A meta-analysis of risk factors of postoperative infectious complications after liver resection for hepatocellular carcinoma / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the risk factors of postoperative infectious complications (PIC) after liver resection for hepatocellular carcinoma (HCC) using evidence based medicine to provide a basis for prediction and prevention of PIC.Methods The fixed-effects or random-effects model was performed on studies on risk factors of PIC in HCC patients published from January 1990 to May 2015 by searching the PubMed,Embase,CNKI,VIP and Wanfang Data.Results Fourteen studies involving HCC 5 841 patients were included in this meta-analysis.The level of serum albumin was significantly lower in the PIC group than the NPIC group (WMD =-1.80,95％ CI-2..79 ～-0.80 ; P ＜ 0.05) ; Patients with diabetes mellitus had a higher incidence of PIC than those without diabetes mellitus (OR =1.94,95％ CI1.27 ～ 2.95 ; P ＜ 0.05) ; Patients with operation time less than 5 h had an decreased incidence of PIC than the other group (OR =0.31,95 ％ CI0.22 ～ 0.45 ; P ＜ 0.05).Patients with blood loss less than 2 000 ml had a lower incidence of PIC than the other group (OR =0.30,95％ CI0.19 ～ 0.48 ; P ＜ 0.05).Patients with blood transfusion had a higher incidence of PIC than those without transfusion (OR =2.83,95％ CI2.04 ～ 3.93 ; P ＜ 0.05).Patients with postoperative bile leakage had a higher incidence of PIC than those without bile leakage (OR =3.79,95％ CI2.06 ～ 6.96; P ＜ 0.05).Patients after primary hepatectomy had a higher incidence of PIC than those after repeat hepatectomy,but there was no significant difference between the two groups (OR =1.52,95％ CI0.99 ～ 2.33 ; P =0.05).Patients with tumor diameter less than 5 cm had a higher incidence of PIC than the other group,but there was no significant difference between the two groups (OR=1.09,95％CI0.76 ～1.56; P＞0.05).Conclusion A low level of serum albumin,diabetes mellitus,operation time more than 5 h,blood loss more than 2 000 ml,blood transfusion,bile leakage were risk factors for the development of PIC.