Objective To explore intraoperative bleeding of patients with early stage hepatocellular carcinoma which may relate to perioperative events and the prognosis. Methods A retrospective analysis was performed on 222 patients with early stage hepatocellular carcinoma who underwent surgical resection in Tianjin Medical University Cancer Hospital from January 2008 to December 2013. According to the receiver operating characteristic curve analysis of the volume of intraoperative blood loss, 185 cases with blood loss 200 mL or less were assigned into group A and 37 cases with blood loss more than 200 mL into group B. Hospital stay, complication and overall survival were compared between two groups. Results There were no significant difference in gender, age, preoperative platelet counting, prothrombin time and total serum bilirubin and diameter and number of tumor between two groups statistically (P>0.05). Longer median survival time of the patients, shorter hospital stay, less cases with ascites and infection were found in group A when compared those in group B (P<0.05). Conclusions For patients with early stage hepatocellular carcinoma, intraoperative bleeding may be a negative factor for the perioperative complications and long term survival. It is necessary to reduce the bleeding during hepatectomy.
ZHANG Yongqiang, ZHANG Ti, KONG Yinlong, HOU Zhenyu, LI Huikai, CUI Yunlong, SONG Tianqiang, LI Qiang
. Intraoperative hemorrhage related to perioperative events and prognosis of patients with early stage hepatocellular carcinoma[J]. Journal of Surgery Concepts & Practice, 2018
, 23(04)
: 342
-345
.
DOI: 10.16139/j.1007-9610.2018.04.014
[1] Parkin DM, Bray F, Ferlay J, et al.Global cancer statistics[J]. CA Cancer J Clin,2005,55(2):74-108.
[2] 张风华, 彭和平, 王宝枝, 等. 肝癌肝切除术后感染性并发症的危险因素分析[J]. 中国普通外科杂志,2015, 24(1):133-135.
[3] Attallah AM, Omran MM, Attallah AA, et al.Simplified HCC-ART score for highly sensitive detection of small-sized and early-stage hepatocellular carcinoma in the widely used Okuda, CLIP, and BCLC staging systems[J]. Int J Clin Oncol,2017,22(2):332-339.
[4] 中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范(2017年版)[J]. 中国实用外科杂志,2017,37(7):705-720.
[5] 陈万青, 郑荣寿, 张思维, 等. 2012年中国恶性肿瘤发病和死亡分析[J]. 中国肿瘤,2016,25(1):1-8.
[6] 崔瑞文, 朱曙光, 范磊, 等. 射频消融与手术切除治疗早期肝细胞癌疗效比较Meta分析[J]. 中华肝脏外科手术学电子杂志,2017,6(4):280-284.
[7] Taketomi A.Development and future directions of antiangiogenic therapy in hepatocellular carcinoma[J]. Int J Clin Oncol,2016,21(2):205.
[8] 戴朝六, 贾昌俊. 以外科手术为主的肝癌多学科综合治疗[J]. 腹部外科,2017,30(2):84-88.
[9] Vitale A, Burra P, Frigo AC, et al.Survival benefit of li-ver resection for patients with hepatocellular carcinoma across different Barcelona Clinic Liver Cancer stages: a multicentre study[J]. J Hepatol,2015,62(3):617-624.
[10] Zhong JH, Ke Y, Gong WF, et al.Hepatic resection associated with good survival for selected patients with intermediate and advanced stage hepatocellular carcinoma[J]. Ann Surg,2014,260(2):329-340.
[11] Song J, Liu H, Li Z, et al.Long-term prognosis of surgical treatment for early ampullary cancers and implications for local ampullectomy[J]. BMC Surg,2015,15:32.
[12] van den Broek MA, Olde Damink SW, Dejong CH, et al. Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment[J]. Liver Int,2008,28(6):767-780.
[13] Nathan H, Weiss MJ, Soff GA, et al.Pharmacologic prophylaxis,postoperative INR, and risk of venous thromboembolism after hepatectomy[J]. J Gastrointest Surg,2014,18(2):295-302.
[14] 李辉, 于淼, 刘成科, 等. 肝癌患者肝脏部分切除术后感染的影响因素分析[J]. 中华医院感染学杂志,2017, 27(24):5611-5614.
[15] Yang T, Lu JH, Lau WY, et al.Perioperative blood transfusion does not influence recurrence-free and overall survivals after curative resection for hepatocellular carcinoma: A Propensity Score Matching Analysis[J]. J He-patol,2016,64(3):583-593.
[16] 张贯启, 张志伟, 陈孝平, 等. 大肝癌手术切除术中不同肝血流阻断方法的临床研究[J]. 中国普通外科杂志,2015,24(1):18-22.
