Predicting pleural effusion and ascites following extended hepatectomy in the non-cirrhotic liver. 2007

Yasuhiro Shimizu, and Tsuyoshi Sano, and Kenzo Yasui
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan. yshimizu@aichi-cc.jp

BACKGROUND There are cases in which intractable pleural effusion and/or ascites appear even in the non-cirrhotic liver following extended liver resection, making postoperative management difficult. In this study we investigated the risk factors for pleural effusion and ascites following extended hepatectomy. METHODS Subjects were 50 patients between 1996 and 2003 who had hepatic metastasis of colorectal cancer, and who underwent extended liver resection of hemihepatectomy or greater at a time separate from the surgery for their colorectal cancer. The 50 patients were classified according to the presence or absence of pleural effusion and/or ascites, and compared for preoperative ICGR15, pre- and postoperative total serum protein and albumin levels, operating time, amount of blood loss, resected liver weight g/bodyweight kg (Hx ratio), intraoperative fluid replacement volume, period of surgery, operative procedure, use of serum and plasma derivatives, and use of catecholamines. RESULTS In a univariate analysis of pleural effusion and ascites, the Hx ratio, period of surgery, operative procedure, use of fresh frozen plasma and use of albumin preparations were significant factors, but in a multivariate analysis only the Hx ratio was a significant independent factor. Among patients with an Hx ratio of 8 or above, many had postoperative pleural effusion and ascites. CONCLUSIONS The Hx ratio is a simple method for the evaluation of postoperative remnant liver function and is extremely useful as a predictive factor for pleural effusion and ascites following extended hepatectomy in the non-cirrhotic liver.

UI MeSH Term Description Entries
D008113 Liver Neoplasms Tumors or cancer of the LIVER. Cancer of Liver,Hepatic Cancer,Liver Cancer,Cancer of the Liver,Cancer, Hepatocellular,Hepatic Neoplasms,Hepatocellular Cancer,Neoplasms, Hepatic,Neoplasms, Liver,Cancer, Hepatic,Cancer, Liver,Cancers, Hepatic,Cancers, Hepatocellular,Cancers, Liver,Hepatic Cancers,Hepatic Neoplasm,Hepatocellular Cancers,Liver Cancers,Liver Neoplasm,Neoplasm, Hepatic,Neoplasm, Liver
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010996 Pleural Effusion Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. Effusion, Pleural,Effusions, Pleural,Pleural Effusions
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D005260 Female Females
D006498 Hepatectomy Excision of all or part of the liver. (Dorland, 28th ed) Hepatectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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