scholarly journals Factors affecting sufentanil consumption for intravenous controlled analgesia after hepatectomy: retrospective analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yue Wu ◽  
Lina Tian ◽  
Chunye Li ◽  
Minjun Liu ◽  
Shina Qiao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatic Resection ◽  
Laparoscopic Hepatectomy ◽  
Operation Time ◽  
Extent Of Resection ◽  
Fresh Frozen Plasma ◽  
Open Approach ◽  
Factors Affecting ◽  
Major Hepatic Resection ◽  
Perioperative Pain Management

Abstract Background Pain control after hepatectomy is usually achieved by opioids. There are significant individual differences in the amount of opioids used after hepatectomy, and the metabolism of opioids is liver-dependent. The purpose of our study was to explore the possible risk factors for opioid consumption during the first 48 h after surgery. Methods In a retrospective study design involving 562 patients undergoing open or laparoscopic hepatectomy, all patients were treated with intravenous patient-controlled analgesia (IV-PCA) along with continuous and bolus doses of sufentanil for a duration of 48 h after surgery during the time period of August 2015 and February 2019. The primary endpoint was high sufentanil consumption 48 h after hepatectomy, and patients were divided into two groups: those with or without a high PCA sufentanil dosage depending on the third quartile (Q3). The secondary endpoint was the effect of a high PCA sufentanil dosage on various possible clinical risk factors. The relevant parameters were collected, and correlation and multivariate regression analyses were performed. Results The median operation time was 185 min (range, 115–250 min), and the median consumption of sufentanil 48 h after the operation was 91 μg (IQR, 64.00, 133.00). Factors related to the consumption of sufentanil at 48 h after hepatectomy included age, operation time, blood loss, intraoperative infusion (red blood cells and fresh-frozen plasma), pain during movement after surgery (day 1 and day 2), preoperative albumin, and postoperative blood urea nitrogen. Age (≤ 60 and > 60 years), extent of resection (minor hepatic resection and major hepatic resection), surgical approach (laparoscope and open) and operation time (min) were independent risk factors for sufentanil consumption at 48 h postoperatively. Conclusion Age younger than 60 years, major hepatic resection, an open approach and a longer operation are factors more likely to cause patients to require higher doses of sufentanil after hepatectomy, and the early identification of such patients can increase the efficacy of perioperative pain management.

scholarly journals Risk factors and outcomes for cholangitis after major hepatic resection

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S637
Author(s):  
C. Mangieri ◽  
M. Strode ◽  
O. Moaven ◽  
C. Valenzuela ◽  
R. Erali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatic Resection ◽  
Major Hepatic Resection

scholarly journals Treatment of Non-Endemic Hepatolithiasis in a Western Country. The Role of Hepatic Resection

2006 ◽  
Vol 88 (4) ◽  
pp. 383-389 ◽  
Author(s):  
Marco Catena ◽  
Luca Aldrighetti ◽  
Renato Finazzi ◽  
Giandomenico Arzu ◽  
Marcella Arru ◽  
...  
Keyword(s):  
Hepatic Resection ◽  
Operation Time ◽  
Western Country ◽  
Fresh Frozen Plasma ◽  
Control Group ◽  
Period Range ◽  
Left Lateral Sectionectomy ◽  
Packed Red Blood Cells ◽  
Fresh Frozen ◽  
Lateral Sectionectomy

