Does Anatomic Resection Get More Benefits than Wedge Hepatectomy on the Prognosis for pT3 Unsuspected Gallbladder Cancer?

Background: Re-radical surgery is the only curative therapy for unsuspected gallbladder carcinoma (UGC). The aim of this study was to compare prognosis of pT3 UGC patients receiving anatomic hepatectomy (AH) or wedge hepatectomy (WH) combined with en bloc local-regional lymphadenectomy of the hepatoduodenal ligament using propensity score-matching (PSM) analysis. Materials and Methods: A retrospective study was carried out on 81 consecutive pT3 UGC patients who underwent radical re-resection at Eastern Hepatobiliary Surgery Hospital from 2006 to 2015. Overall survival (OS) was estimated using Kaplan-Meier method. The difference in OS between the AH and WH groups was analyzed using the log-rank test and the PSM method. Result: The AH and WH groups showed no significant difference in OS (P > .05) by either log-rank test or PSM analysis. Conclusions: Both AH and WH radical re-resections are effective treatments for UCG patients with pT3 tumors.

Post-operative delayed elevation of ALT correlates with early death in patients with HBV-related hepatocellular carcinoma and Post-hepatectomy Liver Failure.

BACKGROUND: Post-hepatectomy Liver Failure (PHLF) remains the primary cause of perioperative death. The kinetics of transaminase levels are usually measured as markers of hepatocellular injury following partial hepatectomy, but their correlation with PHLF and post-operative mortality is unclear. The aim of study was to compare the post-operative transaminase kinetics with short term survival in those patients that developed PHLF. METHODS: A retrospective review of patients with HBV-related HCC and who developed PHLF was performed. Logistic regression analysis was conducted to analyze risk factors for postoperative delayed elevation of ALT (PDE-ALT) PHLF and lethal PHLF. RESULT: Of the 69 patients who developed PHLF 36 (52%) died. In those patients who died the mean ± SD ALT and AST rose from day (POD) 1-3 and continued to fluctuate with highly abnormal levels beyond day 3 with a mean ± SD peak ALT level beyond POD 3 of 1851 ± 1644 U/L (p < 0.001). CONCLUSIONS: The kinetics of the post-operative transaminases were significantly correlated with perioperative mortality in those patients who developed PHLF. PDE-ALT indicates an increased risk of death in HBV-related HCC patients with PHLF.

Does anti-HBV therapy benefit the prognosis of HBV-related hepatocellular carcinoma following hepatectomy?

The Hepatitis B virus (HBV) is an important etiological factor for hepatocarcinogenesis, because HBV DNA load and HBV reactivation are major risks that influence the long-term survival of hepatocellular carcinoma (HCC) patients who underwent hepatectomy and, thus, may cause postoperative liver function deterioration, tumor recurrence, and reduce patient's overall survival. However, anti-HBV therapy can suppress HBV replication, improve the remnant liver function, render patients better able to tolerate HCC treatments, and may even improve their prognosis. In this paper, an anti-HBV therapy that benefits the prognosis of HBV-related HCC following hepatectomy is reviewed.

The Role of Antiviral Therapy for HBV-Related Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is a highly prevalent and lethal cancer worldwide; despite the curative treatment for HCC, the rate of tumor recurrence after hepatectomy remains high. Tumor recurrence can occur early (<2 years) or late (>2 years) as metastases or de novo tumors. Several tumor factors were associated with HCC recurrence; high hepatitis B virus (HBV) load is the major risk factor for late recurrence of HCC after resection. Preoperative antiviral therapy improves liver function, and postoperative reduce HCC recurrence. In this paper, we focus on antiviral treatment to improve the liver function, prevent recurrence, and lengthen the overall survival for HBV-related HCC.

Experimental study of using acellular dermal dermis instead of donor sclera in orbital implantation / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the histocompatibility of homologous acellular dermal matrix as a wrapping material for a hydroxyapatite orbital implant and compare the speed of fibrovascular ingrowth in hydroxyapatite orbital implant wrapped with homologous acellular dermal matrix and homologous sclera respectively.</p><p><b>METHODS</b>Twenty four New Zealand rabbits were divided into two groups randomly. One group is implanted with hydroxyapatite orbital implant wrapped with homologous acellular dermal matrix behind the globe, the other group with homologous sclera. The observation included immunological reaction of the globe postoperation. Biopsies of implanted material were taken on weeks 1, 4, 8 and 12 postoperation for histopathological and electron microscope examination.</p><p><b>RESULTS</b>Histological examination showed the homologous acellular dermal matrix has no immunological and inflammatory reaction after implanted in orbit. But the speed of fibrovascular ingrowth is a little slower than that of homologous sclera.</p><p><b>CONCLUSIONS</b>The homologous acellular dermal matrix has the better histocompatibility as an encapsulating biomaterial, it can be a new material instead of homologous sclera.</p>