为门静脉腔隙变性肝移植患者选择合适手术的新型术前分类系统

IF 2.1 4区 医学 Q2 SURGERY
Journal of Investigative Surgery Pub Date : 2024-12-01 Epub Date: 2024-11-12 DOI:10.1080/08941939.2024.2427391
Rui Tang, Xuan Tong, Bingjun Tang, Yucheng Hou, Guangdong Wu, Ang Li, Abudusalamu Aini, Yuewei Zhang, Huayuan Hao, Jingyi Lin, Jiyong Song, Guangxun Xu, Jun Yan, Qian Lu
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引用次数: 0

摘要

背景:目的:评估新的门静脉血栓形成(PVT)术前长庚分类(CC)系统在门静脉海绵状变(PVCT)患者肝移植(LT)过程中选择合适的手术方式重建门静脉的效果:这项回顾性观察研究分析了因各种肝病而进行的同种异体肝移植的数据:研究对象包括22名男性和4名女性,LT适应症包括肝硬化(9例)、肝细胞癌(12例)、门静脉海绵状变(2例)、暴发性乙型肝炎引起的肝功能衰竭(1例)、移植肝功能障碍(1例)和移植肝慢性排斥反应(1例)。患者按Yerdel(21例Yerdel II和5例Yerdel III)和CC(C1-C5)分类。C1-C3病例共进行了16例简单手术,C4-C5病例共进行了9例复杂手术,另有1例简单手术。根据 Yerdel 分级,在 Yerdel II 型病例中进行了 16 次简单手术和 5 次复杂手术,在 Yerdel III 型病例中进行了 1 次简单手术和 4 次复杂手术。中位随访时间为27.5个月,队列中一年和三年的总体OS率分别为88.1%和83.9%。具体而言,C1-3与C4-5患者的一年期OS率分别为93.3%和80.0%,三年期OS率分别为86.7%和80.0%(P = 0.526):本研究中提出的CC在术前识别PVCT LT患者是否需要复杂的手术技术方面显示出与Yerdel分类相当的潜力,而且还可能对LT术后的生存获益具有预测能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Preoperative Classification System for Selecting Suitable Surgeries in Liver Transplant Patients with Portal Vein Cavernous Transformation.

Background: To evaluate the new preoperative Changgung classification (CC) system of portal vein thrombosis (PVT) in choosing suitable operative procedures to reconstruct portal veins during liver transplantation (LT) in patients with portal vein cavernous transformation (PVCT).

Methods: This retrospective observational study analyzed data from allograft LTs performed for various liver diseases.

Results: The study included 22 males and 4 females with LT indications comprising cirrhosis (n = 9), hepatocellular carcinoma (n = 12), PVCT (n = 2), liver failure from fulminant hepatitis B (n = 1), dysfunction of transplanted liver (n = 1), and chronic rejection of transplanted liver (n = 1). Patients were classified according to Yerdel (21 Yerdel II and 5 Yerdel III) and CC (C1-C5). In total 16 simple operations were performed on C1-C3 cases and 9 complex operations on C4-C5 cases, with one additional simple operation. The distribution according to the Yerdel classification was 16 simple and 5 complex operations in Yerdel II cases and 1 simple and 4 complex operations in Yerdel III cases. The median follow-up time was 27.5 months with overall one-year and three-year OS rates of 88.1% and 83.9% for the cohort. Specifically, the one-year OS rates for patients classified as C1-3 vs. C4-5 were 93.3% and 80.0%, while the three-year OS rates were 86.7% and 80.0%, respectively (p = 0.526).

Conclusion: The CC proposed in this study shows comparable potential to the Yerdel classification in preoperatively identifying the need for complex surgical techniques in LT patients with PVCT and may also have predictive power for the survival benefits following LT.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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