|Table of Contents|

Efficacy and safety of open anatomic resection via the main hepatic vein approach in primary liver cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 14
Page:
2666-2672
Research Field:
Publishing date:

Info

Title:
Efficacy and safety of open anatomic resection via the main hepatic vein approach in primary liver cancer
Author(s):
GONG Jie; GAO Fengwei; LEI Zehua; JIANG Kangyi; XIE Qingyun; ZHAO Xin
Department of Hepatopancreatobiliary Surgery，Leshan People's Hospital，Leshan Treatment Center of Hepatopancreatobiliary System Diseases，Sichuan Leshan 614000，China.
Keywords:
main hepatic vein approach; anatomical resection; open surgery; primary liver cancer; liver function; immune function; inflammatory response
PACS:
R735.7
DOI:
10.3969/j.issn.1672-4992.2023.14.017
Abstract:
Objective:To explore the efficacy of open AR via the main hepatic vein approach in the treatment of primary liver cancer and its influence on perioperative indicators and postoperative complications of patients.Methods:The clinical data of 158 patients with primary liver cancer who were admitted to our hospital and underwent open anatomical resection were retrospectively analyzed between January 2016 and October 2022.Using propensity matching to match the baseline data in a 1∶1 ratio,52 pairs of samples with no statistically significant differences in baseline data were obtained.Patients who underwent open AR via the main hepatic vein approach were enrolled as study group,and patients who performed open AR via routine approach were included in routine group.The perioperative status,levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL),albumin (ALB),immunoglobulin (Ig) A,IgG,IgM,CD4+T cells,CD8+T cells,interleukin-6 (IL-6),IL-10 and tumor necrosis factor-α (TNF-α) before surgery and at 7 d after surgery and postoperative related complications were compared between the two groups.Results:The intraoperative blood loss in the study group were lower than in the routine group with statistically significant differences (P＜0.05).There were no statistical differences between the two groups in the operative time,percentage of patients with intraoperative blood transfusion,hepatic portal block time and hospital stay between the two groups (P>0.05).At 7 d after surgery,serum ALT,AST and TBIL levels were significantly increased (P＜0.05) while serum ALB level was significantly decreased (P＜0.05),and the levels of serum ALT,AST and TBIL were lower in study group than those in routine group while the level of ALB was higher than that in routine group (P＜0.05).The levels of peripheral blood IgA,IgG,IgM and CD8+T cells in both groups at 7 d after surgery were significantly lower than those before surgery (P＜0.05) while the level of CD4+T cells was significantly higher than that before surgery (P＜0.05),and the levels of peripheral blood IgG and CD8+T cells in study group were higher than those in routine group while the level of CD4+T cells was lower than that in routine group (P＜0.05).Serum levels of IL-6,IL-10 and TNF-α were significantly higher in both groups at 7 d after surgery than before surgery (P＜0.05),and the levels of serum IL-6,IL-10 and TNF-α in study group were lower compared with those in routine group (P＜0.05).There were no statistical differences in the incidence rates of postoperative complications between both groups (P>0.05).Conclusion:Open AR via the main hepatic vein approach is safe and feasible in the treatment of primary liver cancer,and it can reduce the intraoperative blood loss and alleviate the liver function,immune function damage and inflammatory response.In addition,it has a positive effect on promoting the rehabilitation of patients.

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