Correlation Between Onodera's Prognostic Nutritional Index And Liver Regeneration ?Liver Failure In Patients After Hemi-hepatectomy

Objective: This study was to investigate the correlation between preoperative Onodera's prognostic nutritional index(OPNI)and residual liver regeneration ? liver failure after hemi-hepatectomy in patients with hepatocellular carcinoma(HCC),and provide an important reference for perioperative management of hepatic resection.Methods: The clinical data of 74 patients with HCC who underwent hepatectomy in the Department of Hepatobiliary Surgery,Affiliated Tumor Hospital of Guangxi Medical University from August 2013 to August 2018(according to postoperative pathology)were collected.According to the preoperative OPNI value,the patients were divided into high OPNI group(OPNI?45)and low OPNI group(OPNI < 45).The two groups were compared for clinical data.The measurement data were analyzed by t test or non-parametric rank sum test.The count data was analyzed by chi-square test,continuity-corrected chi-square test or Fisher's exact test.Residual liver regeneration rates were analyzed using multiple linear regression analysis.The test level is chosen ? = 0.05(both sides).Results: Compared with the low OPNI group,the liver fibrosis in the high OPNI group was milder,preoperative HgB,preoperative PA and preoperative transferrin(TRF)were higher,and the difference was statistically significant(P < 0.05).The median value of standard residual liver volume(SRLV)regeneration on the 7th day after surgery in patients with low OPNI and high OPNI was 148.3ml and 227.6ml,respectively.The former was lower than the latter,the difference was statistically significant(P<0.001).The median residual liver volume regeneration rate(RLRR)on the 7th postoperative day of patients with low OPNI and high OPNI was 20.3% and 38.3%,respectively.The former was lower than the latter,and the difference was statistically significant(P <0.001).The number of postoperative LF patients with low OPNI and high OPNI was 8 and 1 respectively.Compared with preoperative high OPNI patients,the number of postoperative LF patients with low OPNI was more.The difference was statistically significant.Significance(P<0.05).In the univariate analysis of RLRR on day 7 after hemi-hepatectomy,SRLV,preoperative OPNI group,age,BMI,preoperative PLT,preoperative TRF,postoperative day 1 OPNI,postoperative day 3 OPNI,liver inflammation classification and liver fibrosis stage were compared,the difference was statistically significant(P<0.05).In the multiple linear regression analysis of RLRR on the 7th day after hepatectomy,the regression model was statistically significant,F(10,63)=9.929(P<0.001),R=0.782,adjusted R2=0.550.The coefficient of the SRLV grouping was-8.773(P = 0.006),the coefficient of the preoperative OPNI group was 9.734(P = 0.005),and the coefficient of liver fibrosis stage was-2.865(P = 0.047).Conclusion: Compared with low OPNI group patients,the RLV Recycling amount and RLRR on the 7th day after surgery were relatively high in high OPNI group patients.The number of patients with postoperative LF was relatively less.