Impact of Intraoperative Blood Loss and Blood Transfusion on the Prognosis of Colorectal Liver Metastasis Following Curative Resection

2021 ◽  
Vol 41 (11) ◽  
pp. 5617-5623
Author(s):  
SHIBUTANI MASATSUNE ◽  
KENJIRO KIMURA ◽  
SHINICHIRO KASHIWAGI ◽  
WANG EN ◽  
YUKI OKAZAKI ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Colorectal Liver Metastasis ◽  
Curative Resection ◽  
Intraoperative Blood Loss

scholarly journals Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Alessandro Tafuri ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Univariate Analysis ◽  
Operating Time ◽  
Primary Treatment ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Intraoperative Bleeding ◽  
Perioperative Blood Transfusion

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.

scholarly journals Efficacy and Safety of Tranexamic Acid in Bimaxillary Orthognathic Surgery

2020 ◽  
Vol 28 (2) ◽  
pp. 94-104
Author(s):  
Liang Sun ◽  
Rui Guo ◽  
Yi Feng
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Orthognathic Surgery ◽  
Operation Time ◽  
Controlled Trials ◽  
Allogenic Blood Transfusion ◽  
Intraoperative Blood Loss ◽  
Irrigation Fluid ◽  
Allogenic Blood

Background: Tranexamic acid (TXA) has been widely used during craniofacial and orthognathic surgery (OS). However, results of the literature are inconsistent due to specific type of surgery and a small sample of studies. The purpose of this study was to evaluate the role of TXA in bimaxillary OS. Methods: We performed a comprehensive literature search of PubMed, Cochrane Central Register of Controlled Trials, and EMBASE to identify randomized controlled trials (RCTs) that compared effect of TXA on bimaxillary OS with placebo. Outcomes of interests included intraoperative blood loss, allogenic transfusion, operation time, and volume of irrigation fluid. Random effects models were chosen considering that heterogeneity between studies was anticipated, and I 2 statistics were used to test for the presence of heterogeneity. Results: Totally 6 RCTs were identified. Tranexamic acid resulted in significantly reduced intraoperative blood loss (weighted mean difference [WMD] = −264.82 mL; 95% CI: −380.60 to −149.04 mL) and decreased amounts of irrigation fluid (WMD = −229.23 mL; 95% CI: −399.63 to −58.83 mL). However, TXA had no remarkable impact on risk of allogenic blood transfusion (pooled risk ratio = 0.50; 95% CI: 0.20-1.23), operation time (WMD = −8.71 min; 95% CI: −20.98 to 3.57 min), and length of hospital stay (WMD = −0.24 day; 95% CI: −0.62 to 0.14 day). No TXA-associated severe adverse reactions or complications were observed. Conclusions: Currently available meta-analysis reveals that TXA is effective in decreasing intraoperative blood loss; however, it does not reduce the risk of allogenic blood transfusion in bimaxillary OS.

P42 Predicting bleeding risk during meningioma surgery

2019 ◽  
Vol 90 (3) ◽  
pp. e35.3-e35
Author(s):  
A Tsyben ◽  
M Surour ◽  
K Budohoski ◽  
R Kirollos ◽  
A Helmy
Keyword(s):  
Multivariate Analysis ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Univariate Analysis ◽  
Estimate Blood Loss ◽  
Bleeding Risk ◽  
Intraoperative Blood Loss ◽  
Dural Tail ◽  
Meningioma Surgery ◽  
Tumour Characteristics

ObjectivesSurgical treatment of meningioma is frequently accompanied by significant intraoperative blood loss and the associated risks of blood transfusion. Surgical adjuncts such as pre-operative embolisation and the use of tranexamic acid have attendant risks. An ability to estimate blood loss can appropriately target these interventions.DesignRetrospective studySubjectsPatients following surgery for meningioma between 2015–2018MethodsIntraoperative blood loss, pre- to post-operative haemoglobin difference and blood transfusion were evaluated. Pre-operative imaging included size, shape and location of meningioma, involvement of sinuses and blood vessels, T1 and T2 weighted characteristics, restricted diffusion, peritumoral oedema, dural tail and hyperostosis. Multivariate analysis was used to determine the relationship between meningioma characteristics and blood loss.ResultsTumour diameter and venous sinus opening were significantly related to blood loss on multivariate analysis (p=0.004 and p=0.001 respectively). Furthermore, on univariate analysis additional factors included procedure duration (p<0.0001), pre-operative radiotherapy (p=0.042) and pre-operative platelet count (p=0.03).ConclusionsOnly size of tumour and opening venous sinuses was related to intraoperative bloods loss in this cohort of patients. Further research is required to define tumour characteristics that can be used to identify patients suitable for pre- and intra-operative adjunct therapies.

