Tianjin Medical Journal ›› 2020, Vol. 48 ›› Issue (7): 650-653.doi: 10.11958/20193933

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The effect of perioperative anesthesia management on alanine aminotransferase recovery in patients with liver cancer

WEI Jin, YU Ling, TAN Hong-yu△   

  1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Anesthesiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
  • Received:2019-12-27 Revised:2020-05-12 Published:2020-07-15 Online:2020-07-16

Abstract: Objective To explore the related factors of anesthesia that affect the recovery of alanine aminotransferase (ALT) in patients after hepatectomy. Methods Clinical data of 177 liver cancer patients underwent hepatectomy were retrospectively collected. Patients whose ALT returned to normal or less than the preoperative baseline on the fifth postoperative day were classified as ALT recovery group (n=78). Patients whose ALT did not return to normal and was higher than the preoperative baseline were classified as ALT un-recovery group (n=99). Single factor analysis and binary Logistic regression were conducted to screen out the independent risk factors of ALT recovery. Results The median value of ALT, central venous pressure (CVP) and lactate were lower in ALT recovery group on the fifth day after operation than those in the ALT un-recovery group. The proportion of patients with resection range exceeding 3 liver segments and postoperative body temperature < 35.5 ℃ was lower in the ALT recovery group than that of the ALT un-recovery group, while the proportion of patients with operation time ≤ 180 min was higher in the ALT recovery group than that in the ALT un-recovery group (P< 0.05). Binary Logistic regression showed that higher postoperative lactate level (OR=1.526,95%CI: 1.105-2.107), lower CVP (OR=1.170,95%CI: 1.017-1.346) and resection range exceeding 3 liver segments (OR=2.487,95%CI: 1.185-5.216) were independent risk factors of ALT recovery. Conclusion The increased value of lactate after surgery, the decreased value of CVP and large range of hepatic resection may affect the recovery of ALT in patients with liver cancer.

Key words: alanine transaminase, lactate, central venous pressure, liver neoplasms, carcinoma, hepatectomy; anesthesia