A Comparative Study of Surgical Approaches for Hepatocellular Carcinoma: Conversion versus Direct Resection.

IF 4.2 3区 医学 Q2 ONCOLOGY
Journal of Hepatocellular Carcinoma Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI:10.2147/JHC.S483397
Xinlin Li, Kai Chen, Xu Feng, Xinhua Wu, Shiguai Qi, Qingmiao Wang, Zhengrong Shi
{"title":"A Comparative Study of Surgical Approaches for Hepatocellular Carcinoma: Conversion versus Direct Resection.","authors":"Xinlin Li, Kai Chen, Xu Feng, Xinhua Wu, Shiguai Qi, Qingmiao Wang, Zhengrong Shi","doi":"10.2147/JHC.S483397","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of This study is exploring the intraoperative and perioperative differences between patients undergoing conversion surgery and those undergoing direct surgery, so as to improve preoperative preparation.</p><p><strong>Methods: </strong>The retrospective study was approved by an ethics review committee. A total of 232 patients with hepatocellular carcinoma who underwent surgical resection at the First Affiliated Hospital of Chongqing Medical University from September 2022 to December 2023 were included, comprising 210 operating patients and 53 conversion patients. Propensity score matching was employed for comparison in order to minimize bias.</p><p><strong>Results: </strong>The conversion group had more intraoperative bleeding (each P=0.001), longer operation time (P=0.033; PSM p=0.025), and higher intraoperative blood transfusion rate (p=0.001; PSM p=0.044). The incidence of perioperative complications, including perioperative ascites formation (p=0.011; PSM p=0.005), moderate to severe anemia (p=0.001; PSM p=0.002), postoperative blood transfusion (p=0.004; PSM p=0.036), and postoperative ICU transfer (p=0.041; PSM p=0.025), was higher in the conversion group compared to the operation group. The postoperative hospital stay (p=0.001; PSM p=0.003) was prolonged in the conversion group.</p><p><strong>Conclusion: </strong>Post-conversion operations carry a higher risk of bleeding and are more likely to result in moderate to severe anemia and ascites formation in the perioperative period. However, the risk is reversible with adequate preoperative blood preparation and prompt postoperative symptomatic treatment. Conversion patients should be encouraged to undergo operating therapy when they can withstand surgical resection.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531269/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepatocellular Carcinoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JHC.S483397","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: The purpose of This study is exploring the intraoperative and perioperative differences between patients undergoing conversion surgery and those undergoing direct surgery, so as to improve preoperative preparation.

Methods: The retrospective study was approved by an ethics review committee. A total of 232 patients with hepatocellular carcinoma who underwent surgical resection at the First Affiliated Hospital of Chongqing Medical University from September 2022 to December 2023 were included, comprising 210 operating patients and 53 conversion patients. Propensity score matching was employed for comparison in order to minimize bias.

Results: The conversion group had more intraoperative bleeding (each P=0.001), longer operation time (P=0.033; PSM p=0.025), and higher intraoperative blood transfusion rate (p=0.001; PSM p=0.044). The incidence of perioperative complications, including perioperative ascites formation (p=0.011; PSM p=0.005), moderate to severe anemia (p=0.001; PSM p=0.002), postoperative blood transfusion (p=0.004; PSM p=0.036), and postoperative ICU transfer (p=0.041; PSM p=0.025), was higher in the conversion group compared to the operation group. The postoperative hospital stay (p=0.001; PSM p=0.003) was prolonged in the conversion group.

Conclusion: Post-conversion operations carry a higher risk of bleeding and are more likely to result in moderate to severe anemia and ascites formation in the perioperative period. However, the risk is reversible with adequate preoperative blood preparation and prompt postoperative symptomatic treatment. Conversion patients should be encouraged to undergo operating therapy when they can withstand surgical resection.

肝细胞癌手术方法的比较研究:转换与直接切除。
目的:本研究旨在探讨接受转换手术和直接手术的患者在术中和围手术期的差异,从而改进术前准备:这项回顾性研究已获得伦理审查委员会批准。研究共纳入2022年9月至2023年12月在重庆医科大学附属第一医院接受手术切除的232例肝细胞癌患者,包括210例手术患者和53例转化患者。为减少偏倚,采用倾向评分匹配法进行比较:结果:转换组术中出血量更多(各P=0.001),手术时间更长(P=0.033;PSM P=0.025),术中输血率更高(P=0.001;PSM P=0.044)。与手术组相比,转换组围手术期并发症的发生率更高,包括围手术期腹水形成(p=0.011;PSM p=0.005)、中重度贫血(p=0.001;PSM p=0.002)、术后输血(p=0.004;PSM p=0.036)和术后转入 ICU(p=0.041;PSM p=0.025)。术后住院时间(P=0.001;PSM p=0.003)在转换手术组更长:结论:转换手术后出血风险较高,围手术期更有可能导致中重度贫血和腹水的形成。不过,只要术前充分备血,术后及时对症治疗,这种风险是可以逆转的。应鼓励转归患者在能够承受手术切除的情况下接受手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信