Clinical application value of "West China Hospital Classification" for central type liver space-occupying lesions

Abstract:

Objective: To explore the clinical application value of “West China Hospital Classification” for central type focal liver lesions. Methods: The clinical data of 186 patients with central type focal liver lesions were admitted to The First Affiliated Hospital of Chongqing Medical University from July 2014 to December 2019 were retrospectively analyzed. Such indicators as operative time，blood loss，length of stay，and complication rate for each type of “West China Hospital Classification” for centrally located liver lesions were compared. SPSS 16.0 statistical software was used for analysis，and chi-square test was used for comparison of the rates. The measurement data were expressed as median and quartile spacing，and Kruskal-Wallis H test was conducted. When P<0.05，there was statistical significance. Results: Of the 186 patients included，120 cases were primary liver cancer，40 cases were metastatic liver cancer and 26 were benign lesions. According to “West China Hospital Classification”，there were 55 cases of type I，33 cases of type Ⅱ，36 cases of type Ⅲa，18 cases of type Ⅲb，and 44 cases of type Ⅳ. In the whole group，there were no deaths，the overall postoperative complication rate was 17.7%，and the average postoperative hospital stay was（10±4） d. The median operation time for type Ⅰ，type Ⅱ，type IIIa，Ⅲb and type Ⅳ were 225 min，285 min，182 min，290 min，355 min respectively. The median bleeding loss for type Ⅰ and type Ⅱ，type Ⅲa，Ⅲb and type Ⅳ were 445 mL，550 mL，320 mL，600 mL，1 100 mL respectively. The median amount of red blood cell transfusion for type Ⅰ and type Ⅱ，type Ⅲa，Ⅲb and type Ⅳ were 1.0 U，2.0 U，1.5 U，3.0 U，5.0 U respectively. The incidence of postoperative complications for type Ⅰ and type Ⅱ，type Ⅲa，Ⅲb and type Ⅳ were 7.3%，6.1%，8.3%，11.1% and 27.2%，respectively. Compared with the other four types，type Ⅳ had the characteristics of long operation time，large intraoperative blood loss and high incidence of postoperative complications（all P<0.05）. Conclusion: Preoperative diagnosis of central type focal liver lesions according to “West China Hospital Classification” is beneficial to individualize and standardize for each type of mesohepatectomy and reduce postoperative complications of patients.