Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort study

Introduction Liver resection is the only curative treatment for primary and secondary hepatic tumours. Improvements in perioperative preparation of patients and new surgical developments have made complex liver resections possible. However, small for size and flow syndrome (SFSF) is still a challeng...

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Main Authors: Karl Heinz Weiss, Mohammad Golriz, Anastasia Lemekhova, Elias Khajeh, Omid Ghamarnejad, Mohammed Al-Saeedi, Oliver Strobel, Beat Müller-Stich, Martin Schneider, Christoph Berchtold, Parham Tinoush, Philipp Mayer, De-Hua Chang, Katrin Hoffmann
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e029618.full
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author Karl Heinz Weiss
Mohammad Golriz
Anastasia Lemekhova
Elias Khajeh
Omid Ghamarnejad
Mohammed Al-Saeedi
Oliver Strobel
Beat Müller-Stich
Martin Schneider
Christoph Berchtold
Parham Tinoush
Philipp Mayer
De-Hua Chang
Katrin Hoffmann
author_facet Karl Heinz Weiss
Mohammad Golriz
Anastasia Lemekhova
Elias Khajeh
Omid Ghamarnejad
Mohammed Al-Saeedi
Oliver Strobel
Beat Müller-Stich
Martin Schneider
Christoph Berchtold
Parham Tinoush
Philipp Mayer
De-Hua Chang
Katrin Hoffmann
author_sort Karl Heinz Weiss
collection DOAJ
description Introduction Liver resection is the only curative treatment for primary and secondary hepatic tumours. Improvements in perioperative preparation of patients and new surgical developments have made complex liver resections possible. However, small for size and flow syndrome (SFSF) is still a challenging issue, rendering patients inoperable and causing postoperative morbidity and mortality. Although the role of transhepatic flow in the postoperative outcome has been shown in small partial liver transplantation and experimental studies of SFSF, this has never been studied in the clinical setting following liver resection. The aim of this study is to systematically evaluate transhepatic flow changes following major liver resection and its correlation with postoperative outcomes.Methods and analysis The TransHEpatic FLOW (THEFLOW) study is a single-centre, non-interventional cohort study, and aims to enrol 50 patients undergoing major hepatectomy (defined as hemihepatectomy or extended hepatectomy based on the Brisbane classification) with or without prior chemotherapy. The portal venous flow, hepatic artery flow and portal venous pressure are measured before and after each resection. All patients are followed-up for 3 months after the operation. During each evaluation, standard clinical data, posthepatectomy liver failure and overall morbidity and mortality will be recorded. THEFLOW study was initiated on 25 March 2018 and is expected to progress for 2 years.Ethics and dissemination This protocol study received approval from the Ethics Committee of the University of Heidelberg (registration number: S576/2017). The results of this study will be published in a peer-reviewed journal, and will also be presented at medical meetings.Trial registration number NCT03762876.
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spelling doaj-art-a1ae3e8ea35a4e98a1fbd310469492cd2024-12-13T20:30:09ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-029618Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort studyKarl Heinz Weiss0Mohammad Golriz1Anastasia Lemekhova2Elias Khajeh3Omid Ghamarnejad4Mohammed Al-Saeedi5Oliver Strobel6Beat Müller-Stich7Martin Schneider8Christoph Berchtold9Parham Tinoush10Philipp Mayer11De-Hua Chang12Katrin Hoffmann13Department of Gastroenterology and Hepatology, University of Heidelberg, Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Baden-Württemberg, GermanyDepartment of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Baden-Württemberg, GermanyDepartment of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Baden-Württemberg, GermanyDepartment of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Baden-Württemberg, GermanyLiver Cancer Center Heidelberg, University of Heidelberg, Heidelberg, GermanyDepartment of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, GermanyDepartment of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, GermanyLiver Cancer Center Heidelberg, University of Heidelberg, Heidelberg, GermanyGeneral, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, GermanyIntroduction Liver resection is the only curative treatment for primary and secondary hepatic tumours. Improvements in perioperative preparation of patients and new surgical developments have made complex liver resections possible. However, small for size and flow syndrome (SFSF) is still a challenging issue, rendering patients inoperable and causing postoperative morbidity and mortality. Although the role of transhepatic flow in the postoperative outcome has been shown in small partial liver transplantation and experimental studies of SFSF, this has never been studied in the clinical setting following liver resection. The aim of this study is to systematically evaluate transhepatic flow changes following major liver resection and its correlation with postoperative outcomes.Methods and analysis The TransHEpatic FLOW (THEFLOW) study is a single-centre, non-interventional cohort study, and aims to enrol 50 patients undergoing major hepatectomy (defined as hemihepatectomy or extended hepatectomy based on the Brisbane classification) with or without prior chemotherapy. The portal venous flow, hepatic artery flow and portal venous pressure are measured before and after each resection. All patients are followed-up for 3 months after the operation. During each evaluation, standard clinical data, posthepatectomy liver failure and overall morbidity and mortality will be recorded. THEFLOW study was initiated on 25 March 2018 and is expected to progress for 2 years.Ethics and dissemination This protocol study received approval from the Ethics Committee of the University of Heidelberg (registration number: S576/2017). The results of this study will be published in a peer-reviewed journal, and will also be presented at medical meetings.Trial registration number NCT03762876.https://bmjopen.bmj.com/content/9/10/e029618.full
spellingShingle Karl Heinz Weiss
Mohammad Golriz
Anastasia Lemekhova
Elias Khajeh
Omid Ghamarnejad
Mohammed Al-Saeedi
Oliver Strobel
Beat Müller-Stich
Martin Schneider
Christoph Berchtold
Parham Tinoush
Philipp Mayer
De-Hua Chang
Katrin Hoffmann
Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort study
BMJ Open
title Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort study
title_full Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort study
title_fullStr Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort study
title_full_unstemmed Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort study
title_short Evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy (THEFLOW): study protocol for a single-centre, non-interventional cohort study
title_sort evaluation of the role of transhepatic flow in postoperative outcomes following major hepatectomy theflow study protocol for a single centre non interventional cohort study
url https://bmjopen.bmj.com/content/9/10/e029618.full
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