Lorf, T. and Schnitzbauer, A. A. and Schaefers, S. K. H. and Scherer, M. N. and Schlitt, H. J. and Oellerich, M. and Becker, H. and Obed, Aiman (2008) Prognostic value of the monoethylglycinexylidide (MEGX)-test prior to liver resection. HEPATO-GASTROENTEROLOGY, 55 (82-83). pp. 539-543. ISSN 0172-6390,
Full text not available from this repository. (Request a copy)Abstract
Background/Aims: The critical issue before major hepatic resection is to evaluate and detect patients with a potentially increased risk of hepatic failure. In this study the prognostic value of the monoethylglycinexylidide (MEGX-)- liver function test was evaluated with regards to clinical course and survival after partial liver resection. Methodology: Between 1995 and 2000 a total of 55 patients (29 male, 26 female) underwent a partial liver resection at the Georg-August University of Gottingen. Forty-two patients were treated for malignant, and 13 for benign, disease. MEGX-testing was performed 15 and 30 minutes after a single-dose of 1 mg/kg BW Lidocaine i.v. was applied. Results: MEGX-test results after 30 minutes had significant influence on hospital mortality. Patients who died during the hospital stay showed median MEGX-30 minutes results of 32 mu g/L in (4-107 mu g/L) in comparison to the surviving patients with a median 68 mu g/L (16-176 mu g/L) (p=0.026). Furthermore, patients with MEGX scaled categories of 3 and 4 had a significantly lower surivial at 150 days (p=0.008) and overall (p=0.0002). There was an indirect impact of MEGX on hospital stay, costs and mortality reflecting high fluid loss: patients with lower loss of fluid over drainages had a significantly lower mortality at 150 days (p=0.000416) and overall (p=0.00008), than did patients with higher fluid loss. Low MEGX-values significantly influenced long hospital stay (p=0.00001) and high costs (p=0.00001). Pathologic MEGX in combination with increased age, increased BMI and extensive surgical procedures including resection of over 50% volume of the liver had a significant influence on complications (p=0.015). Conclusion: The preoperative MEGX-test, especially the 30 minutes value, is a useful medium to estimate the liver reserve in non-cirrhotic patients prior to liver resection. In combination with the resection volume it may be very useful to identify patients with a high risk of developing a postoperative liver failure.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HEPATIC RESECTION; GRAFT FUNCTION; DONOR LIVER; MEGX TEST; CIRRHOSIS; TRANSPLANTATION; HEPATECTOMY; MORTALITY; SURGERY; INDEX; MEGX; liver resection; liver reserve |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Nov 2020 11:44 |
| Last Modified: | 09 Nov 2020 11:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/31261 |
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