Safety of nighttime elective hepatectomy for hepatocellular carcinoma patients: a retrospective study
10.4174/astr.2024.106.2.68
- Author:
Zhan-cheng QIU
1
;
You-wei WU
;
Wei-li QI
;
Chuan LI
Author Information
1. Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2024;106(2):68-77
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to investigate whether nighttime elective surgery influenced the short-term outcomes and prognosis of hepatocellular carcinoma (HCC) patients.
Methods:The 1,339 HCC patients who underwent hepatectomy were divided into the daytime surgery group (8 a.m.–6 p.m., n = 1,105) and the nighttime surgery group (after 6 p.m., n = 234) based on the start time of surgery. The 1:2 propensity score matching (PSM) analysis was used to control confounding factors. The short-term outcomes of HCC patients in the 2 groups were compared before and after PSM. Factors associated with major complications (Clavien-Dindo grade, ≥III) and textbook oncologic outcomes (TOO) were separately identified by multivariable logistic regression based on variables screened via least absolute shrinkage and selection operator (LASSO). The Kaplan-Meier method was used to analyze overall survival (OS) and recurrence-free survival (RFS).
Results:TOO was achieved after surgery in 897 HCC patients. HCC patients in the nighttime surgery group had a higher body mass index (P = 0.010). After 1:2 PSM, the baseline characteristics of patients between the 2 groups were similar. Short-term outcomes in HCC patients were comparable both before and after PSM (all Ps > 0.05), as were TOO in the 2 groups before (P = 0.673) and after PSM (P = 0.333). In our LASSO-logistic regression, nighttime surgery was not an independent factor associated with major complications or TOO. Both groups also had similar OS (P = 0.950) and RFS (P = 0.740) after PSM.
Conclusion:Our study revealed the safety of nighttime elective hepatectomy for HCC patients.
