[Analysis of factors relating to early repairment of the surgical margin following liver resection--factors relating to duration of hospital stay].
To analyze relating factors to early repairment of the surgical margin of the remnant liver we measured plasma fibronectin (FN), coagulation factor XIII (XIII), polymorphonuclear leukocyte elastase (PMNE), platelet counts (Plt), prothrombin time (PT%) before and at the first, third, 7th and 14th days after liver resection in 25 patients. Changes in these factors (1) were compared with their clinical status, such as liver cirrhosis, high fever, abscess formation, duration of drainage and use of microwave tissue coagulator (MTC) (2). The multivariate analysis about the factors influencing the duration of hospital stay (3) were carried out. (1) In the all cases FN, XIII (14th), PT%, Plt decreased and PMNE increased significantly versus pre-operative data. There were significant correlations between FN and XIII, FN and PMNE. (2) In the cirrhotic group FN, XIII, PT% and Plt were significantly lower than those of non cirrhotic group. In the abscess formation group PT% was significantly lower than the no abscess formation group. In the MTC group XIII, PT% and Plt were significantly lower than those of the no-MTC group. In conclusion, FN, XIII, Plt and PT% in the cirrhotic, high fever, abscess formation or longer drainage group were in lower levels compared with the each control group. (3) By the multivariate analyses, abscess formation, high fever and liver cirrhosis were the most influencing factors for the duration of hospital stay.
Kohno
T
T
First Department of Surgery, Yamanashi Medical College, Japan.
Yamamoto
M
M
Sugahara
K
K
D000328:Adult; D000368:Aged; D005176:Factor XIII / Q000378:metabolism; D005260:Female; D005353:Fibronectins / Q000097:blood; D006498:Hepatectomy; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000201:enzymology; D010196:Pancreatic Elastase / Q000097:blood; D010976:Platelet Count; D011182:Postoperative Care; D011517:Prothrombin Time; D012044:Regression Analysis; D014945:Wound Healing
D005353:Fibronectins; D005176:Factor XIII; D010196:Pancreatic Elastase