Association between intraoperative hyperoxia and liver function in patients undergoing hepatectomy: a multicenter observational study.

IF 1.8 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-08-21 DOI:10.1007/s00423-025-03832-3

Yumeng Fu, Ke Hao, Xiaohan Lin, Xiaojun Wu, Shuting Yang, Ziyi Cheng, Minghan Wang, Yongqian Yuan, Baoli Cheng

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引用次数: 0

Abstract

Purpose: Oxygen (O₂) is recognized as both a "friend and foe" to various organs, with emerging evidence suggesting potential adverse effects of hyperoxia on the liver. This study aimed to evaluate whether a high intraoperative partial pressure of arterial oxygen (PaO₂ ≥ 300 mmHg) during hepatectomy is associated with postoperative liver injury.

Methods: A comparative analysis was conducted on patients undergoing hepatectomy at a university hospital, stratified by intraoperative PaO₂ levels (≥ 300 mmHg vs. <300 mmHg). Primary outcomes included markers of liver function impairment, specifically elevated levels of alanine aminotransferase (ALT), aspartate transaminase (AST), and total bilirubin (Tbil), reduced plasma albumin levels, as well as increased international normalized ratio (INR), prothrombin time (PT). Secondary outcomes encompassed hospital length of stay (LOS) and postoperative complications (Clavien-Dindo classification). Subgroup analyses were performed based on Child‒Pugh score (≥ 7), age (≥ 65 years), surgical approach (laparoscopic), and surgery duration. Additionally, findings were validated in a prospective cohort of 76 patients.

Results: The study included 292 patients who underwent hepatectomy between January 2021 and December 2021. All patients survived through hospital discharge. There were no cases diagnosed as post-hepatectomy liver failure. Postoperative changes in ALT, AST, Tbil, albumin levels, and INR, PT were comparable between the high and low PaO₂ groups. No significant differences were observed in hospital LOS and postoperative complications. Subgroup analyses yielded consistent results. These findings were further corroborated in the prospective validation cohort.

Conclusions: The findings suggest that intraoperative high PaO₂ (≥ 300 mmHg) is not associated with adverse effects on postoperative liver injury in patients undergoing hepatectomy.

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查看原文本刊更多论文

肝切除术患者术中高氧与肝功能的关系：一项多中心观察性研究。

目的：氧（O₂）被认为是各种器官的“朋友和敌人”，越来越多的证据表明，高氧对肝脏有潜在的不利影响。本研究旨在评估肝切除术中较高的术中动脉氧分压（PaO₂≥300 mmHg）是否与术后肝损伤有关。方法：对某大学医院行肝切除术的患者进行比较分析，按术中PaO₂水平（≥300 mmHg）与结果进行分层：研究纳入了2021年1月至2021年12月行肝切除术的292例患者。所有患者都顺利出院。无肝切除术后肝衰竭病例。术后ALT、AST、bil、白蛋白水平以及INR、PT的变化在高、低PaO 2组之间具有可比性。两组在住院LOS和术后并发症方面无显著差异。亚组分析结果一致。这些发现在前瞻性验证队列中得到进一步证实。结论：肝切除术患者术中高PaO₂（≥300 mmHg）与术后肝损伤的不良反应无关。

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

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.