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Impact of steatosis on perioperative outcome following hepatic resection
Fatty liver disease may interfere with liver regeneration and is postulated to result in an adverse outcome for patients subjected to partial hepatectomy. This study examines the impact of steatosis on outcome following hepatic resection for neoplasms. All patients with fatty livers (n = 325) who un...
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| Published in: | Journal of gastrointestinal surgery 2003-12, Vol.7 (8), p.1034-1044 |
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| container_end_page | 1044 |
| container_issue | 8 |
| container_start_page | 1034 |
| container_title | Journal of gastrointestinal surgery |
| container_volume | 7 |
| creator | Kooby, David A Fong, Yuman Suriawinata, Arief Gonen, Mithat Allen, Peter J Klimstra, David S DeMatteo, Ronald P D'Angelica, Michael Blumgart, Leslie H Jarnagin, William R |
| description | Fatty liver disease may interfere with liver regeneration and is postulated to result in an adverse outcome for patients subjected to partial hepatectomy. This study examines the impact of steatosis on outcome following hepatic resection for neoplasms. All patients with fatty livers (n
=
325) who underwent hepatectomy between December 1991 and September 2001 were identified from a prospective database. Slides were reviewed and steatosis was quantified as follows: |
| doi_str_mv | 10.1016/j.gassur.2003.09.012 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71462573</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1091255X03001975</els_id><sourcerecordid>71462573</sourcerecordid><originalsourceid>FETCH-LOGICAL-c505t-e2fb2c6d69a2b09aeddaeff32ea6a07be6f6355517b55843d3403bb65ad235e13</originalsourceid><addsrcrecordid>eNp9kF1LwzAUhoMobk7_gUhB8K41H02y3ggy_BgMvFHwLqTp6cxom5q0E_-9GRsIXniTBM7znnPyIHRJcEYwEbebbK1DGH1GMWYZLjJM6BGakrlkaS6oOI5vXJCUcv4-QWchbDAmEpP5KZqQXEguCZui52XbazMkrk7CAHpwwYbEdUkP3rp46MFuIXHjYFwLSe2axn3Zbp18QB9LJvEQwAzWdefopNZNgIvDPUNvjw-vi-d09fK0XNyvUsMxH1KgdUmNqEShaYkLDVWloa4ZBS00liWIWjDOOZEl5_OcVSzHrCwF1xVlHAiboZt93967zxHCoFobDDSN7sCNQcn4N8oli-D1H3DjRt_F3RQhhDIpBdtR-Z4y3oXgoVa9t63234pgtfOsNmrvWe08K1yo6DnGrg7Nx7KF6jd0EBuBuz0A0cXWglfBWOgMVNZHYapy9v8JPymIkWA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1112377633</pqid></control><display><type>article</type><title>Impact of steatosis on perioperative outcome following hepatic resection</title><source>Springer Nature</source><creator>Kooby, David A ; Fong, Yuman ; Suriawinata, Arief ; Gonen, Mithat ; Allen, Peter J ; Klimstra, David S ; DeMatteo, Ronald P ; D'Angelica, Michael ; Blumgart, Leslie H ; Jarnagin, William R</creator><creatorcontrib>Kooby, David A ; Fong, Yuman ; Suriawinata, Arief ; Gonen, Mithat ; Allen, Peter J ; Klimstra, David S ; DeMatteo, Ronald P ; D'Angelica, Michael ; Blumgart, Leslie H ; Jarnagin, William R</creatorcontrib><description><![CDATA[Fatty liver disease may interfere with liver regeneration and is postulated to result in an adverse outcome for patients subjected to partial hepatectomy. This study examines the impact of steatosis on outcome following hepatic resection for neoplasms. All patients with fatty livers (n
=
325) who underwent hepatectomy between December 1991 and September 2001 were identified from a prospective database. Slides were reviewed and steatosis was quantified as follows: <30% (mild) and ≥30% (marked). Patient data were gathered and compared with results in 160 control patients with normal livers; subjects were matched for age, comorbidity, and extent of liver resection. There were 223 patients with mild and 102 with marked steatosis. Those with steatosis were more likely to be men (59% marked vs. 55% mild vs. 43% control;
P
=
0.01) with a higher body mass index (29.7±5.5 marked vs. 28.2±5.5 mild vs. 26.0±5.4 control;
P<0.01), and treated preoperatively with chemotherapy (66% marked vs. 55% mild vs. 38% control;
