title: Safety of hepatectomy accompanying combined resection of other organs.
abstract: OBJECTIVE
  The present study analyzed postoperative outcomes for patients who underwent hepatectomy accompanied by resection of other organs, to clarify operative safety.
  
  
  METHODS
  We examined perioperative parameters in 95 patients who underwent hepatectomy and other organ resections (colorectal resection, n=46; gastrectomy or duodenectomy, n=13; splenectomy, n=17; resection of diaphragm, n=9; pulmonary resection, n=4; others, n=6).
  
  
  RESULTS
  Prevalence of chronic liver dysfunction (100%) or hepatocellular carcinoma (HCC) (100%) was significantly higher in patients who underwent splenectomy than in other groups (17% and 21%, respectively; p<0.01). Extent of hepatectomy, operating time and blood loss did not differ significantly between groups. Frequency of blood transfusion use was highest in patients who underwent splenectomy (p<0.01). Postoperative complications tended to be more frequent among patients who underwent splenectomy, but this difference was not significant. Wound infection tended to be more frequent among patients who underwent colorectal resection, but not significantly (p=0.11). Hepatectomy-associated complications in patients who underwent splenectomy most often appeared in the form of uncontrolled ascites (p<0.01), with hospital deaths rarely observed and hospital stay not significantly different between groups.
  
  
  CONCLUSIONS
  Good postoperative outcomes in multi-organ resections with hepatectomy were observed by careful perioperative management based on adequate indications for hepatectomy.
authors.affiliation: Division of Surgical Oncology and Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Naoya
authors.initials: N
authors.lastname: Yamasaki
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003964:Diaphragm / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D007902:Length of Stay; D016014:Linear Models; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011013:Pneumonectomy / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000628:therapy; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome