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[Specific complications of liver resection and their prevention]. / Rezektsiia pecheni. Spetsificheskie oslozhneniia i ikh profilaktika.
Shabunin, A V; Parfenov, I P; Bedin, V V; Tavobilov, M M; Grekov, D N; Drozdov, P A; Karpov, A A.
Afiliación
  • Shabunin AV; Russian Medical Academy for Continuing Professional Education of the Ministry of Health of Russia, Moscow, Russia; Botkin Municipal Clinical Hospital of the Moscow Healthcare Department, Moscow, Russia.
  • Parfenov IP; Russian Medical Academy for Continuing Professional Education of the Ministry of Health of Russia, Moscow, Russia.
  • Bedin VV; Russian Medical Academy for Continuing Professional Education of the Ministry of Health of Russia, Moscow, Russia; Botkin Municipal Clinical Hospital of the Moscow Healthcare Department, Moscow, Russia.
  • Tavobilov MM; Russian Medical Academy for Continuing Professional Education of the Ministry of Health of Russia, Moscow, Russia; Botkin Municipal Clinical Hospital of the Moscow Healthcare Department, Moscow, Russia.
  • Grekov DN; Russian Medical Academy for Continuing Professional Education of the Ministry of Health of Russia, Moscow, Russia; Botkin Municipal Clinical Hospital of the Moscow Healthcare Department, Moscow, Russia.
  • Drozdov PA; Botkin Municipal Clinical Hospital of the Moscow Healthcare Department, Moscow, Russia.
  • Karpov AA; Botkin Municipal Clinical Hospital of the Moscow Healthcare Department, Moscow, Russia.
Khirurgiia (Mosk) ; (3): 5-12, 2020.
Article en Ru | MEDLINE | ID: mdl-32271731
AIM: To improve the results of treatment of patients with focal liver formations by preventing the development of postoperative complications after liver resections. METHODS: The study included 304 patients with benign and malignant liver lesions. In 196 (64.4%) patients, resections were performed for malignant liver damage, in 108 (35.6%) - for a benign process. To assess the impact of ongoing measures to prevent the development of postoperative complications, patients were divided into two time periods: from 2007 to 2012 and from 2013 to 2018. RESULTS: The introduction of a protocol of preoperative examination of patients for whom resection of 3 or more liver segments is planned, with the inclusion of SPECT/CT, which allows determining the volume of the remaining functioning liver parenchyma, allowed to reduce the percentage of development of acute post-resection liver failure from 11.6% to 3.6% during the second time period (p=0.0064). The use of modern suture material, surgical binocular loops, as well as the use of the concept of predominantly performing parenchyma-saving resections, reduced the number of biliary complications from 8.1% to 5.7% (p=0.1). The use of a proprietary dissection algorithm for the liver parenchyma significantly reduced hemorrhagic complications from 5.3% to 1.04% (p=0.0074). CONCLUSION: The use of modern pre- and intraoperative technologies has reduced the number of postoperative complications after liver resections from 38.3% to 20.9% (p=0.018) and mortality from 2.6% to 0.5% (p=0.004), thereby improving the results of liver resections.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hepatectomía / Hígado / Neoplasias Hepáticas Tipo de estudio: Etiology_studies / Guideline Límite: Humans Idioma: Ru Revista: Khirurgiia (Mosk) Año: 2020 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Rusia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hepatectomía / Hígado / Neoplasias Hepáticas Tipo de estudio: Etiology_studies / Guideline Límite: Humans Idioma: Ru Revista: Khirurgiia (Mosk) Año: 2020 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Rusia