P<0.01). Total (62%, 48%, and 35%;
P<0.01) and infective (43%, 24%, and 14%;
P<0.01) complications correlated with the degree of steatosis. No difference was observed in complications requiring major medical intervention, hospitalization, or admission to the intensive care unit between groups. On multivariate analysis, steatosis was an independent predictor of complications (
P<0.01, risk ratio
=
3.04, 95% confidence interval
=
1.7 to 5.54). There was a nonsignificant trend toward higher 60-day mortality in patients with marked steatosis who had lobe or more resections (9.4% marked vs. 5.0% mild vs. 5.0% control;
P
=
0.30). Marked steatosis is an independent predictor of complications following hepatic resection but does not have a significant impact on 60-day mortality. Steatosis alone should not preclude aggressive hepatic resection for neoplasms when indicated; however, patients with marked steatosis undergoing large resections should still be approached with due caution.]]></description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1016/j.gassur.2003.09.012</identifier><identifier>PMID: 14675713</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Chemotherapy ; Confidence intervals ; Fatty Liver - complications ; Fatty Liver - surgery ; Female ; Hepatectomy - mortality ; Humans ; infection ; Liver ; Liver Neoplasms - complications ; Liver Neoplasms - surgery ; Liver Regeneration - physiology ; Male ; Medical research ; Middle Aged ; Mortality ; Multivariate analysis ; nonalcoholic steatohepatitis ; Postoperative Complications ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; surgical complications ; Survival Analysis ; Treatment Outcome</subject><ispartof>Journal of gastrointestinal surgery, 2003-12, Vol.7 (8), p.1034-1044</ispartof><rights>2003 The Society for Surgery of the Alimentary Tract</rights><rights>The Society for Surgery of the Alimentary Tract 2003.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-e2fb2c6d69a2b09aeddaeff32ea6a07be6f6355517b55843d3403bb65ad235e13</citedby><cites>FETCH-LOGICAL-c505t-e2fb2c6d69a2b09aeddaeff32ea6a07be6f6355517b55843d3403bb65ad235e13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14675713$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kooby, David A</creatorcontrib><creatorcontrib>Fong, Yuman</creatorcontrib><creatorcontrib>Suriawinata, Arief</creatorcontrib><creatorcontrib>Gonen, Mithat</creatorcontrib><creatorcontrib>Allen, Peter J</creatorcontrib><creatorcontrib>Klimstra, David S</creatorcontrib><creatorcontrib>DeMatteo, Ronald P</creatorcontrib><creatorcontrib>D'Angelica, Michael</creatorcontrib><creatorcontrib>Blumgart, Leslie H</creatorcontrib><creatorcontrib>Jarnagin, William R</creatorcontrib><title>Impact of steatosis on perioperative outcome following hepatic resection</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><description><![CDATA[Fatty liver disease may interfere with liver regeneration and is postulated to result in an adverse outcome for patients subjected to partial hepatectomy. This study examines the impact of steatosis on outcome following hepatic resection for neoplasms. All patients with fatty livers (n
=
325) who underwent hepatectomy between December 1991 and September 2001 were identified from a prospective database. Slides were reviewed and steatosis was quantified as follows: <30% (mild) and ≥30% (marked). Patient data were gathered and compared with results in 160 control patients with normal livers; subjects were matched for age, comorbidity, and extent of liver resection. There were 223 patients with mild and 102 with marked steatosis. Those with steatosis were more likely to be men (59% marked vs. 55% mild vs. 43% control;
P
=
0.01) with a higher body mass index (29.7±5.5 marked vs. 28.2±5.5 mild vs. 26.0±5.4 control;
P<0.01), and treated preoperatively with chemotherapy (66% marked vs. 55% mild vs. 38% control;
P<0.01). Total (62%, 48%, and 35%;
P<0.01) and infective (43%, 24%, and 14%;
