Analysis of postoperative early nutritional status and influencing factors of postoperative infection in patients with hepatocellular carcinoma undergoing laparoscopic hepatectomy
Objective To explore the postoperative early nutritional status in patients with hepatocellular carcinoma undergoing laparoscopic anatomical and non-anatomical hepatectomy,and analyze the influencing factors of postopera-tive infection.Method A total of 60 patients with hepatocellular carcinoma who underwent laparoscopic hepatectomy were divided into control group(n=27,underwent laparoscopic non-anatomical hepatectomy)and observation group(n=33,underwent laparoscopic anatomical hepatectomy)according to different surgical methods.The perioperative indica-tors and nutritional status[prognostic nutritional index(PNI),Naples prognostic score(NPS)]were compared between the two groups.Multivariate Logistic regression analysis was used to investigate the influencing factors of postoperative infection in patients with hepatocellular carcinoma undergoing laparoscopic hepatectomy.Result There were no statisti-cally significant differences in surgery time and intraoperative bleeding between the two groups(P>0.05).The hospitaliza-tion time in observation group was significantly shorter than that in control group,and the difference was statistically sig-nificant(P<0.01).After surgery,the PNI and NPS of two groups of hepatocellular carcinoma patients with different Child-Pugh liver function grading were lower than those before surgery,the PNI and NPS of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Among 60 patients with hepato-cellular carcinoma undergoing laparoscopic hepatectomy,there were 10 cases of infection and 50 cases without infection after laparoscopic hepatectomy,which were divided into the infection group and the non-infection group.There were sta-tistically significant differences in age,Child-Pugh liver function grading,American Society of Anesthesiologists(ASA)grading,comorbidities,preoperative PNI,and preoperative NPS between infection group and non-infection group(P<0.05).Multivariate Logistic regression analysis showed that Child-Pugh liver function grading B,preoperative PNI<51,and preoperative NPS<3 scores were independent risk factors for postoperative infection in patients with hepatocellular carcinoma undergoing laparoscopic hepatectomy(P<0.05).Conclusion Laparoscopic anatomical hepatectomy has a rel-atively small impact on postoperative early nutritional status in patients with hepatocellular carcinoma,which is benefi-cial for their postoperative recovery.Child-Pugh liver function grading B,preoperative PNI<51,and preoperative NPS<3 scores are independent risk factors for postoperative infection in patients with hepatocellular carcinoma undergoing lapa-roscopic hepatectomy.
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