Decreased blood loss reduces postoperative complications in resection for hepatocellular carcinoma. (19th February 2014)

• Record Type: Journal Article
• Authors: Aramaki, Osamu; Takayama, Tadatoshi; Higaki, Tokio; Nakayama, Hisashi; Ohkubo, Takao; Midorikawa, Yutaka; Moriguchi, Masamichi; Matsuyama, Yutaka
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 21:Number 8(2014)
• Page Start: 585
• Page End: 591
• Publication Date: 2014-02-19
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.101
• Languages: English
• ISSNs: 1868-6974

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jhbp101-sec-0001" sec-type="section"> <title>Background</title> <p>The correlation between blood loss and the risk of postoperative complications was unclear in patients undergoing resection of hepatocellular carcinoma (HCC).</p> </sec> <sec id="jhbp101-sec-0002" sec-type="section"> <title>Methods</title> <p>We studied 539 patients who had resection of HCC. Postoperative complications were recorded according to the modified Clavien‐Dindo classification. Variables were compared between patients with grade III to V complications and those with no or grade I to II. A spline regression analysis was used to estimate the probability of grade III to V complications.</p> </sec> <sec id="jhbp101-sec-0003" sec-type="section"> <title>Results</title> <p>Among variables, blood loss (<italic>P</italic> = 0.0001), operating time (<italic>P</italic> = 0.0001), blood transfusion (<italic>P</italic> = 0.0001), and tumor size (<italic>P</italic> = 0.02) differed significantly between patients with grade III to V and those with no or I to II. Multivariate analysis revealed that the factor most strongly related to complications was blood loss (odds ratio 1.68; 95% confidence interval [CI] 1.45–1.96, <italic>P</italic> = 0.0001). Spline regression analysis showed that an increase in blood loss was accompanied by increase in the risk of complication; when the estimated probability of grade III to V complications exceeded 50% (95% CI 30.0–70.0), the corresponding blood loss was 820 ml.</p> </sec> <sec id="jhbp101-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Decrease in blood loss in resection of HCC is accompanied by reduced risk of complications. Surgeons need to minimize blood loss as less as 820 ml.</p> </sec> </abstract>