396][397] Original Article Original Article Original Article Original Article Original Article DOI: 10.1590/0100-69912015006008 Evaluation of liver regeneration diet supplemented with omega-3 Evaluation of liver regeneration diet supplemented with omega-3 Evaluation of liver regeneration diet supplemented with omega-3 Evaluation of liver regeneration diet supplemented with omega-3 Evaluation of liver regeneration diet supplemented with omega-3 fatty acids: experimental study in rats fatty acids: experimental study in rats fatty acids: experimental study in rats fatty acids: experimental study in rats fatty acids: experimental study in rats Avaliação da regeneração hepática com dieta suplementada com ácidos graxos Avaliação da regeneração hepática com dieta suplementada com ácidos graxos Avaliação da regeneração hepática com dieta suplementada com ácidos graxos Avaliação da regeneração hepática com dieta suplementada com ácidos graxos Avaliação da regeneração hepática com dieta suplementada com ácidos graxos ômega-3: estudo experimental em ratos ômega-3: estudo experimental em ratos ômega-3: estudo experimental em ratos ômega-3: estudo experimental em ratos ômega-3: estudo experimental em ratos Objective Objective: to evaluate liver regeneration in rats after partial hepatectomy of 60% with and without action diet supplemented with fatty acids through the study of the regenerated liver weight, laboratory parameters of liver function and histological study. Methods Methods Methods Methods Methods: thirty-six Wistar rats, males, adults were used, weighing between 195 and 330 g assigned to control and groups. The supplementation group received the diet by gavage and were killed after 24h, 72h and seven days. Evaluation of regeneration occurred through analysis of weight gain liver, serum aspartate aminotransferase, alanine aminotransferase, gammaglutamyltranspeptidase, and mitosis of the liver stained with H&E. Results Results ResultsResults Results: the diet supplemented group showed no statistical difference (p>0.05) on the evolution of weights. Administration of fatty acids post-hepatectomy had significant reduction in gamma glutamyltransferase levels and may reflect liver regeneration. Referring to mitotic index, it did not differ between period of times among the groups. Conclusion Conclusion Conclusion Conclusion Conclusion: supplementation with fatty acids in rats undergoing 60% hepatic resection showed no significant interference related to liver regeneration.

show abstract

Liver resection: 10-year experience from a single Institution

Cited by 17 publications

References 28 publications

Liver trisectionectomies for primary and secondary liver cancer in the modern era: results of a single tertiary center

Liver trisectionectomies for primary and secondary liver cancer in the modern era: results of a single tertiary center

A Randomized Controlled Trial on Pharmacological Preconditioning in Liver Surgery Using a Volatile Anesthetic

Evaluation of liver regeneration diet supplemented with omega-3 fatty acids: experimental study in rats

Contact Info

Product

Resources

About