Morbidity and mortality of hepatectomy for benign liver tumors

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• 作者：Timothy E. Newhook ; M.D. ; Damien J. LaPar ; M.D. ; M.Sc. ; James M. Lindberg ; M.D. ; Todd W. Bauer ; M.D. ; F.A.C.S. ; Reid B. Adams ; M.D. ; F.A.C.S. ; Victor M. Zaydfudim ; M.D. ; M.P.H. ; ^{vz8h@virginia.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：NSQIP ; Liver metastases ; Benign liver tumors ; Hepatic adenoma ; Hepatic hemangioma ; Surgical outcomes
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：211
• 期：1
• 页码：102-108
• 全文大小：171 K

文摘

This study compared the morbidity and mortality following hepatectomy for benign liver tumors and hepatic metastases.

Methods

This retrospective cohort study compared patients who underwent hepatectomy for benign liver tumors and metastases reported to National Surgical Quality Improvement Program between 2005 and 2011.

Results

A total of 5,542 patients underwent hepatectomy: 1,164 (21%) for benign and 4,378 (79%) for metastatic diseases. Patients with benign tumors were younger, predominantly female, and were less likely to have preoperative comorbidities (all P < .037). Rates of major complications including infections, embolism, renal failure, stroke, coma, cardiac arrest, reoperation, and ventilator dependence were similar between the 2 groups (all P ≥ .05). Thirty-day mortality was .9% among patients with benign tumors and 1.4% among patients with metastases (P = .128). After adjusting for significant effects of age and major complications (both P ≤ .007), benign vs malignant diagnosis and extent of hepatectomy was not associated with 30-day survival (both P ≥ .083).

Conclusions

Despite patients with benign disease being younger and healthier, risks of major complications are similar after hepatectomy for benign and metastatic disease. Hepatectomy should be offered selectively for patients with benign liver tumors.