Yıl: 2021 Cilt: 51 Sayı: 3 Sayfa Aralığı: 1388 - 1395 Metin Dili: İngilizce DOI: 10.3906/sag-2008-78 İndeks Tarihi: 19-01-2022

Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience

Öz:
Background/aim: Operative bleeding is one of the major determinants of outcome in liver surgery. This study aimed to describe the impact of intraoperative blood loss on the postoperative course of liver resection (LR). Materials and methods: The data of 257 patients who were treated with LR between January 2007 and October 2018 were retrospectively analyzed. LRs were performed via intermittent portal triad clamping (PTC) under low central venous pressure. Results: LRs were performed for 67.7% of patients with a malignant disease and 32.3% of patients with a benign disease. Major LR was performed in 89 patients (34.6%). The mean PTC period was 20.32 min (±13.7). The median intraoperative bleeding amount was 200 mL (5–3500 mL), the 30-day mortality rate was 4.3%, and the morbidity rate was 31.9%. The hospital stay (p = 0.002), morbidity (p = 0.009), and 30-day mortality (p = 0.041) of patients with a bleeding amount of more than 500 mL significantly increased. Conclusion: Surgeons should consider the adverse effects of intraoperative bleeding during liver resection on patients’ outcome. Favorable outcomes would be obtained with diligent postoperative care.Key words: Liver surgery, operative bleeding, portal triad clamping, low central venous pressure, hemostasis
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L et al. Improvement in perioperative outcome after hepatic resection: analysis of 1803 consecutive cases over the past decade. Annals of Surgery 2002; 236: 397-406. doi: 10.1097/01. SLA.0000029003.66466.B3
  • 2. Topaloglu S, Inci I, Calik A, Aras O, Oztuna F et al. Intensive pulmonary care after liver surgery: a retrospective survey from a single center. Transplantation Proceedings 2013; 45: 986-992. doi: 10.1016/j.transproceed.2013.02.082
  • 3. Hallet J, Tsang M, Cheng ESW, Habashi R, Kulyk I et al. The impact of perioperative red blood cell transfusions on long-term outcomes after hepatectomy for colorectal liver metastases. Annals of Surgical Oncology 2015; 22: 4038-4045. doi: 10.1245/s10434-015-4477-4
  • 4. Eeson G, Karanicolas PJ. Hemostasis and hepatic surgery. Surgical Clinics of North America 2016; 96: 219-228. doi: 10.1016/j.suc.2015.12.001
  • 5. Gurusamy KS, Li J, Sharma D, Davidson BR. Pharmacological interventions to decrease blood loss and blood transfusion requirements for liver resection. Cochrane Database of Systematic Reviews 2009; 4: CD008085. doi: 10.1002/14651858. CD008085
  • 6. Smyrniotis V, Farantos C, Kostopanagiotou G, Arkadopoulos N. Vascular control during hepatectomy: review of methods and results. World Journal of Surgery 2005; 29: 1384-1396. doi: 10.1007/s00268-005-0025-x
  • 7. Ikeda M, Hasegawa K, Sano K, Imamura H, Beck Y et al. The vessel sealing system (LigaSure) in hepatic resection: a randomized controlled trial. Annals of Surgery 2009; 250: 199- 203. doi: 10.1097/SLA.0b013e3181a334f9
  • 8. Patrlj L, Tuorto S, Fong Y. Combined blunt-clamp dissection and LigaSure ligation for hepatic parenchyma dissection: Postcoagulation technique. Journal of the American College of Surgeons 2010; 210: 39-44. doi: 10.1016/j. jamcollsurg.2009.09.035
  • 9. Topaloglu S, Yesilcicek Calik K, Calik A, Aydın C, Kocyigit S et al. Efficacy and safety of hepatectomy performed with intermittent portal triad clamping with low central venous pressure. BioMed Research International 2013. doi: 10.1155/2013/297971
  • 10. Arslan MK, Aydin C, Topaloglu S, Calik A, Tomas K et al. Incidence of and risk factors for incisional hernia after liver surgery performed with a J-shaped right subcostal incision. The American Surgeon 2017; 83:e49-53.doi: 10.1177/000313481708300204
  • 11. Tomas K, Oguz S, Topaloglu S, Calik A, Arslan M et al. Is it rational to perform liver resection for patients with intermediate and advanced stages of hepatocellular carcinoma? The American Surgeon 2020; 86: 313-323. doi: 10.1177/000313482008600427
  • 12. Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011; 149: 713-724. doi: 10.1016/j. surg.2010.10.001
  • 13. Topaloğlu S, Yankol Y, Küçükkartallar T, Ocak İ, Doğruer K et al. The current status of non-biologic liver support in the treatment of liver failure. Yoğun Bakım Dergisi 2010; 1: 14-20.
