Introdução:
O
tratamento
do
carcinoma
hepatocelular
(CHC)
é
complexo
e
requer
abordagem
multidisciplinar.A
ressecção
cirúrgica
a
modalidade
de
escolha
em
pacientes
com
função
hepática
preservada
e,
comparada
ao
transplante,
tem
critérios
menos
restritivos
para
sua
indicação,
sendo
aplicável
imediatamente
sem
necessidade
fila
espera.Entretanto,
seleção
criteriosa
dos
pacientes,
qual
pode
ser
realizada
o
auxílio
diversos
métodos,
como
escore
Child-Pugh,
"Model
for
End-Stage
Liver
Disease"
(MELD)
Albumina-Bilirrubina
(ALBI).Neste
contexto,
plaqueta-albumina
(PAL)
foi
desenvolvido
predizer
morbidade
sobrevida
após
CHC,
porém
ainda
não
testado
ou
aplicado
na
população
ocidental.O
objetivo
presente
estudo
avaliar
capacidade
PAL
morbimortalidade
pós-operatória
tardia
ocidental
compará-lo
os
escores
MELD
ALBI.Métodos:
Estudo
coorte
retrospectivo
observacional
182
CHC
submetidos
entre
2008
2019.Resultados:
A
taxa
complicações
pós-operatórias
43,9%
mortalidade
perioperatória
ocorreu
13
casos
(7,1%).A
global
5
anos
49,8%.Os
foram
classificados
2
grupos:
I
(110
pacientes)
II-III
(72
pacientes).A
pósoperatória
maior
nos
(OR
1,98,
p
=
0,032),
ALBI
2,05,
0,028),
>
10
2,71,
0,042),
hepatectomias
maiores
2,55,
0,005)
cirurgias
abertas
2,96,
<
0,001),
naqueles
que
receberam
hemotransfusão
10,1,
0,001).Insuficiência
(PHLF)
36
(19,8%)
incidência
3,50,
0,001)
3,46,
0,001).Escore
(p
OR
3,3,
0,036)
único
associado
à
perioperatória,
também
associada
reoperação
10,06,
PHLF
5,63,
transfusão
3,81,
0,027).O
fator
prognóstico
independente
análise
multivariada
0,018).
Journal of Gastrointestinal Surgery,
Год журнала:
2025,
Номер
unknown, С. 102035 - 102035
Опубликована: Март 1, 2025
Posthepatectomy
liver
failure
(PHLF)
is
the
most
fatal
complication
following
resection,
particularly,
in
patients
with
comorbidities.
This
study
aimed
to
assess
impact
of
long-term
medication
on
PHLF
incidence
after
open
resections.
A
retrospective
analysis
682
who
underwent
elective
hepatectomies
between
2008
and
2015
at
two
academic
centers
was
performed.
Preoperative,
intraoperative,
postoperative
data
were
collected,
including
medication.
Risk
factors
for
development
other
complications
evaluated
using
univariate
multivariable
logistic
regression
analyses.
occurred
11.9%
(n=81)
patients,
a
higher
those
taking
diuretics
as
(17.7%
vs.
5.3%,
P
<
0.001).
Diuretic
use
identified
strong
independent
risk
factor
(OR
3.8,
95%CI
2.1
-
7.0,
0.001),
alongside
cirrhosis
1.9
7.6,
primary
malignancies
1.6
9.3,
major
3.1,
1.7
5.7,
0.001)
long
operating
time
4.2,
95%
CI
2.4
7.2,
Patients
diuretic
intake
older,
had
BMIs,
more
comorbidities,
cirrhosis.
Long-term
associated
significantly
increased
hepatectomy.
Artificial Intelligence Surgery,
Год журнала:
2024,
Номер
4(2), С. 59 - 67
Опубликована: Май 27, 2024
The
rapid
evolution
of
modern
technology
has
made
artificial
intelligence
(AI)
an
important
emerging
tool
in
healthcare.
AI,
which
is
a
broad
field
computer
science,
can
be
used
to
develop
systems
or
machines
equipped
with
the
ability
tackle
tasks
that
traditionally
necessitate
human
intelligence.
AI
perform
multifaceted
involve
synthesis
large
amounts
data
generation
solutions,
algorithms,
and
decision
support
tools.
Various
approaches,
including
machine
learning
(ML)
natural
language
processing
(NLP),
are
increasingly
being
analyze
vast
healthcare
datasets.
In
addition,
visual
potential
revolutionize
surgery
intraoperative
experience
for
surgeons
through
augmented
reality
enhancing
surgical
navigation
real-time.
Specific
applications
hepatobiliary
tumors
such
as
hepatocellular
carcinoma
biliary
tract
cancer
improve
patient
diagnosis,
prognostic
risk
stratification,
well
treatment
allocation
based
on
ML-based
models.
integration
radiomics
models
also
clinical
making.
We
herein
review
how
may
particular
interest
care
patients
complex
cancers,
tumors,
these
often
require
multimodal
approach.
