Evaluation of prognostic criteria for the development of postoperative complications of liver resection in its focal diseases
Abstract
Background. The incidence rate of focal liver formations and its
predicted growth in the future, the relevance of liver metastases suggests an
increase in the number of liver resections and encourages the development of
this direction. To improve the quality and results of treatment, including by
reducing the frequency of postoperative complications, a personalized approach
in determining the tactics of treating patient will help. It is possible to
implement this approach by examining the predictors of postoperative
complications.
Aim. To determine prognostic criteria for the development
of postoperative complications.
Material and methods. In accordance with the inclusion, non-inclusion and
exclusion
criteria, 66 patients
were selected for the study. All of them underwent liver resection of various
sizes. Next, dependent and independent variables were determined to evaluate
the prognostic criteria. For each independent variable, the odds ratio (OR) and
significance level (p) were calculated. Risk factors were assessed at
the preoperative, operative and postoperative stages.
Results. The following risk factors turned out to be common
for all: AST level (≥30–38.7 U/l, p<0.05), PTI level (≤80–92%; p<0.05),
fibrinogen (≥ 3.98–5.74 g/l, p<0.05) before surgery; AST level
(≥346–741 U/l; p<0.05), total bilirubin level (≥27.5–30 µmol/l; p<0.05)
on day 1 after surgery. In addition to the indicators of laboratory
diagnostics, the duration of the operation (≥315–390 min; p<0.05),
intraoperative blood loss (≥330–740 ml; p<0.05), intra- and
postoperative transfusion of blood components (p<0.02), resection of
3 or more segments (p<0.05).
Conclusion. The results of the study showed that the patient’s
age, the amount of surgical aid, the duration of the operation and
intraoperative blood loss, transfusion of blood components during and after the
operation, the results of laboratory diagnostics (such as the level of hepatic
transferases, total bilirubin, fibrinogen, protrombin index) can be
statistically significant predictors of postoperative complications. These
criteria can be used to build complex prognostic models that will be in demand
in clinical practice.
Keywords:liver; liver resection; postoperative complication; prognostic criteria; perioperative planning
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Subbot V.S., Semenkov A.V., Tulskih D.А. Evaluation
of prognostic criteria for the development of postoperative complications of
liver resection in its focal diseases. Clinical and Experimental Surgery.
Petrovsky Journal. 2023; 11 (1): 104–12. DOI: https://doi.org/10.33029/2308-1198-2023-11-1-104-112
(in Russian)
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