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Tanaka K, Ogiso S, Yoh T, Abdelhafez AH, Masano Y, Okumura S, Kageyama S, Ito T, Hata K, Hatano E. Impact of thoracic shape on the surgical outcomes of laparoscopic-assisted living donor hepatectomy. Ann Gastroenterol Surg 2024; 8:490-497. [PMID: 38707221 PMCID: PMC11066496 DOI: 10.1002/ags3.12755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/18/2023] [Accepted: 10/30/2023] [Indexed: 05/07/2024] Open
Abstract
Background Although laparoscopic-assisted donor hepatectomy (LADH) has become the definitive procedure for harvesting living donor livers, its surgical outcomes in association with donor body shape have not been elucidated. Methods The impact of donor factors, including thoracic shape, on LADH outcomes was retrospectively investigated. Thoracic anthropometric data were examined in all LADHs with a left/right graft between 2013 and 2022. Results The study included 210 LADHs, consisting of 106 left- and 104 right-lobe donors with similar blood loss and similar operation time. Males have greater thoracic depth and greater thoracic width compared with females, respectively. Thoracic depth was associated with graft weight (p < 0.001), blood loss (p < 0.001), and operation time (p < 0.001). On multivariate analyses, blood loss >500 mL and operation time >8 h were associated with graft weight in the left-lobe donors, and blood loss >500 mL was associated with thoracic depth in the right-lobe donors. Conclusion The greater thoracic depth is associated with massive blood loss in right-lobe donors. Anthropometric parameters might be helpful for estimating LADH outcomes.
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Affiliation(s)
- Kosuke Tanaka
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Satoshi Ogiso
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Tomoaki Yoh
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Ahmed Hussein Abdelhafez
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
- Department of General SurgeryAin Shams UniversityCairoEgypt
| | - Yuki Masano
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Shinya Okumura
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Shoichi Kageyama
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Takashi Ito
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Koichiro Hata
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Etsuro Hatano
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
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Qiu W, Zhou S, Han G, Chen Z, Chen Z, Ding L, Sun Z, Li W. The Role of Thoracic Tilt in Identifying Thoracic Compensation and Predicting Proximal Junctional Kyphosis in Degenerative Lumbar Scoliosis. Spine (Phila Pa 1976) 2023; 48:1446-1454. [PMID: 37530101 PMCID: PMC10516171 DOI: 10.1097/brs.0000000000004788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023]
Abstract
STUDY DESIGN A retrospective cohort study of consecutive patients. OBJECTIVE To investigate the clinical value of thoracic tilt (TT) in characterizing thoracic compensation and predicting proximal junctional kyphosis (PJK) in degenerative lumbar scoliosis (DLS). SUMMARY OF BACKGROUND DATA Thoracic compensation has been shown to be associated with the development of PJK, while thoracic shape and morphology in patients with DLS remain understudied. METHODS Patients with DLS who underwent long-segment fusion were divided into a PJK group and a non-PJK group. Asymptomatic elderly volunteers were recruited as healthy controls. Thoracic parameters were measured in both cohorts, including the TT, T1-L1 pelvic angle (TLPA), T12 slope, thoracic kyphosis (TK, T4-T12), global thoracic kyphosis (GTK, T1-T12), and thoracolumbar kyphosis (TLK, T10-L2). Multivariate logistic regression was used to assess the association between TT and the development of PJK, adjusting for confounders. Multivariate linear regression was used to establish the predictive formula for TT. RESULTS A total of 126 patients with DLS were enrolled, of which 37 (29.4%) developed PJK. Compared with 110 healthy controls, DLS patients had significantly greater TT, TLPA, T12 slope, and TLK as well as smaller TK and GTK (all P <0.001). Preoperatively, the PJK group showed significantly greater TT ( P =0.013), TLPA ( P <0.001), and TLK ( P =0.034) than the non-PJK group. No significant differences were found in TK and GTK before surgery. Postoperatively, the PJK group showed significantly greater TT ( P <0.001), TLPA ( P <0.001), TLK ( P <0.001), and proximal junctional angle ( P <0.001). Multivariate logistic regression analysis showed that greater postoperative TT was associated with the development of PJK. Multivariate linear regression analysis suggested that the regression formula was postoperative TT=0.675×T12slope+0.412×TK+0.158×TLK-4.808 ( R2 =0.643, P <0.001). CONCLUSIONS The novel sagittal parameter TT can be used for the evaluation of thoracic compensation. Greater preoperative TT might represent a decompensated state of TK. Rebalancing the TT in a sagittal neutral position might help to prevent PJK in patients with DLS.
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Affiliation(s)
- Weipeng Qiu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
- Peking University Health Science Center, Beijing, China
| | - Siyu Zhou
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Gengyu Han
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
- Peking University Health Science Center, Beijing, China
| | - Zimu Chen
- Peking University Health Science Center, Beijing, China
| | - Ze Chen
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
- Peking University Health Science Center, Beijing, China
| | - Linyao Ding
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
- Peking University Health Science Center, Beijing, China
| | - Zhuoran Sun
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Weishi Li
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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