Hideaki Uchiyama1, Norifumi Harimoto2, Shinji Itoh2, Tomoharu Yoshizumi2, Toru Ikegami2, Yoshihiko Maehara2. 1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan. huchi@surg2.med.kyushu-u.ac.jp. 2. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan.
Abstract
BACKGROUND: Although posthepatectomy pleural effusion (PHPE) is a commonly observed phenomenon, its precise etiology and the impact of its emergence on oncological outcomes have still unknown. The aim of the current study was to retrospectively investigate risk factors for PHPE and its impact on oncological outcomes of hepatocellular carcinoma (HCC). METHODS: Medical records of 330 patients who underwent primary curative hepatectomy for HCC were reviewed. All 330 patients had CT around day 7 after hepatectomy, and the emergence of PHPE on CT was examined. Presumed 38 risk factors for the emergence of PHPE and already-known 9 risk factors together with PHPE for HCC recurrence and patient death after hepatectomy were analyzed. RESULTS: The overall incidence of PHPE was 54.5% (180/330). One hundred seventy-nine and 38 out of the 180 patients had right-sided PHPE and left-sided PHPE, respectively. The independent risk factors for right-sided PHPE were hepatitis B or C back ground, lower preoperative white blood cell count, larger intraoperative blood loss, longer operation time, subcostal incision, and longer total inflow occlusion time, while the only independent risk factor for left-sided PHPE was longer operation time. Left-sided PHPE was testified to be one of the independent risk factors not only for HCC recurrence but also for patient death. CONCLUSIONS: Although the cause of PHPE after hepatectomy might be multifactorial, the emergence of left-sided PHPE is a portent of worse oncological outcomes after curative hepatectomy for HCC and patients with left-sided PHPE need close follow-ups.
BACKGROUND: Although posthepatectomy pleural effusion (PHPE) is a commonly observed phenomenon, its precise etiology and the impact of its emergence on oncological outcomes have still unknown. The aim of the current study was to retrospectively investigate risk factors for PHPE and its impact on oncological outcomes of hepatocellular carcinoma (HCC). METHODS: Medical records of 330 patients who underwent primary curative hepatectomy for HCC were reviewed. All 330 patients had CT around day 7 after hepatectomy, and the emergence of PHPE on CT was examined. Presumed 38 risk factors for the emergence of PHPE and already-known 9 risk factors together with PHPE for HCC recurrence and patientdeath after hepatectomy were analyzed. RESULTS: The overall incidence of PHPE was 54.5% (180/330). One hundred seventy-nine and 38 out of the 180 patients had right-sided PHPE and left-sided PHPE, respectively. The independent risk factors for right-sided PHPE were hepatitis B or C back ground, lower preoperative white blood cell count, larger intraoperative blood loss, longer operation time, subcostal incision, and longer total inflow occlusion time, while the only independent risk factor for left-sided PHPE was longer operation time. Left-sided PHPE was testified to be one of the independent risk factors not only for HCC recurrence but also for patientdeath. CONCLUSIONS: Although the cause of PHPE after hepatectomy might be multifactorial, the emergence of left-sided PHPE is a portent of worse oncological outcomes after curative hepatectomy for HCC and patients with left-sided PHPE need close follow-ups.
Authors: Peter D Peng; Mark G van Vledder; Susan Tsai; Mechteld C de Jong; Martin Makary; Julie Ng; Barish H Edil; Christopher L Wolfgang; Richard D Schulick; Michael A Choti; Ihab Kamel; Timothy M Pawlik Journal: HPB (Oxford) Date: 2011-03-29 Impact factor: 3.647
Authors: T Yoshizumi; T Ikegami; T Toshima; N Harimoto; H Uchiyama; Y Soejima; Y Yamashita; K Shirabe; Y Maehara Journal: Transplant Proc Date: 2013-11 Impact factor: 1.066
Authors: Kit Fai Lee; John Wong; Sunny Y S Cheung; Charing C N Chong; Joyce W Y Hui; Vivian Y F Leung; Simon C H Yu; Paul B S Lai Journal: World J Surg Date: 2018-10 Impact factor: 3.352