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HPB Surgery  2013 

A Randomized Clinical Trial Comparing the Effect of Different Haemostatic Agents for Haemostasis of the Liver after Hepatic Resection

DOI: 10.1155/2013/587608

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Abstract:

Introduction. Operative blood loss is still a great obstacle to liver resection, and various topical hemostatic agents were introduced to reduce it. The aim of the current study is to evaluate effects of 3 different types of these agents. Methods. In this randomized clinical trial, 45 patients undergoing liver resection were assigned to receive TachoSil, Surgicel, and Glubran 2 for controlling bleeding. Intraoperative and postoperative findings were compared between groups. Results. Postoperative bleeding (0 versus 33.3%, ) and drainage volume first day after surgery ( versus ?mL, ) were significantly higher in Surgicel than in TachoSil group. Postoperative complications included bile leak (3 cases in Surgicel, 1 case in TachoSil and Glubran 2), noninfectious collection (2 cases in TachoSil and Surgicel and 1 case in Glubran 2), perihepatic abscess, and massive hematoma around hepatectomy site both in Surgicel group. There was no death during the study period. Conclusion. Due to higher complications in Surgicel group, its application as hemostatic agent after liver resection is not recommended. Better results in TachoSil in comparison to the other two are indicative of its better efficacy and superiority in controlling hemostasis. 1. Introduction Advances in surgical technique have reduced the occurrence of postoperative complications following liver resection [1] and resulted in low surgical mortality and morbidity rates in high-volume centers [2–4]. Surgical techniques and devices to facilitate haemostasis have been developed in the last decades and have minimized operative risks of liver resection [1, 2]. During liver resection, the control of bleeding is a major concern. Despite the improvements in anatomic resection and dissection techniques, operative blood loss remains a major problem affecting the prognosis of patients undergoing liver resection [2, 5]. Nevertheless, a parenchymal transection of the liver tissue is always associated with some degree of bleeding due to the division of small blood vessels which cannot be isolated and ligated [6, 7]. In order to control diffuse bleeding and to prevent intraperitoneal complications attributed to bleeding, various topical products are used when the conventional methods, such as suture, ligation, or argon beam coagulation, fail. Currently, there are numerous products on the market which are promising a successful outcome for hemostasis. These products include gelatin, collagen, oxidized regenerated cellulose, fibrin sealant glues, and synthetic glues [7–11]. TachoSil (fibrin sealant glue) and Surgicel

References

[1]  D. R. Holt, D. Van Thiel, S. Edelstein, and J. J. Brems, “Hepatic resections,” Archives of Surgery, vol. 135, no. 11, pp. 1353–1358, 2000.
[2]  W. R. Jarnagin, M. Gonen, Y. Fong et al., “Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade,” Annals of Surgery, vol. 236, no. 4, pp. 397–407, 2002.
[3]  J. Brice?o, A. Naranjo, R. Ciria et al., “A prospective study of the efficacy of clinical application of a new carrier-bound fibrin sealant after liver resection,” Archives of Surgery, vol. 145, no. 5, pp. 482–488, 2010.
[4]  M. Makuuchi and K. Sano, “The surgical approach to HCC: our progress and results in Japan,” Liver Transplantation, vol. 10, no. 2, pp. S46–S52, 2004.
[5]  W. O. Bechstein and P. Neuhaus, “Bleeding in hepatic resection and transplantation,” Chirurg, vol. 71, no. 4, pp. 363–368, 2000.
[6]  W. R. Clark Jr. and R. P. Leather, “Hemostasis during liver resections,” Surgery, vol. 67, no. 3, pp. 556–557, 1970.
[7]  W. C. Chapman, P.-A. Clavien, J. Fung, A. Khanna, A. Bonham, and H. B. Kram, “Effective control of hepatic bleeding with a novel collagen-based composite combined with autologous plasma: results of a randomized controlled trial,” Archives of Surgery, vol. 135, no. 10, pp. 1200–1205, 2000.
[8]  J. Figueras, L. Llado, M. Miro et al., “Application of fibrin glue sealant after hepatectomy does not seem justified: results of a randomized study in 300 patients,” Annals of Surgery, vol. 245, no. 4, pp. 536–542, 2007.
[9]  T. W. Kraus, A. Mehrabi, P. Schemmer, A. Kashfi, P. Berberat, and M. W. Büchler, “Scientific evidence for application of topical hemostats, tissue glues, and sealants in hepatobiliary surgery,” Journal of the American College of Surgeons, vol. 200, no. 3, pp. 418–427, 2005.
[10]  E. A. Boonstra, I. Q. Molenaar, R. J. Porte, and M. T. de Boer, “Topical haemostatic agents in liver surgery: do we need them?” HPB, vol. 11, no. 4, pp. 306–310, 2009.
[11]  H. Seyednejad, M. Imani, T. Jamieson, and A. M. Seifalian, “Topical haemostatic agents,” British Journal of Surgery, vol. 95, no. 10, pp. 1197–1225, 2008.
[12]  S. M. V. Hosseini, A. Bahador, H. R. Foroutan, B. Sabet, B. Geramizadeh, and M. Zarenezhad, “The application of a new cyanoacrylate glue in pediatric surgery for fistula closure,” Iranian Journal of Medical Sciences, vol. 36, no. 1, pp. 54–56, 2011.
[13]  S. D?browiecki, S. Pier?ciński, and W. Szcz?sny, “The Glubran 2 glue for mesh fixation in Lichtenstein's hernia repair: a double-blind randomized study,” Videosurgery and Other Miniinvasive Techniques, vol. 7, no. 2, pp. 96–104, 2012.
[14]  A. J. Singer and H. C. Thode Jr., “A review of the literature on octylcyanoacrylate tissue adhesive,” American Journal of Surgery, vol. 187, pp. 238–248, 2004.
[15]  P. Losi, S. Burchielli, D. Spiller et al., “Cyanoacrylate surgical glue as an alternative to suture threads for mesh fixation in hernia repair,” Journal of Surgical Research, vol. 163, no. 2, pp. e53–e58, 2010.
[16]  I. Takács, J. Wegmann, S. Horváth et al., “Efficacy of different hemostatic devices for severe liver bleeding: a randomized controlled animal study,” Surgical Innovation, vol. 17, no. 4, pp. 346–352, 2010.
[17]  T. Zacharias and N. Ferreira, “Carrier-bound fibrin sealant compared to oxidized cellulose application after liver resection,” HPB, vol. 14, no. 12, pp. 839–847, 2012.
[18]  P. I. Ellman, T. B. Reece, T. S. Maxey et al., “Evaluation of an absorbable cyanoacrylate adhesive as a suture line sealant,” Journal of Surgical Research, vol. 125, no. 2, pp. 161–167, 2005.
[19]  M. D. Stringer, D. Dasgupta, P. McClean, S. Davison, and W. Ramsden, ““Surgicel abscess” after pediatric liver transplantation: a potential trap,” Liver Transplantation, vol. 9, no. 2, pp. 197–198, 2003.

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