Randomized clinical trial of stapler versus clamp-crushing transection in elective liver resection  

Oleh:

Rahbari, N. N. ; Elbers, H. ; Koch, M. ; Vogler, P. ; Striebel, F.

Jenis: Article from Article - diterbitkan di jurnal ilmiah internasional
Dalam koleksi: BJS: British Journal of Surgery vol. 101 no. 03 (Feb. 2014), page 200-207.

Ketersediaan

Perpustakaan FK Nomor Panggil: B15.K.2014.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Various devices have been developed to facilitate liver transection and reduce blood loss in liver resections. None of these has proven superiority compared with the classical clamp-crushing technique. This randomized clinical trial compared the effectiveness and safety of stapler transection with that of clamp-crushing during open liver resection. Methods Patients admitted for elective open liver resection between January 2010 and October 2011 were assigned randomly to stapler transection or the clamp-crushing technique. The primary endpoint was the total amount of intraoperative blood loss. Secondary endpoints included transection time, duration of operation, complication rates and resection margins. Results A total of 130 patients were enrolled, 65 to clamp-crushing and 65 to stapler transection. There was no difference between groups in total intraoperative blood loss: median (i.q.r.) 1050 (525–1650) versus 925 (450–1425) ml respectively (P?=?0·279). The difference in total intraoperative blood loss normalized to the transection surface area was not statistically significant (P?=?0·092). Blood loss during parenchymal transection was significantly lower in the stapler transection group (P?=?0·002), as were the parenchymal transection time (mean(s.d.) 30(21) versus 9(7) min for clamp-crushing and stapler transection groups respectively; P?

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