Abstract
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the most frequent complications after surgery. PONV prophylaxis has been strongly recommended, and identifying risk factors is the first step. The well-known PONV risk assessment tools were not validated in the liver cancer population, however, no study has explored the relationship between PONV and liver surgery-specific factors. This study aimed to identify whether there was an association between hepatic portal occlusion and PONV among patients after hepatectomy. METHODS: Participants were consecutively enrolled during June 2023 to August 2023 in the cancer center in Fudan Univesity Zhongshan Hospital. Liver cancer patients who underwent liver resection surgery were eligible. The impact of hepatic portal occlusion on PONV was determined using Logistic regression models. RESULTS: A total of 380 patients were consecutively included in the study, and 192 patients (50.53%) developed PONV. A linear relationship between PONV and the time of hepatic portal occlusion was observed. Even adjusted for 9 PONV-related factors, the hepatic portal occlusion was still significantly correlated with PONV (OR = 1.22, 95%CI = 1.05-1.43, P = 0.012). In addition, the numbers of hepatic portal occlusion were positively related to the incidence of PONV (OR = 1.30, 95% CI = 1.04-1.62, P for trend = 0.022); as the number of occlusions increased, patients were more likely to experience PONV. CONCLUSIONS: Hepatic portal occlusion was an important PONV predictor for patients undergoing liver surgery and should be used to update PONV scoring systems to guide personalized prophylactic antiemetics use in clinical practice. TRIAL REGISTRATION: The study was registered with the US National Institutes of Health ClinicalTrials.gov (NCT05894408) on May 30, 2023.