INTRODUCTION The aim of this study was to assess the safety and the efficacy of hepatic resective surgery in the treatment of single lobe hepatolithiasis. PATIENTS AND METHODS Retrospective analysis and comparison between hepatic resections in patients with hepatolithiasis (hepatolithiasis group [HG]) and liver masses (control group [CG]). Seventeen consecutive Caucasian patients with single lobe hepatolithiasis (HG) and 30 patients with liver masses without chronic liver disease and previous chemotherapy (CG), were operated during the 5-year period 2000–2005, inclusive. Major hepatic resections including 4 right hepatectomies, 10 left hepatectomies, and 3 left lateral sectionectomy in HG, and 12 right hepatectomies, 3 extended right hepatectomy, 5 left hepatectomies, 4 left lateral sectionectomy, 5 bisegmentectomy, and 1 mesohepatectomy in CG. The main outcome measures were: type and length of surgical procedures, intra- and postoperative blood losses and transfusions (packed red blood cells [PRBC] and fresh frozen plasma [FFP]), intra- and postoperative course and complications (within 30 days of the operation), length of hospitalisation, histopathology, and recurrence of hepatolithiasis. RESULTS Mean operation time was 6.21 ± 2.38 h in HG versus 7.10 ± 2.21 h in CG (P = 0.33). Mean intra-operative blood loss in CG was higher than in HG (1010 ± 550 ml versus 560 ± 459 ml; P = 0.035). The other variables considered in the two groups were not statistically different. Intra-operative transfusion were 0.50 ± 0.85 units in HG versus 1.35 ± 2.25 units of PRBC in CG (P = 0.06), and 0.66 ± 1.34 units in HG versus 0.68 ± 1.20 units of FFP in CG (P = 0.44), respectively. No cases of death were registered. Postoperative complications occurred in 12 patients (25.5%) – 5 cases (10.6%) in HG and 7 cases (14.8%) in CG (P = 0.18). Mean postoperative transfusions were 0.47 ± 1.24 units in HG versus 1.10 ± 1.18 units of PRBC in CG (P = 0.35), and 0.65 ± 1.40 units in HG versus 0.46 ± 0.82 units of FFP in CG (P = 0.25), respectively. Difference in median hospitalisation was not statistically significant (14 ± 10 days versus 12 ± 9 days; P = 0.28). Histopathology showed cholangiocarcinoma in 2 cases (11.7%). During the follow-up period (range, 5–127 months; mean, 50.4 ± 41.9 months), 1 patient had lithiasis recurrence and 1 patient died for the co-existing cholangiocarcinoma. CONCLUSIONS Hepatic resection is the treatment of choice in patients with single lobe hepatolithiasis. An early indication for surgery may reduce the mortality/morbidity rates of hepatic resection for hepatolithiasis.

The use of fresh frozen plasma after major hepatic resection for colorectal metastasis: is there a standard for transfusion?

2003 ◽  
Vol 196 (3) ◽  
pp. 402-409 ◽  
Author(s):  
Robert C.G Martin ◽  
William R Jarnagin ◽  
Yuman Fong ◽  
Peter Biernacki ◽  
Leslie H Blumgart ◽  
...  
Keyword(s):  
Hepatic Resection ◽  
Fresh Frozen Plasma ◽  
Colorectal Metastasis ◽  
Major Hepatic Resection ◽  
Fresh Frozen ◽  
Frozen Plasma

scholarly journals Clinical outcomes observation in stage IIB–IIIB cervical cancer treated by adjuvant surgery following concurrent chemoradiotherapy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Li ◽  
Zhiying Chen ◽  
Xiang Wang ◽  
Xiumei Li ◽  
Jie Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Logistic Regression ◽  
Operation Time ◽  
Residual Tumor ◽  
Postoperative Recurrence ◽  
Surgery Complications ◽  
Factors Affecting ◽  
Adjuvant Surgery ◽  
Chi Squared

Abstract Background To explore the feasibility of adjuvant surgery following concurrent chemoradiation therapy (CCRT) in stage IIB–IIIB (according to FIGO staging of 2009) cervical cancer and analyze risk factors of recurrence after surgery. Methods Forty-nine patients diagnosed with stage IIB–IIIB cervical cancer were reviewed retrospectively. We investigated the risk factors of recurrence after surgery using Chi-squared Test and further analyzed multiple factors affecting postoperative recurrence using the multi-factor logistic regression. Furthermore, the correlation of surgery outcomes (including operation time, bleeding, and hospitalization date and surgery complications) with the time which carried out between CCRT and completion surgery was analyzed. Results Tumor histology and residual tumor in the cervix were significantly associated with postoperative recurrence (P = 0.014 and P = 0.040, respectively). Logistic regression analysis demonstrated that the independent risk factors of postoperative recurrence were age and residual tumor in the cervix (P = 0.017 and P = 0.030, respectively). Complications (operation time, bleeding, hospitalization date) were compared between patients with an interval with radiotherapy less than 6 weeks and patients with an interval longer than 6 weeks. There were statistical differences in the amount of bleeding and postoperative complications between the two groups (P = 0.019 and P = 0.044, respectively). Conclusion CCRT combined with surgery for stage IIB–IIIB cervical cancer was feasible, reduced the rate of postoperative recurrence and surgery complications were tolerated.

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

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