The number of elderly patients with hepatocellular carcinoma(HCC) has been increasing.Characteristics of elderly HCC patients are a higher proportion of females,a lower rate of positive hepatitis B surface antigen,and...The number of elderly patients with hepatocellular carcinoma(HCC) has been increasing.Characteristics of elderly HCC patients are a higher proportion of females,a lower rate of positive hepatitis B surface antigen,and a higher rate of positive hepatitis C antibodies.Careful patient selection is vital for performing hepatectomy safely in elderly HCC patients.Treatment strategy should be decided by not only considering tumor stage and hepatic functional reserve,but also physiological status,including comorbid disease.Various assessment tools have been applied to predict the risk of hepatectomy.The reported mortality and morbidity rates after hepatectomy in elderly HCC patients ranged from 0% to 42.9% and from 9% to 51%,respectively.Overall survival rate after hepatectomy in elderly HCC patients at 5 years ranged from 26% to 75.9%.Both short-term and long-term results after hepatectomy for strictly selected elderly HCC patients are almost the same as those for younger patients.However,considering physiological characteristics and the high prevalence of comorbid disease in elderly patients,it is important to assess patients more meticulously and to select them strictly if scheduled to undergo major hepatectomy.展开更多
Objective: To review the characteristics of and the procedure for preventing postoperative bleeding after neck surgery. Materials and Methods: A retrospective review of 9 patients (9/893;1.0%) with postoperative bleed...Objective: To review the characteristics of and the procedure for preventing postoperative bleeding after neck surgery. Materials and Methods: A retrospective review of 9 patients (9/893;1.0%) with postoperative bleeding who required reoperation was performed to analyze clinical findings. Results: There was no significant difference in the incidence of bleeding between types of surgical procedures. Postoperative bleeding occurred within 24 hours in all cases except 2, in which it occurred 7 days or more after the operation. Seven cases showed bleeding from the cut surface of the muscle. Other bleeding points included vessels and the Berry ligament. There were no additional complications after reoperation. Conclusion: When separating the muscles in neck surgery, it is important to sufficiently ligate vessels and induce coagulation with an ultrasonically activated scalpel to prevent postoperative bleeding.展开更多
文摘The number of elderly patients with hepatocellular carcinoma(HCC) has been increasing.Characteristics of elderly HCC patients are a higher proportion of females,a lower rate of positive hepatitis B surface antigen,and a higher rate of positive hepatitis C antibodies.Careful patient selection is vital for performing hepatectomy safely in elderly HCC patients.Treatment strategy should be decided by not only considering tumor stage and hepatic functional reserve,but also physiological status,including comorbid disease.Various assessment tools have been applied to predict the risk of hepatectomy.The reported mortality and morbidity rates after hepatectomy in elderly HCC patients ranged from 0% to 42.9% and from 9% to 51%,respectively.Overall survival rate after hepatectomy in elderly HCC patients at 5 years ranged from 26% to 75.9%.Both short-term and long-term results after hepatectomy for strictly selected elderly HCC patients are almost the same as those for younger patients.However,considering physiological characteristics and the high prevalence of comorbid disease in elderly patients,it is important to assess patients more meticulously and to select them strictly if scheduled to undergo major hepatectomy.
文摘Objective: To review the characteristics of and the procedure for preventing postoperative bleeding after neck surgery. Materials and Methods: A retrospective review of 9 patients (9/893;1.0%) with postoperative bleeding who required reoperation was performed to analyze clinical findings. Results: There was no significant difference in the incidence of bleeding between types of surgical procedures. Postoperative bleeding occurred within 24 hours in all cases except 2, in which it occurred 7 days or more after the operation. Seven cases showed bleeding from the cut surface of the muscle. Other bleeding points included vessels and the Berry ligament. There were no additional complications after reoperation. Conclusion: When separating the muscles in neck surgery, it is important to sufficiently ligate vessels and induce coagulation with an ultrasonically activated scalpel to prevent postoperative bleeding.
