Kamamoto Dai, Kanazawa Tokunori, Ishihara Eriko, Yanagisawa Kaoru, Tomita Hideyuki, Ueda Ryo, Jinzaki Masahiro, Yoshida Kazunari, Toda Masahiro
Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo.
Department of Neurosurgery, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga city, Tochigi.
Surg Neurol Int. 2020 Feb 7;11:16. doi: 10.25259/SNI_272_2019. eCollection 2020.
Hemostasis plays an important role in safe brain tumor resection and also reduces the risk for surgical complications. This study aimed to evaluate the efficacy of FLOSEAL, a topical hemostatic agent that contains thrombin and gelatin granules, in brain tumor resections.
We evaluated the hemostatic effect of FLOSEAL by scoring the intensity of bleeding from 1 (mild) to 4 (life threatening). We assessed the rate of success of hemostasis with 100 patients who underwent intracranial tumor resection. We also investigated the duration of the operation, the amount of intra- and postoperative bleeding, the number of hospital stays, and adverse events in patients who used FLOSEAL compared with those who did not use FLOSEAL.
FLOSEAL was applied to a total of 109 bleeding areas in 100 patients. A total of 95 bleeding areas had a score of 1 and 91 (96%) showed successful hemostasis. Thirteen bleeding areas scored 2 and 8 (62%) showed hemostasis with the first application of FLOSEAL. The second application was attempted with five bleeding areas and four showed hemostasis. About 94% (103/109 areas) of bleeding points successfully achieved hemostasis by FLOSEAL. Moreover, FLOSEAL significantly decreased the amount of intraoperative bleeding and postoperative bleeding as assessed with computed tomography on 1 day postoperatively compared with no use of FLOSEAL. There were no adverse events related to FLOSEAL use.
Our results indicate that FLOSEAL is a reliable, convenient, and safe topical hemostatic agent for intracranial tumor resection.
止血在安全的脑肿瘤切除术中起着重要作用，还可降低手术并发症的风险。本研究旨在评估含有凝血酶和明胶颗粒的局部止血剂FLOSEAL在脑肿瘤切除术中的疗效。
我们通过将出血强度从1（轻度）到4（危及生命）进行评分来评估FLOSEAL的止血效果。我们评估了100例行颅内肿瘤切除术患者的止血成功率。我们还调查了使用FLOSEAL与未使用FLOSEAL的患者的手术时间、术中和术后出血量、住院天数及不良事件。
100例患者共109个出血区域应用了FLOSEAL。共有95个出血区域评分为1，其中91个（96%）显示止血成功。13个出血区域评分为2，首次应用FLOSEAL时8个（62%）显示止血。对5个出血区域尝试了第二次应用，4个显示止血。约94%（103/109个区域）的出血点通过FLOSEAL成功止血。此外，与未使用FLOSEAL相比，术后1天通过计算机断层扫描评估，FLOSEAL显著减少了术中和术后出血量。未发生与使用FLOSEAL相关的不良事件！
我们的结果表明，FLOSEAL是一种用于颅内肿瘤切除的可靠、方便且安全的局部止血剂。
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