Safety of nighttime elective hepatectomy for hepatocellular carcinoma patients: a retrospective study.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2024-02-01 Epub Date: 2024-01-29 DOI:10.4174/astr.2024.106.2.68

Zhan-Cheng Qiu, You-Wei Wu, Wei-Li Qi, Chuan Li

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引用次数: 0

Abstract

Purpose: This study aimed to investigate whether nighttime elective surgery influenced the short-term outcomes and prognosis of hepatocellular carcinoma (HCC) patients.

Methods: The 1,339 HCC patients who underwent hepatectomy were divided into the daytime surgery group (8 a.m.-6 p.m., n = 1,105) and the nighttime surgery group (after 6 p.m., n = 234) based on the start time of surgery. The 1:2 propensity score matching (PSM) analysis was used to control confounding factors. The short-term outcomes of HCC patients in the 2 groups were compared before and after PSM. Factors associated with major complications (Clavien-Dindo grade, ≥III) and textbook oncologic outcomes (TOO) were separately identified by multivariable logistic regression based on variables screened via least absolute shrinkage and selection operator (LASSO). The Kaplan-Meier method was used to analyze overall survival (OS) and recurrence-free survival (RFS).

Results: TOO was achieved after surgery in 897 HCC patients. HCC patients in the nighttime surgery group had a higher body mass index (P = 0.010). After 1:2 PSM, the baseline characteristics of patients between the 2 groups were similar. Short-term outcomes in HCC patients were comparable both before and after PSM (all Ps > 0.05), as were TOO in the 2 groups before (P = 0.673) and after PSM (P = 0.333). In our LASSO-logistic regression, nighttime surgery was not an independent factor associated with major complications or TOO. Both groups also had similar OS (P = 0.950) and RFS (P = 0.740) after PSM.

Conclusion: Our study revealed the safety of nighttime elective hepatectomy for HCC patients.

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肝细胞癌患者夜间择期肝切除术的安全性：一项回顾性研究。

目的：本研究旨在探讨夜间择期手术是否会影响肝细胞癌（HCC）患者的短期疗效和预后：根据手术开始时间，将1,339名接受肝切除术的HCC患者分为日间手术组（上午8时至下午6时，n = 1,105）和夜间手术组（下午6时后，n = 234）。采用1:2倾向得分匹配（PSM）分析来控制混杂因素。两组HCC患者的短期疗效在PSM前后进行了比较。根据最小绝对缩小和选择算子（LASSO）筛选出的变量，通过多变量逻辑回归分别确定了与主要并发症（Clavien-Dindo分级，≥III级）和教科书肿瘤结局（TOO）相关的因素。采用 Kaplan-Meier 法分析总生存期（OS）和无复发生存期（RFS）：结果：897 例 HCC 患者术后达到了 TOO。夜间手术组的 HCC 患者体重指数更高（P = 0.010）。1:2 PSM后，两组患者的基线特征相似。HCC患者在PSM前后的短期疗效相当（Ps均大于0.05），两组患者在PSM前（P = 0.673）和PSM后（P = 0.333）的TOO也相当。在我们的LASSO-逻辑回归中，夜间手术并不是与主要并发症或TOO相关的独立因素。两组患者在 PSM 后的 OS（P = 0.950）和 RFS（P = 0.740）也相似：结论：我们的研究揭示了HCC患者夜间择期肝切除术的安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).