Ultrasonographic versus Fluoroscopic Access for Percutaneous Nephrolithotomy: A Meta-Analysis

2015 ◽  
Vol 95 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Kun Wang ◽  
Peijin Zhang ◽  
Xianlin Xu ◽  
Min Fan
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Controlled Trials ◽  
Intraoperative Blood Loss ◽  
Stone Free Rate ◽  
Operative Complications ◽  
Free Rate

Objective: To assess the safety and efficacy of ultrasonographic vs. fluoroscopic access for percutaneous nephrolithotomy (PCNL). Methods: Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify clinically controlled trials (CCTs) and randomized controlled trials (RCTs) that compared ultrasonographic access with fluoroscopic access for PCNL. RevMan 5.1 software and Stat Manager V4.1 software were used for the meta-analysis. Results: Five RCTs and nine CCTs were included in our study, which contained a total of 3,019 patients. Of these, 1,574 (52%) had undergone ultrasonographic access, and 1,445 (48%) had undergone fluoroscopic access. The pooled results revealed that the ultrasonographic access patients had shorter duration of access (min) by 2.56 min (weighted mean difference (WMD) = −2.56, 95% confidence interval (CI): −4.40 to −0.72, p = 0.006). There was a higher stone-free rate in the ultrasonographic access group (odds ratio (OR) = 1.26, 95% CI: 1.02-1.55, p = 0.03), as well as a lower rate of operative complications (OR = 0.72, 95% CI: 0.56-0.93, p = 0.01), reduced intraoperative blood loss (ml) (WMD = −14.55 ml, 95% CI: −27.65 to −1.46, p = 0.03), and a lower rate of blood transfusion requirement (OR = 0.39, 95% CI: 0.24-0.63, p = 0.0001). Sensitivity and subgroup analyses were also performed. Conclusion: Except for no radiation exposure, our meta-analysis revealed that ultrasonographic access had many advantages, such as a shorter access time, reduced intraoperative blood loss, a lower rate of operative complications, a lower rate of blood transfusion, and a higher stone-free rate. Because of these significant advantages, we recommend the use of ultrasonographic access for PCNL.

scholarly journals The role of Tranexamic acid in reducing the need for intraoperative and postoperative blood transfusion in patients undergoing arthroplasty for osteoarthritis

2021 ◽  
Vol 12 (1) ◽  
pp. 384-387
Author(s):  
Thiyagarajan U ◽  
Senthil Loganathan ◽  
Raghavendar ◽  
Pradeep P
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Low Dose ◽  
Postoperative Blood Loss ◽  
Renal Diseases ◽  
Intraoperative Blood Loss ◽  
Allogenic Blood ◽  
Postoperative Blood Transfusion ◽  
Mechanical Methods

Intraoperative blood loss and postoperative anaemia in patients undergoing arthroplasty of the hip and knee increase patient's morbidity and mortality. This increases the need for postoperative transfusion of blood products. Though mechanical methods like using tourniquet reduce the intraoperative blood loss, postoperative loss and resulting anaemia cannot be prevented. Our aim was to establish that the use of low dose tranexamic acid Intravenously and Topically in these patients reduce the total blood loss in these patients and hence the need for postoperative blood transfusion and associated complications of anaemia. Our study conducted in SRIHER between 2018-2020 prospectively, included an analysis of 84 patient's undergoing arthroplasty of the hip and knee. All patients included were above 55 years undergoing arthroplasty for hip and knee for osteoarthritis. Patients with h/o stroke, cardiac stents and chronic liver and renal diseases were excluded. Intravenous Tranexamic acid 1gm was given to all patients an hour before surgery as an infusion in normal saline along with tranexamic acid 500mg injected through the drain after closure. The average blood loss was 480ml intraoperatively and the average drain volume was 140ml. Only 14 patients (16.6%) had postoperative anaemia and required transfusion of allogenic blood. The mean postoperative haemoglobin in these patients was 12.2gm/dl. Our study indicates that low dose intravenous and topical Tranexamic acid significantly reduces the intraoperative and postoperative blood loss and resulting anaemia. This effectively reduces the need for postoperative blood transfusion and associated complications.

scholarly journals Prognostic Value of the C-Reactive Protein/Albumin Ratio and Systemic Immune-Inflammation Index for Patients With Colorectal Liver Metastasis Undergoing Curative Resection

2021 ◽  
Vol 27 ◽  
Author(s):  
Yuxiang Deng ◽  
Yujie Zhao ◽  
Jiayi Qin ◽  
Xiaozhen Huang ◽  
Ruomei Wu ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Prognostic Value ◽  
Curative Resection ◽  
Cox Regression ◽  
Independent Predictor ◽  
Receiver Operating Curve ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Immune Inflammation

Background: We evaluated the prognostic value of C-reactive protein/albumin (CAR) and systemic immune-inflammation index (SII), which we calculated as neutrophil × platelet/lymphocyte) in patients with colorectal liver metastasis (CRLM) after curative resection.Methods: We retrospectively enrolled 283 consecutive patients with CRLM who underwent curative resection between 2006 and 2016. We determined the optimal cutoff values of CAR and SII using receiver operating curve (ROC) analysis. Overall survival (OS)- and recurrence-free survival (RFS)-related to CAR and SII were analyzed using the log-rank test and multivariate Cox regression methods.Results: We found that a high CAR was significantly associated with poor OS (P &lt; 0.001) and RFS (P = 0.008) rates compared with a low CAR; a high SII was significantly associated with poor RFS (P = 0.003) rates compared with a low SII. The multivariate analysis indicated that CAR was an independent predictor of OS (hazard ratio [HR] = 2.220; 95% confidence interval [CI] = 1.387–3.550; P = 0.001) and RFS (HR = 1.494; 95% CI = 1.086–2.056; P = 0.014). The SII was an independent predictor of RFS (HR = 1.973; 95% CI = 1.230–3.162; P = 0.005) in patients with CRLM.Conclusion: We proved that CAR was an independent predictor of OS and RFS in patients with CRLM who underwent curative resection, and that the prognostic value of CAR was superior to that of SII.

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