P<0.01) complications correlated with the degree of steatosis. No difference was observed in complications requiring major medical intervention, hospitalization, or admission to the intensive care unit between groups. On multivariate analysis, steatosis was an independent predictor of complications (
P<0.01, risk ratio
=
3.04, 95% confidence interval
=
1.7 to 5.54). There was a nonsignificant trend toward higher 60-day mortality in patients with marked steatosis who had lobe or more resections (9.4% marked vs. 5.0% mild vs. 5.0% control;
P
=
0.30). Marked steatosis is an independent predictor of complications following hepatic resection but does not have a significant impact on 60-day mortality. Steatosis alone should not preclude aggressive hepatic resection for neoplasms when indicated; however, patients with marked steatosis undergoing large resections should still be approached with due caution.]]></description><subject>Aged</subject><subject>Chemotherapy</subject><subject>Confidence intervals</subject><subject>Fatty Liver - complications</subject><subject>Fatty Liver - surgery</subject><subject>Female</subject><subject>Hepatectomy - mortality</subject><subject>Humans</subject><subject>infection</subject><subject>Liver</subject><subject>Liver Neoplasms - complications</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver Regeneration - physiology</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>nonalcoholic steatohepatitis</subject><subject>Postoperative Complications</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>surgical complications</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNp9kF1LwzAUhoMobk7_gUhB8K41H02y3ggy_BgMvFHwLqTp6cxom5q0E_-9GRsIXniTBM7znnPyIHRJcEYwEbebbK1DGH1GMWYZLjJM6BGakrlkaS6oOI5vXJCUcv4-QWchbDAmEpP5KZqQXEguCZui52XbazMkrk7CAHpwwYbEdUkP3rp46MFuIXHjYFwLSe2axn3Zbp18QB9LJvEQwAzWdefopNZNgIvDPUNvjw-vi-d09fK0XNyvUsMxH1KgdUmNqEShaYkLDVWloa4ZBS00liWIWjDOOZEl5_OcVSzHrCwF1xVlHAiboZt93967zxHCoFobDDSN7sCNQcn4N8oli-D1H3DjRt_F3RQhhDIpBdtR-Z4y3oXgoVa9t63234pgtfOsNmrvWe08K1yo6DnGrg7Nx7KF6jd0EBuBuz0A0cXWglfBWOgMVNZHYapy9v8JPymIkWA</recordid><startdate>20031201</startdate><enddate>20031201</enddate><creator>Kooby, David A</creator><creator>Fong, Yuman</creator><creator>Suriawinata, Arief</creator><creator>Gonen, Mithat</creator><creator>Allen, Peter J</creator><creator>Klimstra, David S</creator><creator>DeMatteo, Ronald P</creator><creator>D'Angelica, Michael</creator><creator>Blumgart, Leslie H</creator><creator>Jarnagin, William R</creator><general>Elsevier Inc</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20031201</creationdate><title>Impact of steatosis on perioperative outcome following hepatic resection</title><author>Kooby, David A ; Fong, Yuman ; Suriawinata, Arief ; Gonen, Mithat ; Allen, Peter J ; Klimstra, David S ; DeMatteo, Ronald P ; D'Angelica, Michael ; Blumgart, Leslie H ; Jarnagin, William R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-e2fb2c6d69a2b09aeddaeff32ea6a07be6f6355517b55843d3403bb65ad235e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Chemotherapy</topic><topic>Confidence intervals</topic><topic>Fatty Liver - complications</topic><topic>Fatty Liver - surgery</topic><topic>Female</topic><topic>Hepatectomy - mortality</topic><topic>Humans</topic><topic>infection</topic><topic>Liver</topic><topic>Liver Neoplasms - complications</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver Regeneration - physiology</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>nonalcoholic steatohepatitis</topic><topic>Postoperative Complications</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>surgical complications</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kooby, David A</creatorcontrib><creatorcontrib>Fong, Yuman</creatorcontrib><creatorcontrib>Suriawinata, Arief</creatorcontrib><creatorcontrib>Gonen, Mithat</creatorcontrib><creatorcontrib>Allen, Peter J</creatorcontrib><creatorcontrib>Klimstra, David