Rui Tang, Guangdong Wu, Xuan Tong, Lihan Yu, Ang Li, Jingyi Lin, Guangxun Xu, Qian Lu
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引用次数: 0
Abstract
Background: Intraoperative hemorrhage is one of the major complications of orthotopic liver transplantation (OLTX) and is mainly caused by technical difficulties of the surgical procedure besides primary liver diseases. The present study aimed to evaluate the feasibility and clinical effects of a novel proceduralized donor liver back-table preparation (DLBTP) technique for use in OLTX.
Methods: This retrospective study was conducted between January 2018 and June 2020 based on patients who had undergone OLTX. All livers transplanted using the reported back-table procedures were defined as the control group A (n = 43), while those prepared using our new procedure as the experimental group B (n = 160). The first-hand surgical experience of transplant surgeons was surveyed in a post hoc comparative analysis.
Results: DLBTP time was significantly longer and the probability of low-quality hepatic artery skeletonization was lower in group B compared to group A patients. Compared to group A, the time for hemorrhage control was shorter [P < 0.05, 0.3 h (range, 0.17-0.58 h)], and the degree of blood loss was less [P < 0.05, 60 ml (range, 30-240 ml)] in group B. Major bleeding sites were soft tissue of the hepatic hilum and the wall of the inferior vena cava. Due to trimmed soft tissue in the first porta hepatis region, there was less blood oozing, making it easier to stem the bleeding and construct anastomosis.
Conclusion: Although the procedural DLBTP for OLTX was time-consuming, the new procedure significantly reduced the degree of hemorrhage and the time required to control bleeding.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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