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《Oncology Progress》 2018-08
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The effect of the timing of liver cancer resection on the postoperative recurrence,abdominal cavity metastasis and prognosis of patients with primary liver cancer spontaneous rupture and hemorrhage

YIN Tao;LIU Mingming;JIN Ruotian;Department of General Surgery,Affiliated Hospital of Chifeng College;  
Objective To explore the effect of the timing of liver cancer resection on the postoperative recurrence,abdominal cavity metastasis and prognosis of patients with primary liver cancer spontaneous rupture and hemorrhage.Method The medical records of 68 patients with primary liver cancer spontaneous rupture and hemorrhage were retrospectively analyzed. Patients were divided into emergency operation group(n=28) and second-stage operation group(n=40) according to the timing of liver cancer resection. The perioperative indicators of the two groups of patients were compared, and the postoperative recurrence or abdominal metastasis and prognosis of postoperative liver cancer were observed. Result The intraoperative blood loss and intraoperative blood transfusion volume in the emergency operation group were significantly higher than those in the second-stage operation group(P0.01), and the total hospitalization time was significantly shorter than that in the second-stage operation group(P0.01). There was no significant difference in the operation time between the two groups(P0.05). There was no significant difference in the overall survival rate between the two groups(P0.05). However, the 1-year survival rate of the emergency operation group was significantly higher than that of the second-stage operation group(78.5% vs 40.0%), and the difference was statistically significant(P0.01). There was no significant difference in the postoperative recurrence rate and abdominal metastasis rate between the two groups(P0.05). COX regression analysis showed that AFP level(RR=2.05) and tumor diameter(RR=2.46) were independent risk factors for postoperative recurrence or abdominal metastasis in patients with primary liver cancer spontaneous rupture and hemorrhage(P0.05). Conclusion The short-term prognosis of patients undergoing emergency operation is better than that of patients undergoing second-stage operation. The second-stage hepatectomy does not increase the postoperative recurrence rate and abdominal metastasis rate. AFP levels and tumor diameter are independent risk factors for postoperative recurrence or abdominal metastasis in patients with primary liver cancer spontaneous rupture and hemorrhage.
【CateGory Index】: R735.7
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