S</creatorcontrib><creatorcontrib>DeMatteo, Ronald P</creatorcontrib><creatorcontrib>D'Angelica, Michael</creatorcontrib><creatorcontrib>Blumgart, Leslie H</creatorcontrib><creatorcontrib>Jarnagin, William R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kooby, David A</au><au>Fong, Yuman</au><au>Suriawinata, Arief</au><au>Gonen, Mithat</au><au>Allen, Peter J</au><au>Klimstra, David S</au><au>DeMatteo, Ronald P</au><au>D'Angelica, Michael</au><au>Blumgart, Leslie H</au><au>Jarnagin, William R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of steatosis on perioperative outcome following hepatic resection</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><addtitle>J Gastrointest Surg</addtitle><date>2003-12-01</date><risdate>2003</risdate><volume>7</volume><issue>8</issue><spage>1034</spage><epage>1044</epage><pages>1034-1044</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract><![CDATA[Fatty liver disease may interfere with liver regeneration and is postulated to result in an adverse outcome for patients subjected to partial hepatectomy. This study examines the impact of steatosis on outcome following hepatic resection for neoplasms. All patients with fatty livers (n
=
325) who underwent hepatectomy between December 1991 and September 2001 were identified from a prospective database. Slides were reviewed and steatosis was quantified as follows: <30% (mild) and ≥30% (marked). Patient data were gathered and compared with results in 160 control patients with normal livers; subjects were matched for age, comorbidity, and extent of liver resection. There were 223 patients with mild and 102 with marked steatosis. Those with steatosis were more likely to be men (59% marked vs. 55% mild vs. 43% control;
P
=
0.01) with a higher body mass index (29.7±5.5 marked vs. 28.2±5.5 mild vs. 26.0±5.4 control;
P<0.01), and treated preoperatively with chemotherapy (66% marked vs. 55% mild vs. 38% control;
P<0.01). Total (62%, 48%, and 35%;
P<0.01) and infective (43%, 24%, and 14%;
P<0.01) complications correlated with the degree of steatosis. No difference was observed in complications requiring major medical intervention, hospitalization, or admission to the intensive care unit between groups. On multivariate analysis, steatosis was an independent predictor of complications (
P<0.01, risk ratio
=
3.04, 95% confidence interval
=
1.7 to 5.54). There was a nonsignificant trend toward higher 60-day mortality in patients with marked steatosis who had lobe or more resections (9.4% marked vs. 5.0% mild vs. 5.0% control;
P
=
0.30). Marked steatosis is an independent predictor of complications following hepatic resection but does not have a significant impact on 60-day mortality. Steatosis alone should not preclude aggressive hepatic resection for neoplasms when indicated; however, patients with marked steatosis undergoing large resections should still be approached with due caution.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>14675713</pmid><doi>10.1016/j.gassur.2003.09.012</doi><tpages>11</tpages></addata></record> |
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| ispartof | Journal of gastrointestinal surgery, 2003-12, Vol.7 (8), p.1034-1044 |
| issn | 1091-255X 1873-4626 |
| language | eng |
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| source | Springer Nature |
| subjects | Aged Chemotherapy Confidence intervals Fatty Liver - complications Fatty Liver - surgery Female Hepatectomy - mortality Humans infection Liver Liver Neoplasms - complications Liver Neoplasms - surgery Liver Regeneration - physiology Male Medical research Middle Aged Mortality Multivariate analysis nonalcoholic steatohepatitis Postoperative Complications Predictive Value of Tests Prognosis Retrospective Studies surgical complications Survival Analysis Treatment Outcome |
| title | Impact of steatosis on perioperative outcome following hepatic resection |
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