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Article: Intraoperative iatrogenic rupture of hepatocellular carcinoma

TitleIntraoperative iatrogenic rupture of hepatocellular carcinoma
Authors
Issue Date2002
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 2002, v. 26 n. 3, p. 348-352 How to Cite?
AbstractIntraoperative iatrogenic rupture of hepatocellular carcinoma (HCC), which can occur during hepatic resection when large tumors are being mobilized, may adversely affect the operative outcome. Little information is available in the literature on this serious intraoperative complication. The aim of the present study is to document iatrogenic rupture of HCC as a serious complication during hepatic resection and its effects on the operative and long-term outcomes of patients with this complication. A retrospective study was performed on all patients with intraoperative iatrogenic rupture of HCC during hepatic resection from 1989 to 1997, and the operative and long-term survival outcomes were compared with those of patients without the complication. Among 194 patients who underwent hepatic resection for a large HCC (≥ 5 em) during the study period, 8 (4.1%) had intraoperative iatrogenic rupture of the tumor. When compared with 186 patients with similar clinical parameters but without intraoperative rupture, patients with intraoperative rupture had significantly more intraoperative blood loss (median 5.7 vs. 2.0 L; p = 0.01) and blood transfusion requirement (median 3.1 vs 0.9 L; p = 0.02). On follow-up, patients in the intraoperative rupture group had a significantly higher intraperitoneal extrahepatic recurrence rate (33.3% vs. 2.9%; p = 0.02) and significantly shorter survival (median 11.5 vs. 37.9 months, p = 0.04) when compared with patients without the complication. Intraoperative iatrogenic rupture is a serious complication of hepatic resection for HCC because it is associated with increased intraoperative blood loss, increased incidence of intraperitoneal extrahepatic recurrence, and short survival. Extreme care should be taken during mobilization of the tumor, and an alternative operative approach in the presence of a difficult hepatic resection of a large HCC may be required to avoid the complication.
Persistent Identifierhttp://hdl.handle.net/10722/88619
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T09:45:45Z-
dc.date.available2010-09-06T09:45:45Z-
dc.date.issued2002en_HK
dc.identifier.citationWorld Journal Of Surgery, 2002, v. 26 n. 3, p. 348-352en_HK
dc.identifier.issn0364-2313en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88619-
dc.description.abstractIntraoperative iatrogenic rupture of hepatocellular carcinoma (HCC), which can occur during hepatic resection when large tumors are being mobilized, may adversely affect the operative outcome. Little information is available in the literature on this serious intraoperative complication. The aim of the present study is to document iatrogenic rupture of HCC as a serious complication during hepatic resection and its effects on the operative and long-term outcomes of patients with this complication. A retrospective study was performed on all patients with intraoperative iatrogenic rupture of HCC during hepatic resection from 1989 to 1997, and the operative and long-term survival outcomes were compared with those of patients without the complication. Among 194 patients who underwent hepatic resection for a large HCC (≥ 5 em) during the study period, 8 (4.1%) had intraoperative iatrogenic rupture of the tumor. When compared with 186 patients with similar clinical parameters but without intraoperative rupture, patients with intraoperative rupture had significantly more intraoperative blood loss (median 5.7 vs. 2.0 L; p = 0.01) and blood transfusion requirement (median 3.1 vs 0.9 L; p = 0.02). On follow-up, patients in the intraoperative rupture group had a significantly higher intraperitoneal extrahepatic recurrence rate (33.3% vs. 2.9%; p = 0.02) and significantly shorter survival (median 11.5 vs. 37.9 months, p = 0.04) when compared with patients without the complication. Intraoperative iatrogenic rupture is a serious complication of hepatic resection for HCC because it is associated with increased intraoperative blood loss, increased incidence of intraperitoneal extrahepatic recurrence, and short survival. Extreme care should be taken during mobilization of the tumor, and an alternative operative approach in the presence of a difficult hepatic resection of a large HCC may be required to avoid the complication.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_HK
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.subject.meshAdulten_HK
dc.subject.meshCarcinoma, Hepatocellular - mortality - pathology - surgeryen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHepatectomy - adverse effectsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIatrogenic Diseaseen_HK
dc.subject.meshIntraoperative Complicationsen_HK
dc.subject.meshLiver Neoplasms - mortality - pathology - surgeryen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMedical Errors - adverse effectsen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshRupture - etiology - mortality - pathologyen_HK
dc.subject.meshSurvival Rateen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleIntraoperative iatrogenic rupture of hepatocellular carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0364-2313&volume=26&spage=348&epage=352&date=2002&atitle=Intraoperative+iatrogenic+rupture+of+hepatocellular+carcinomaen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00268-001-0231-0en_HK
dc.identifier.pmid11865373-
dc.identifier.scopuseid_2-s2.0-0036514444en_HK
dc.identifier.hkuros68691en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036514444&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume26en_HK
dc.identifier.issue3en_HK
dc.identifier.spage348en_HK
dc.identifier.epage352en_HK
dc.identifier.isiWOS:000174440500012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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