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Effects of intraoperative blood loss during liver resection on patients’ outcome: a single-center experience
Authors:Muhammed Selim BODUR,Kadir TOMAS,Serdar TOPALOĞ  LU,Ş  ü  krü    UZ,Hakan KÜ  Ç  Ü  KASLAN,Davut DOHMAN,Erdem KARABULUT,Adnan Ç  ALIK
Affiliation:1. Department of Surgery, School of Medicine, Karadeniz Technical University, Trabzon, Turkey ; 2. Department of Radiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey ; 3. Department of Anesthesiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey ; 4. Department of Biostatistics, Hacettepe University, Ankara, Turkey
Abstract: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.
Keywords:Liver surgery   operative bleeding   portal triad clamping   low central venous pressure   hemostasis
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