  • 14. Moggia E, Rouse B, Simillis C, Li T, Vaughan J et al. Methods to decrease blood loss during liver resection: a network metaanalysis. Cochrane Database of Systematic Reviews 2016; 10: CD010683. doi: 10.1002/14651858.CD010683.pub3
  • 15. Huntington JT, Royall NA, Schmidt CR. Minimizing blood loss during hepatectomy: a literature review. Journal of Surgical Oncology 2014; 109: 81-88. doi: 10.1002/jso.23455
  • 16. Ibrahim S, Chen CL, Lin CC, Yang CH, Wang CC et al. Intraoperative blood loss is a risk factor for complications in donors after living donor hepatectomy. Liver Transplantation 2006; 12: 950-957. doi: 10.1002/lt.20746
  • 17. Yang T, Zhang J, Lu JH, Yang GS, Wu MC et al. Risk factors influencing postoperative outcomes of major hepatic resection of hepatocellular carcinoma for patients with underlying liver diseases. World Journal of Surgery 2011; 35: 2073-2082. doi: 10.1007/s00268-011-1161-0
  • 18. Poon RT, Fan ST, Lo CM, Liu CL, Lam CM et al. Improving perioperative outcome expands the role of hepatectomy in management of benign and malignant hepatobiliary diseases. Annals of Surgery 2004; 240: 698-710. doi: 10.1097/01. sla.0000141195.66155.0c
  • 19. Hughes MJ, Ventham NT, Harrison EM, Wigmore SJ. Central venous pressure and liver resection: a systematic review and meta-analysis. The Official Journal of International HepatoPancreato-Biliary Association 2015; 17: 863-871. doi: 10.1111/ hpb.12462
  • 20. Hoekstra LT, van Trigt JD, Reiniers MJ, Busch OR, Gouma DJ et al. Vascular occlusion or not during liver resection: the continuing story. Digestive Surgery 2012; 29: 35-42. doi: 10.1159/000335724
  • 21. Alexiou VG, Tsitsias T, Mavros MN, Robertson GS, Pawlik TM. Technology-assisted versus clamp-crush liver resection: a systematic review and meta-analysis. Surgical Innovation 2013; 20: 414-428. doi: 10.1177/1553350612468510
  • 22. Xiao WK, Chen D, Hu AB, Peng BG, Guo YZ et al. Radiofrequency-assisted versus clamp-crush liver resection: a systematic review and meta-analysis. Journal of Surgical Research 2014; 187: 471-483. doi: 10.1016/j.jss.2013.10.055
  • 23. Brustia R, Granger B, Scatton O. An update on topical haemostatic agents in liver surgery: systematic review and meta-analysis. Journal of Hepato-Biliary-Pancreatic Sciences 2016; 23: 609-621. doi: 10.1002/jhbp.389
  • 24. Oguz S, Tayar S, Topaloglu S, Calik A, Dinc H et al. Enhancing hepatic microcirculation in postoperative hepatic failure with intra-arterial recombinant tissue plasminogen activator treatment. Experimental and Clinical Transplantation 2017. doi: 10.6002/ect.2017
APA BODUR M, tomas k, Topaloglu S, oğuz ş, KÜÇÜKASLAN H, dohman d, karabulut e, Calik A (2021). Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. , 1388 - 1395. 10.3906/sag-2008-78
Chicago BODUR Muhammed Selim,tomas kadir,Topaloglu Serdar,oğuz şükrü,KÜÇÜKASLAN HAKAN,dohman davut,karabulut erdem,Calik Adnan Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. (2021): 1388 - 1395. 10.3906/sag-2008-78
MLA BODUR Muhammed Selim,tomas kadir,Topaloglu Serdar,oğuz şükrü,KÜÇÜKASLAN HAKAN,dohman davut,karabulut erdem,Calik Adnan Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. , 2021, ss.1388 - 1395. 10.3906/sag-2008-78
AMA BODUR M,tomas k,Topaloglu S,oğuz ş,KÜÇÜKASLAN H,dohman d,karabulut e,Calik A Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. . 2021; 1388 - 1395. 10.3906/sag-2008-78
Vancouver BODUR M,tomas k,Topaloglu S,oğuz ş,KÜÇÜKASLAN H,dohman d,karabulut e,Calik A Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. . 2021; 1388 - 1395. 10.3906/sag-2008-78
IEEE BODUR M,tomas k,Topaloglu S,oğuz ş,KÜÇÜKASLAN H,dohman d,karabulut e,Calik A "Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience." , ss.1388 - 1395, 2021. 10.3906/sag-2008-78
ISNAD BODUR, Muhammed Selim vd. "Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience". (2021), 1388-1395. https://doi.org/10.3906/sag-2008-78
APA BODUR M, tomas k, Topaloglu S, oğuz ş, KÜÇÜKASLAN H, dohman d, karabulut e, Calik A (2021). Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. Turkish Journal of Medical Sciences, 51(3), 1388 - 1395. 10.3906/sag-2008-78
Chicago BODUR Muhammed Selim,tomas kadir,Topaloglu Serdar,oğuz şükrü,KÜÇÜKASLAN HAKAN,dohman davut,karabulut erdem,Calik Adnan Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. Turkish Journal of Medical Sciences 51, no.3 (2021): 1388 - 1395. 10.3906/sag-2008-78
MLA BODUR Muhammed Selim,tomas kadir,Topaloglu Serdar,oğuz şükrü,KÜÇÜKASLAN HAKAN,dohman davut,karabulut erdem,Calik Adnan Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. Turkish Journal of Medical Sciences, vol.51, no.3, 2021, ss.1388 - 1395. 10.3906/sag-2008-78
AMA BODUR M,tomas k,Topaloglu S,oğuz ş,KÜÇÜKASLAN H,dohman d,karabulut e,Calik A Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. Turkish Journal of Medical Sciences. 2021; 51(3): 1388 - 1395. 10.3906/sag-2008-78
Vancouver BODUR M,tomas k,Topaloglu S,oğuz ş,KÜÇÜKASLAN H,dohman d,karabulut e,Calik A Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience. Turkish Journal of Medical Sciences. 2021; 51(3): 1388 - 1395. 10.3906/sag-2008-78
IEEE BODUR M,tomas k,Topaloglu S,oğuz ş,KÜÇÜKASLAN H,dohman d,karabulut e,Calik A "Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience." Turkish Journal of Medical Sciences, 51, ss.1388 - 1395, 2021. 10.3906/sag-2008-78
ISNAD BODUR, Muhammed Selim vd. "Effects of intraoperative blood loss during liver resection on patients’ outcome: a singlecenter experience". Turkish Journal of Medical Sciences 51/3 (2021), 1388-1395. https://doi.org/10.3906/sag-2008-78