An An Open-Label, Single Center, Retrospective Study to Evaluate Clinical Outcomes with Surgical Sealant in Bentall Procedures: A Cohort Study.

Jiawei Gu, H. Lai, Jun Li, Yongxin Sun, Chen Liu, Yulin Wang, Zhiqi Zhang, Le Kang, Ben Huang, Chunsheng Wang
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Abstract

BACKGROUND Cardiovascular surgery is associated with substantial risk for postoperative bleeding with increased patient morbidity and mortality. Numerous intraoperative techniques have been utilized to reduce this risk. This study was to assess postoperative bleeding-related parameters following Bentall procedures and to examine the impact of intraoperative surgical sealant application. METHOD The medical/surgical records of 100 consecutive Bentall procedure cases were examined retrospectively for perioperative surgical sealant use and postoperative bleeding-related outcomes. RESULTS Of the 100 patient cases, three died during the postoperative period, and 97 were evaluable. Surgical sealant was utilized in 56 patient cases (57.8%). The utilization versus no utilization of surgical sealant was associated with significant reductions in most postoperative bleeding-related parameters, including less drainage (P = .028), resternotomy for hemorrhage (P = .036), transfusion of red blood cells (P = .022 at 48 hours; P = .027 total in-hospital), transfusion of fresh frozen plasma (P = .04 at 48 hours; P = .004 total in-hospital), and a higher percentage of cases not needing blood transfusion (P = .002). The surgical sealant group had longer cardiopulmonary bypass circuit (P = .016) and aortic cross-clamp time (P = .001), with no significant between-group differences in intubation time (P = .636) or intensive care unit duration (P = .294). When excluding urgent cases or Stanford type A aortic dissections, intensive care unit duration significantly was shorter in the surgical sealant group (P = .017). Surgical sealant use was not associated with any adverse events. CONCLUSION The application of surgical sealant to the anastomosis suture line in Bentall procedures reduces postoperative drainage, bleeding, and transfusion utilization. Further studies are warranted to investigate these benefits in prospective, randomized clinical trials.
一项开放标签、单中心、回顾性研究评估Bentall手术中使用外科密封胶的临床效果:一项队列研究。
背景:心血管手术与术后出血的重大风险相关,患者发病率和死亡率增加。许多术中技术被用来降低这种风险。本研究旨在评估本特尔手术后出血相关参数,并检查术中应用外科密封胶的影响。方法回顾性分析100例本特尔手术患者围术期使用外科密封胶及术后出血相关情况。结果100例患者中,术后死亡3例,可评价97例。56例(57.8%)使用外科密封胶。使用手术密封剂与不使用手术密封剂与大多数术后出血相关参数的显著降低相关,包括减少引流(P = 0.028),剖开胸腔出血(P = 0.036),输血红细胞(P = 0.022, 48小时;住院总P = 0.027)、新鲜冷冻血浆输注(48 h时P = 0.04;住院总人数P = 0.004),不需要输血的病例比例更高(P = 0.002)。手术封闭组体外循环时间(P = 0.016)和主动脉交叉夹夹时间(P = 0.001)较长,插管时间(P = 0.636)和重症监护病房时间(P = 0.294)组间差异无统计学意义。当排除紧急病例或Stanford A型主动脉夹层时,手术密封剂组重症监护时间明显缩短(P = 0.017)。手术密封剂的使用与任何不良事件无关。结论本特尔手术吻合缝合线应用外科密封剂减少了术后引流、出血和输血的使用。有必要在前瞻性随机临床试验中进一步研究这些益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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