Two decades of liver resection with a multidisciplinary approach in a single institution: What has changed? Analysis of 1409 cases

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art_HERMAN_Two_decades_of_liver_resection_with_a_multidisciplinary_2022.PDF (940.05 KB)
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2022
DOI
SciELO
Scopus
Web of Science
PubMed
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ISSN da Revista
Título do Volume
Editora
ELSEVIER ESPANA
Autores
Citação
CLINICS, v.77, article ID 100088, 8p, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objectives: To evaluate results of patients undergoing liver resection in a single center over the past two decades with a particular look at Colorectal Liver Metastasis (CRLM) and Hepatocellular Carcinoma (HCC). Method: Patients were divided into two eras, from 2000 to 2010 (Era 1) and 2011 to 2020 (Era 2). The most frequent diagnosis was CRLM and HCC, with 738 (52.4%) and 227 (16.1%) cases respectively. An evaluation of all liver resection cases and a subgroup analysis of both CRLM and HCC were performed. Preoperative and per operative variables and long-term outcomes were evaluated. Results: 1409 liver resections were performed. In Era 2 the authors observed higher BMI, more: minimally invasive surgeries, Pringle maneuvers, and minor liver resections; and less transfusion, less ICU necessity, and shorter length of hospital stay. Severe complications were observed in 14.7% of patients, and 90-day mortality was 4.2%. Morbidity and mortality between eras were not different. From 738 CRLM resections, in Era 2 there were significantly more patients submitted to neoadjuvant chemotherapy, bilateral metastases, and smaller sizes with significantly less transfusion, the necessity of ICU, and shorter length of hospital stay. More pedicle clamping, minimally invasive surgeries, and minor resections were also observed. From 227 HCC resections, in Era 2 significantly more minimally invasive surgeries, fewer transfusions, less necessity of ICU, and shorter length of hospital stay were observed. OS was not different between eras for CRLM and HCC. Conclusions: Surgical resection in a multidisciplinary environment remains the cornerstone for the curative treatment of primary and metastatic liver tumors.
Palavras-chave
Hepatectomy, Liver neoplasms, Hepatocellular carcinoma, Colorectal liver metastases, Morbidity
URI
https://observatorio.fm.usp.br/handle/OPI/49221
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/02
Artigos e Materiais de Revistas Científicas - LIM/07
Artigos e Materiais de Revistas Científicas - LIM/37
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