Impact of thoracic shape on the surgical outcomes of laparoscopic-assisted living donor hepatectomy

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of Gastroenterological Surgery Pub Date : 2023-11-17 DOI:10.1002/ags3.12755

Kosuke Tanaka, Satoshi Ogiso, Tomoaki Yoh, Ahmed Hussein Abdelhafez, Yuki Masano, Shinya Okumura, Shoichi Kageyama, Takashi Ito, Koichiro Hata, Etsuro Hatano

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Abstract

Background

Although laparoscopic-assisted donor hepatectomy (LADH) has become the definitive procedure for harvesting living donor livers, its surgical outcomes in association with donor body shape have not been elucidated.

Methods

The impact of donor factors, including thoracic shape, on LADH outcomes was retrospectively investigated. Thoracic anthropometric data were examined in all LADHs with a left/right graft between 2013 and 2022.

Results

The study included 210 LADHs, consisting of 106 left- and 104 right-lobe donors with similar blood loss and similar operation time. Males have greater thoracic depth and greater thoracic width compared with females, respectively. Thoracic depth was associated with graft weight (p < 0.001), blood loss (p < 0.001), and operation time (p < 0.001). On multivariate analyses, blood loss >500 mL and operation time >8 h were associated with graft weight in the left-lobe donors, and blood loss >500 mL was associated with thoracic depth in the right-lobe donors.

Conclusion

The greater thoracic depth is associated with massive blood loss in right-lobe donors. Anthropometric parameters might be helpful for estimating LADH outcomes.

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胸廓形状对腹腔镜辅助活体肝切除术手术效果的影响

虽然腹腔镜辅助供体肝切除术（LADH）已成为获取活体供体肝脏的权威手术，但其手术效果与供体体形的关系尚未阐明。研究人员回顾性地调查了供体因素（包括胸廓形状）对LADH手术效果的影响。研究纳入了210例LADH，包括106例左叶和104例右叶供体，失血量和手术时间相似。与女性相比，男性的胸廓深度更大，胸廓宽度更大。左叶供体的胸廓深度与移植物重量（p 500 mL）相关，手术时间大于 8 小时与移植物重量相关，右叶供体的失血量大于 500 mL 与胸廓深度相关。人体测量参数可能有助于估计 LADH 的结果。

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