ABSTRACT
Objective:To study the intraoperative surgical factors which influenced non-immediate postoperative tracheal extubation (IPTE) after liver transplantation.Methods:The clinical data of all liver transplant recipients operated at the Qilu Hospital of Shandong University from January 2011 to July 2019 were reviewed. Patients who returned to a surgical ward with a tracheal cannula or who underwent re-intubation within 48 hours after IPTE because of hypoxemia were assigned to the cannula-preserving group (non-IPTE). The remaining liver recipients were assigned to the control group (IPTE). Univariate and multivariate logistic regression analysis were used to analyze the risk factors influencing IPTE.Results:Of 70 patients enrolled into this study, there were 30 patients in the cannula-preserving group (with 25 males, 5 females, and age of 51.8±7.3). And 40 patients in the control group (with 35 males, 5 females, and age of 48.4±9.6). Univariate logistic regression analysis showed anhepatic phase >45 min, blood loss >800 ml and intraoperative hypothermia were related with non-IPTE after liver transplantation(all P<0.05). Multivariate logistic regression analysis revealed anhepatic phase >45 min ( OR=3.972, 95% CI: 1.193-13.220, P=0.025) and intraoperative hypothermia ( OR=23.682, 95% CI: 2.434-230.438, P=0.006) increased the risk of unsuccessful IPTE. Conclusion:A long anhepatic phase and intraoperative hypothermia were surgical risk factors affecting non-IPTE after liver transplantation. Surgeons should avoid patients having hypothermia and a prolong anhepatic phase during liver transplantation.
ABSTRACT
Objective To evaluate hepatic segment vascular occlusion technology in precise resection of liver segment.Methods Sixty-seven cases of liver cancer patients who underwent precision liver segment resection from August 2007 to May 2012 in Qilu Hospital were analyszed retrospectively.There were 51 male patients and 16 female patients,age ranging from 45 to 66 yrs.Results All operations were performed successfully.All cases were with single tumor,the diameter ranged from 2 cm to 6 cm.Resection of segment Ⅲ was performed in 22 cases,segment Ⅳ in 10 cases and segment Ⅵ in 35 cases.Operation time was 50-120 minutes,and the average time was 73 minutes.Blood loss was 50-200 ml,averaging 86 ml.No patient needed blood transfusion.Postoperative incisional liquefaction was found in 6 cases which were cured with interference in time.There was no bile leakage,hemorrhage,celiac infection and complications such as liver failure.The average hospital stay was 7.8 days.No rccurrence was found during 3 months follow-up.Conclusions Hepatic segment vascular occlusion technology was safe and feasible in precise resection of liver segment in liver cancer patients.It effectively controlled blood loss and reduced liver damage.