The majority of these operations were performed in the last two decades. Early mortality within 30 days of operation was 7.9% for repair and 17.6% for replacement (P = 0.29). The 1-, 5-, 10- and 25-year survival rates were 83.8, 74.5, 63.6 and Citarinostat 32.8% for tricuspid repair and 81.8, 68.2, 61.4 and 15.2% for tricuspid replacement, respectively. Preoperative loop diuretic dose (P = 0.0120) and preoperative haemoglobin level (P = 0.0377) were independent predictors of survival for all isolated tricuspid surgery, while preoperative creatinine level (P = 0.04) independently predicted
reoperation during the follow-up.
CONCLUSIONS: Both isolated tricuspid replacement and repair were associated with significant but acceptable early and late mortality with no statistically significant difference in cumulative survival. Preoperative
loop diuretic dose, haemoglobin and creatinine are individually associated www.selleckchem.com/products/ly3039478.html with survival and/or reoperation after isolated tricuspid valve surgery.”
“The purpose of this study is to review indications and results of surgical treatments of hepatocellular carcinoma (HCC). This tumor, which represents one of the most common malignancies worldwide, is characterized by its prominent development in patients with chronic liver disease (CLD). Liver transplantation (LT) is considered as the ideal treatment of limited HCC removing both tumor(s) and the pre-neoplasic underlying diseased liver. However, this treatment, which is not available in many countries, is restricted to patients with minimum risk of tumor recurrence under immunosuppression. The risk of recurrence is minimized in patients fulfilling the Milan criteria with a tendency to accept slight expansion of size in patients with favourable natural history and low AFP level. Increasing duration in the waiting list before LT leads several teams to use neoadjuvant therapies such as percutaneous ablation, TACE and liver resection. Liver resection Adavosertib ic50 in cirrhotic patients with good liver function remains the most available efficient treatment of patients with HCC. Better liver function assessment, understanding of the segmental liver anatomy
with more accurate imaging studies and surgical technique refinements are the most important factors that have contributed to reduce mortality with an expecting 5 years survival of 70%. There is considerable interest in combined treatment associating resection and LT. Transplantable patients with good liver function should be considered for liver resection as primary therapy and for LT in case of tumor recurrence. This salvage strategy is refined using pathological analysis of the resected specimen which identifies histological pejorative factors allowing selecting patients who should transplanted before recurrence.
The improvement of survival in HCC patients after surgical treatment results from refinements in surgical technique and better identification of adverse prognostic factors.