Role of ablation therapy in conjunction with surgical resection for neuroendocrine tumors involving the liver

查看全文 作　　者：Alexander [1]Ostapenko;Stephanie [2]Stroever;Lud [1]Eyasu;Minha [1]Kim;Krist [1]Aploks;Xiang Da [3]Dong;Ramanathan [3]Seshadri 机构地区：[1]Department of General Surgery,Danbury Hospital,Danbury,CT 06810,United States;[2]Department of Research and Innovation,Nuvance Health,Danbury,CT 06810,United States;[3]Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery,Danbury Hospital,Danbury,CT 06810,United States 出　　处：《World Journal of Gastrointestinal Surgery》索引2024年第16卷第3期,共9页 摘　　要：BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic NETs.AIM To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile leak.METHODS A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy alone.RESULTS Of the 966 patients included in the study,298(30.9%)underwent ablation during hepatectomy.There were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation group.Bile leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),respectively.After con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate analysis.CONCLUSION Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile leak.Surgeons should utilize this modality when appropriate to a-chieve optimal disease control and outcomes. 关 键 词：HEPATECTOMY Neuroendocrine tumor Ablation Bile leaks BLEEDING Surgical site infections