Postoperative Complication after Hepatic Resection by the Right Thoraco-abdominal Approach

Masaki Kitazono, Gen Tanabe, Masahiro Hamanoue, Shin-ichi Ueno, Takashi Aikou

First Department of Surgery, Faculty of Medicine, Kagoshima University

To clarify the factors concerned with postoperative complications after hepatic resection by the right thoraco-abdominal approach (TAA), charts of 114 patients who had undergone hepatic resection for hepatocellular carcinoma between 1991 and 1995 were reviewed retrospectively. Among the patients, 45 received hepatic resection associated with right lobe by the abdominal approach (AA) and 32 by TAA, and various comparisons were made between AA and TAA. No difference was found in age, clinical stage, tumor size, morbidity and kinds of postoperative complications between the two approaches. But a number of patient in TAA had a resection of upper section (p<0.01). Then, risk factors concerned with major complications after TAA such as hyperbilirubinemia more than 10 mg/dl and and/or disseminated intravascular coagulopathy were investigated. Elder age (p<0.01), bearing the tumor adjacent to the confluence of the hepatic vein (p<0.01), and liver transection without Pringle's maneuver (p<0.05) were risk factors of major complications after TAA. These results suggest that careful intraoperative hemostasis during hepatic resection is important to avoid the occurrence of major complications after TAA.

Key words
hepatic resection, thoraco-abdominal approach, postoperative complication

Reprint requests
Masa Kitazono First Department of Surgery, Kagoshima University
8-35-1 Sakuragaoka, Kagoshima, 890-0075 JAPAN

Accepted
January 14, 1998

To read the PDF file you will need Abobe Reader installed on your computer.