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Renal resistive index as a predictor of postoperative complications in liver resection surgery. Observational study

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Abstract

Mortality after liver surgery reduced during the last three decades to less than 2%, but post-operative morbidity occurs in 20–50% of cases. Patients are often considered eligible for post-operative intensive-care unit (ICU) admission. Predicting which patients that are at higher risk could lead to a more precise perioperative management. We investigated whether renal resistive index (RRI), alone or along with other items, can predict post-operative complication after hepatic resection. All consecutive patients undergoing hepatectomy for primary or metastatic neoplasm at our Institution between February 2015 and March 2017 were enrolled. They received RRI measurement before entering in operative room and after awakening from general anesthesia. 183 Patients were enrolled. High surgical invasiveness, surgery time > 360 min, pre-operative RRI and postoperative serum lactate clearance <  − 6%, showed to be associated with postoperative complications. Pre-operative RRI, complex liver resection, long-lasting surgery and poor lactate clearance (cLac) close to awakening from general anesthesia, all together may permit to classify the risk of post-operative adverse outcome after hepatic resection surgery.

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Authors and Affiliations

  1. Department of Anesthesia and Intensive Care, Humanitas Clinical and Research Center, IRCCS, Via Manzoni 56, Rozzano, 20089, Milan, Italy

    Enrico Giustiniano, Fabio Procopio, Emanuela Morenghi, Yari Gollo, Laura Rocchi, Nadia Ruggieri, Valeria Lascari, Guido Torzilli & Maurizio Cecconi

  2. Hepato-Biliary & Pancreatic Surgery Unit, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, 20089, Milan, Italy

    Fabio Procopio & Guido Torzilli

  3. Biostatistic Unit, Humanitas Clinical and Research Center, IRCCS, via manzoni 56, 20089, Milan, Italy

    Emanuela Morenghi

Authors
  1. Enrico Giustiniano
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  2. Fabio Procopio
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  3. Emanuela Morenghi
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  4. Yari Gollo
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  9. Maurizio Cecconi
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Correspondence to Enrico Giustiniano.

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Giustiniano, E., Procopio, F., Morenghi, E. et al. Renal resistive index as a predictor of postoperative complications in liver resection surgery. Observational study. J Clin Monit Comput 35, 731–740 (2021). https://doi.org/10.1007/s10877-020-00529-4

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  • DOI: https://doi.org/10.1007/s10877-020-00529-4

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