ABSTRACT
Objective To observe effects of different concentrations of sevoflurane combined with propofol on recovery quality in patients undergoing partial hepatic resection.Methods Seventy-eight patients,aged 20-70 years old,selected for partial hepatic resection were randomly divided into three groups,26 patients in each group:total intravenous propofol anesthesia group (group T), propofol combined with 0.5 MAC sevoflurane anesthesia group (group S1),propofol combined with 1.0 MAC sevoflurane anesthesia group (group S2).Spontaneous respiration recovery time,recovery time,extubation time and modified Aldrete score of 9 time were recorded after operation.Modified OAA/S scores as well as modified Aldrete score at extubation immediate time (T1 )and 5 min (T2 ), 1 5 min(T3 ),30 min(T4 )after extubation were also recorded.Results Total amount of propofol in groups S1,S2 significantly less than group T and total amount of propofol in group S2 significantly less than group S1(P <0.05).The recovery time,extubation time,modified Aldrete score of 9 time in groups S1 and S2 were significantly shorter than group T (P <0.05).Modified OAA/S scores at T1 ,T2 and the modified Aldrete scores at T1 in both groups S1 and S2 were significantly higher than group T,while group S2 was significantly higher than group S1 (P <0.05).Conclusion Compared with total intravenous propofol anesthesia,both propofol combined with 0.5 MAC sevoflurane and propofol combined with 1.0 MAC sevoflurane anesthesia improves the recovery quality in patients un-dergoing partial hepatic resection,and the recovery time was decreased in propofol combined with 1.0 MAC sevoflurane anesthesia.
ABSTRACT
PURPOSE: This study examined the effects a partial hepatectomy through an analysis of survival rates and examine the recurrence pattern after a partial hepatic resection for HCC according to the Milan criteria combined with Child-Pugh A cirrhosis. METHODS: On hundred and twenty seven HCC patients with Child-Pugh A liver cirrhosis undergoing a hepatic resection for HCC from September 1987 through July 2004 in the hospital were retrospectively reviewed. Among them, 85 cases met the Milan criteria (M group). However, the remaining 42 cases did not (N group). The median age was 52 years and males outnumbered females by almost five times. The median follow up period was 39.8 months. RESULTS: No in-hospital mortality occurred in the M group, but there was a single mortality case in the N group. The size of the tumor, multiplicity and major resection rate were different between the two groups. The 5 years overall survival rate of each group was 62.3% and 37.3%, respectively (P=0.002) and the 5 year disease free survival rates were 44.0% and 24.5%, respectively (P=0.023). Forty one patients in the M group developed recurrences, of which 35 had only intrahepatic recurrences. Among them, 28 recurrences still met the Milan criteria. CONCLUSION: A partial hepatic resection should be considered a standard treatment method for a HCC meeting the Milan criteria with compensated liver cirrhosis in terms of safety and long-term survival. A salvage transplantation may play a role after a recurrence because most recurrences are intrahepatic recurrences that meet the Milan criteria.