Abstract
PurposeThe mechanism of postoperative nausea and vomiting after TACE is not clear. This study retrospectively analyzed the patient data to explore the mechanism and risk factors of postoperative nausea and vomiting after TACE.Materials and methodsThe data of 221 patients who underwent TACE in the interventional department from January 2019 to December 2020 were collected. Including: gender, age, liver function before TACE, etiology of liver cirrhosis, BCLC stage of hepatocellular carcinoma, preoperative use of analgesic drugs, preoperative limosis, previous history of vomiting, history of kinetosis, smoking history, history of drinking, chemotherapeutic drugs used during TACE, Dosage of lipiodol, and occurrence of postoperative nausea and vomiting.ResultsThere were 116 cases of nausea after TACE, using binary logistic regression analysis, Sig: ALT0.003; ALP0.000; history of vomiting 0.043; kinetosis 0.006; history of alcohol consumption 0.011; preoperative limosis 0.006; dosage of lipiodol (5–10 mL) 0.029, dosage of lipiodol (> 10 mL) 0.001.There were 89 cases of vomiting after TACE, all accompanied by nausea, Sig: ALP0.000; BCLC stage (B) 0.007; kinetosis 0.034; chemotherapeutic drugs 0.015; dosage of lipiodol (5–10 ml) 0.015, dosage of lipiodol (> 10 ml) 0.000; patients used analgesics before TACE 0.034.ConclusionsCauses of post-TACE nausea and vomiting included operative trauma, aseptic inflammation caused by ischemia and hypoxia, chemotherapeutic drugs, ischemia of liver and bile duct, stress and pain during TACE, and patient factors. ALP, BCLC stage, kinetosis, chemotherapeutic drugs, dosage of lipiodol, and preoperative usage of analgesics were risk factors affecting nausea and vomiting after TACE.
Highlights
Primary hepatocellular carcinoma is one of the malignant tumors with high morbidity and mortality worldwide [1,2,3], and because there are no obvious specific symptoms and signs in the early stage of the disease, most patients have lost the chance of surgery whenLu et al BMC Cancer (2021) 21:513 other hand, after tumor supply artery embolization, it leads to tumor cell ischemia, hypoxia and necrosis
There were 116 cases of nausea after Transarterial chemoembolization (TACE), using binary logistic regression analysis, Sig: ALT0.003; ALP0.000; history of vomiting 0.043; kinetosis 0.006; history of alcohol consumption 0.011; preoperative limosis 0.006; dosage of lipiodol (5–10 mL) 0.029, dosage of lipiodol (> 10 mL) 0.001.There were 89 cases of vomiting after TACE, all accompanied by nausea, Sig: ALP0.000; BCLC stage (B) 0.007; kinetosis 0.034; chemotherapeutic drugs 0.015; dosage of lipiodol (5–10 ml) 0.015, dosage of lipiodol (> 10 ml) 0.000; patients used analgesics before TACE 0.034
Causes of post-TACE nausea and vomiting included operative trauma, aseptic inflammation caused by ischemia and hypoxia, chemotherapeutic drugs, ischemia of liver and bile duct, stress and pain during TACE, and patient factors
Summary
Primary hepatocellular carcinoma is one of the malignant tumors with high morbidity and mortality worldwide [1,2,3], and because there are no obvious specific symptoms and signs in the early stage of the disease, most patients have lost the chance of surgery whenLu et al BMC Cancer (2021) 21:513 other hand, after tumor supply artery embolization, it leads to tumor cell ischemia, hypoxia and necrosis. TACE is effective in the treatment of liver cancer and plays a very important role in the treatment of hepatocellular carcinoma [8]. The most common side effects after TACE are embolic syndrome, including pain, fever, nausea and vomiting [9,10,11]. Can lead to water and electrolyte imbalance in patients, prolong hospital stay, and increase treatment costs [12]. Patients with hepatocellular carcinoma are mostly associated with cirrhosis and gastric esophageal varices, and severe nausea and vomiting will lead to gastric esophageal variceal bleeding, leading to death of patients. The mechanism of postoperative nausea and vomiting after TACE is not clear.
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