Impact of steatosis on perioperative outcome following hepatic resection

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  • معلومة اضافية
    • Author-Supplied Keywords:
      nonalcoholic steatohepatitis
      surgical complications
      Chemotherapy
      infection
      Language of Keywords: English; German; French
    • Abstract:
      Fatty liver disease may interfere with liver regeneration and is postulated to result in an adverse outcome for patients subjected to partial hepatectomy. This study examines the impact of steatosis on outcome following hepatic resection for neoplasms. All patients with fatty livers (n = 325) who underwent hepatectomy between December 1991 and September 2001 were identified from a prospective database. Slides were reviewed and steatosis was quantified as follows: <30% (mild) and ≥30% (marked). Patient data were gathered and compared with results in 160 control patients with normal livers; subjects were matched for age, comorbidity, and extent of liver resection. There were 223 patients with mild and 102 with marked steatosis. Those with steatosis were more likely to be men (59% marked vs. 55% mild vs. 43% control; P = 0.01) with a higher body mass index (29.7±5.5 marked vs. 28.2±5.5 mild vs. 26.0±5.4 control; P<0.01), and treated preoperatively with chemotherapy (66% marked vs. 55% mild vs. 38% control; P<0.01). Total (62%, 48%, and 35%; P<0.01) and infective (43%, 24%, and 14%; P<0.01) complications correlated with the degree of steatosis. No difference was observed in complications requiring major medical intervention, hospitalization, or admission to the intensive care unit between groups. On multivariate analysis, steatosis was an independent predictor of complications (P<0.01, risk ratio = 3.04, 95% confidence interval = 1.7 to 5.54). There was a nonsignificant trend toward higher 60-day mortality in patients with marked steatosis who had lobe or more resections (9.4% marked vs. 5.0% mild vs. 5.0% control; P = 0.30). Marked steatosis is an independent predictor of complications following hepatic resection but does not have a significant impact on 60-day mortality. Steatosis alone should not preclude aggressive hepatic resection for neoplasms when indicated; however, patients with marked steatosis undergoing large resections should still be approached with due caution. [Copyright &y& Elsevier]
    • Abstract:
      Copyright of Journal of Gastrointestinal Surgery is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1From the Departments of Surgery (D.A.K., Y.F., P.J.A., R.P.D., M.D., L.H.B., W.R.J.), Epidemiology and Biostatistics (M.G.), and Pathology (A.S., D.S.K.), Memorial Sloan-Kettering Cancer Center, New York, New York, USA
    • ISSN:
      1091-255X
    • Accession Number:
      10.1016/j.gassur.2003.09.012
    • Accession Number:
      22237426
  • Citations
    • ABNT:
      KOOBY, D. A. et al. Impact of steatosis on perioperative outcome following hepatic resection. Journal of Gastrointestinal Surgery, [s. l.], v. 7, n. 8, p. 1034–1044, 2003. DOI 10.1016/j.gassur.2003.09.012. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=22237426&custid=s8280428. Acesso em: 5 dez. 2019.
    • AMA:
      Kooby DA, Fong Y, Suriawinata A, et al. Impact of steatosis on perioperative outcome following hepatic resection. Journal of Gastrointestinal Surgery. 2003;7(8):1034-1044. doi:10.1016/j.gassur.2003.09.012.
    • APA:
      Kooby, D. A., Fong, Y., Suriawinata, A., Gonen, M., Allen, P. J., Klimstra, D. S., … Jarnagin, W. R. (2003). Impact of steatosis on perioperative outcome following hepatic resection. Journal of Gastrointestinal Surgery, 7(8), 1034–1044. https://doi.org/10.1016/j.gassur.2003.09.012
    • Chicago/Turabian: Author-Date:
      Kooby, David A., Yuman Fong, Arief Suriawinata, Mithat Gonen, Peter J. Allen, David S. Klimstra, Ronald P. DeMatteo, Michael D’Angelica, Leslie H. Blumgart, and William R. Jarnagin. 2003. “Impact of Steatosis on Perioperative Outcome Following Hepatic Resection.” Journal of Gastrointestinal Surgery 7 (8): 1034–44. doi:10.1016/j.gassur.2003.09.012.
    • Harvard:
      Kooby, D. A. et al. (2003) ‘Impact of steatosis on perioperative outcome following hepatic resection’, Journal of Gastrointestinal Surgery, 7(8), pp. 1034–1044. doi: 10.1016/j.gassur.2003.09.012.
    • Harvard: Australian:
      Kooby, DA, Fong, Y, Suriawinata, A, Gonen, M, Allen, PJ, Klimstra, DS, DeMatteo, RP, D’Angelica, M, Blumgart, LH & Jarnagin, WR 2003, ‘Impact of steatosis on perioperative outcome following hepatic resection’, Journal of Gastrointestinal Surgery, vol. 7, no. 8, pp. 1034–1044, viewed 5 December 2019, .
    • MLA:
      Kooby, David A., et al. “Impact of Steatosis on Perioperative Outcome Following Hepatic Resection.” Journal of Gastrointestinal Surgery, vol. 7, no. 8, Dec. 2003, pp. 1034–1044. EBSCOhost, doi:10.1016/j.gassur.2003.09.012.
    • Chicago/Turabian: Humanities:
      Kooby, David A., Yuman Fong, Arief Suriawinata, Mithat Gonen, Peter J. Allen, David S. Klimstra, Ronald P. DeMatteo, Michael D’Angelica, Leslie H. Blumgart, and William R. Jarnagin. “Impact of Steatosis on Perioperative Outcome Following Hepatic Resection.” Journal of Gastrointestinal Surgery 7, no. 8 (December 2003): 1034–44. doi:10.1016/j.gassur.2003.09.012.
    • Vancouver/ICMJE:
      Kooby DA, Fong Y, Suriawinata A, Gonen M, Allen PJ, Klimstra DS, et al. Impact of steatosis on perioperative outcome following hepatic resection. Journal of Gastrointestinal Surgery [Internet]. 2003 Dec [cited 2019 Dec 5];7(8):1034–44. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=22237426&custid=s8280428