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The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy

Background: Bleeding is a negative outcome predictor in liver surgery. Reduction in the abdominal wall trauma in major hepatectomy is challenging but might offer possible benefits for the patient. This study was conducted to assess hemostasis techniques in single-port major hepatectomies (SP-MajH) a...

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Autores principales: Mittermair, Christof, Weiss, Michael, Schirnhofer, Jan, Brunner, Eberhard, Fischer, Katharina, Obrist, Christian, de Cillia, Michael, Kemmetinger, Vanessa, Gollegger, Emanuel, Hell, Tobias, Weiss, Helmut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863947/
https://www.ncbi.nlm.nih.gov/pubmed/33498169
http://dx.doi.org/10.3390/jcm10030374
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author Mittermair, Christof
Weiss, Michael
Schirnhofer, Jan
Brunner, Eberhard
Fischer, Katharina
Obrist, Christian
de Cillia, Michael
Kemmetinger, Vanessa
Gollegger, Emanuel
Hell, Tobias
Weiss, Helmut
author_facet Mittermair, Christof
Weiss, Michael
Schirnhofer, Jan
Brunner, Eberhard
Fischer, Katharina
Obrist, Christian
de Cillia, Michael
Kemmetinger, Vanessa
Gollegger, Emanuel
Hell, Tobias
Weiss, Helmut
author_sort Mittermair, Christof
collection PubMed
description Background: Bleeding is a negative outcome predictor in liver surgery. Reduction in the abdominal wall trauma in major hepatectomy is challenging but might offer possible benefits for the patient. This study was conducted to assess hemostasis techniques in single-port major hepatectomies (SP-MajH) as compared to multiport major hepatectomies (MP-MajH). Methods: The non-randomized study comprised 34 SP-MajH in selected patients; 14 MP-MajH served as the control group. Intraoperative blood loss and number of blood units transfused served as the primary endpoints. Secondary endpoints were complications and oncologic five-year outcome. Results: All resections were completed without converting to open surgery. Time for hepatectomy did not differ between SP-MajH and MP-MajH. Blood loss and number of patients with blood loss > 25 mL were significantly larger in MP-MajH (p = 0.001). In contrast, bleeding control was more difficult in SP-MajH, resulting in more transfusions (p = 0.008). One intestinal laceration (SP-MajH) accounted for the only intraoperative complication; 90-day mortality was zero. Postoperative complications were noted in total in 20.6% and 21.4% of patients for SP-MajH and MP-MajH, respectively. No incisional hernia occurred. During a median oncologic follow-up at 61 and 56 months (SP-MajH and MP-MajH), no local tumor recurrence was observed. Conclusions: SP-MajH requires sophisticated techniques to ensure operative safety. Substantial blood loss requiring transfusion is more likely to occur in SP-MajH than in MP-MajH.
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spelling pubmed-78639472021-02-06 The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy Mittermair, Christof Weiss, Michael Schirnhofer, Jan Brunner, Eberhard Fischer, Katharina Obrist, Christian de Cillia, Michael Kemmetinger, Vanessa Gollegger, Emanuel Hell, Tobias Weiss, Helmut J Clin Med Article Background: Bleeding is a negative outcome predictor in liver surgery. Reduction in the abdominal wall trauma in major hepatectomy is challenging but might offer possible benefits for the patient. This study was conducted to assess hemostasis techniques in single-port major hepatectomies (SP-MajH) as compared to multiport major hepatectomies (MP-MajH). Methods: The non-randomized study comprised 34 SP-MajH in selected patients; 14 MP-MajH served as the control group. Intraoperative blood loss and number of blood units transfused served as the primary endpoints. Secondary endpoints were complications and oncologic five-year outcome. Results: All resections were completed without converting to open surgery. Time for hepatectomy did not differ between SP-MajH and MP-MajH. Blood loss and number of patients with blood loss > 25 mL were significantly larger in MP-MajH (p = 0.001). In contrast, bleeding control was more difficult in SP-MajH, resulting in more transfusions (p = 0.008). One intestinal laceration (SP-MajH) accounted for the only intraoperative complication; 90-day mortality was zero. Postoperative complications were noted in total in 20.6% and 21.4% of patients for SP-MajH and MP-MajH, respectively. No incisional hernia occurred. During a median oncologic follow-up at 61 and 56 months (SP-MajH and MP-MajH), no local tumor recurrence was observed. Conclusions: SP-MajH requires sophisticated techniques to ensure operative safety. Substantial blood loss requiring transfusion is more likely to occur in SP-MajH than in MP-MajH. MDPI 2021-01-20 /pmc/articles/PMC7863947/ /pubmed/33498169 http://dx.doi.org/10.3390/jcm10030374 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mittermair, Christof
Weiss, Michael
Schirnhofer, Jan
Brunner, Eberhard
Fischer, Katharina
Obrist, Christian
de Cillia, Michael
Kemmetinger, Vanessa
Gollegger, Emanuel
Hell, Tobias
Weiss, Helmut
The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy
title The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy
title_full The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy
title_fullStr The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy
title_full_unstemmed The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy
title_short The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy
title_sort shift from multiport to single port increases the amount of bleeding in laparoscopic major hepatectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863947/
https://www.ncbi.nlm.nih.gov/pubmed/33498169
http://dx.doi.org/10.3390/jcm10030374
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