Abstract
Objective: Platelets play an important role in liver regeneration. One major problem after liver surgery represents the impaired postoperative liver function and delayed recovery. The aim of this study was to evaluate the association of platelet counts to liver regeneration and postoperative outcome after liver surgery for colorectal metastases. Methods: This study included 84 patients without chronic liver disease (such as viral hepatitis or liver cirrhosis) who received partial liver resection between July 2007 and July 2012 for colorectal liver metastases in our hospital. 65% received preoperative chemotherapy. All patients presented with normal liver function before surgery. Platelet counts were obtained between day -1 and day 12 to surgery and correlated with postoperative morbidity and mortality. Comparative analysis between patients with platelet counts ≤ 100/nl and >100/nl one day after liver surgery was performed in regard to postoperative outcome and liver regeneration. Results: Postoperative low platelet counts are associated with significant higher morbidity (p=0.003) and need of re-operation (p=0.004). Furthermore, thrombocytopenic patients showed impaired liver function with significantly higher bilirubin levels (p=0.001; p=0.005) and lower prothrombin time (p=0.015; 0.006) between day 1 and day 7. Conclusion: Postoperative low platelet counts are associated with higher morbidity after liver surgery. Low platelet counts lead to impaired liver function with delayed recovery after liver surgery.
Highlights
Colorectal cancer is one of the most common malignant diseases [1]
Patients with pre-existing liver disease such as viral hepatitis or liver cirrhosis were excluded as were patients with simultaneous major visceral operations such as colorectal resections
84 patients who received liver surgery for colorectal liver metastases were included in the analysis
Summary
Colorectal cancer is one of the most common malignant diseases [1]. Fifteen to twenty-five percent of patients with colon carcinoma show liver metastases at the time of diagnosis [2]. The same number of patients develops metachronous liver metastases. Development of multimodal strategies combining chemotherapy, targeted therapies (e.g. AB, SMI) and surgery lead to wider curative therapeutic options for liver metastases [3,4,5,6,7]. Surgery of liver metastases from colorectal cancer became standard therapy. Nowadays colorectal liver metastases are the leading indication for liver surgery in the western world. It is well known that chemotherapy can lead to liver damage with impaired regenerative capacity [8,9]
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