Lee Jeong-Moo, Hong Kwangpyo, Han Eui Soo, Suh Sanggyun, Hong Suyoung, Hong Suk Kyun, Choi YoungRok, Yi Nam-Joon, Lee Kwang-Woong, Suh Kyung-Suk
Department of Surgery, Seoul National University Hospital, Seoul, Korea.
Ann Transl Med. 2021 Jul;9(13):1050. doi: 10.21037/atm-21-1318.
Recipient hepatectomy during liver transplantation (LT) is one of the most challenging aspects of surgery due to the possibility of massive bleeding. This study aimed to compare and analyze the effectiveness between LigaSure and monopolar cautery in recipients.
We reviewed 187 recipients who underwent LT from March 2019 to June 2020. We compared the surgical outcomes of the 69 recipients who underwent recipient hepatectomy with LigaSure (LigaSure group) and 118 recipients who underwent with monopolar cautery. Propensity score matching (PSM) was performed using the nearest-neighbor method at a ratio of 1:1 based on 14 baseline characteristics and possible factors that influence postoperative bleeding.
A total of 187 adult recipients were reviewed retrospectively. In the propensity score-matched analysis, The rates of bleeding and infectious complication were significantly lower in the LigaSure group than in the monopolar cautery group (3/69, 4.35% versus 13/69, 18.8%; P=0.015 and 1/69, 1.45% versus 9/69, 13.0%; P=0.017). The length of postoperative hospital stay was shorter in the LigaSure group (mean: 23.1±16.1 versus 39.6±58.2 days; P=0.024).
Recipient hepatectomy with LigaSure is associated with a short hospital stay due to low re-operation rates, postoperative bleeding, and secondary infection related to bleeding.
肝移植(LT)术中受者肝切除术是手术中最具挑战性的环节之一,因为存在大出血的可能性。本研究旨在比较和分析LigaSure与单极电灼在受者肝切除术中的有效性。
我们回顾了2019年3月至2020年6月期间接受肝移植的187例受者。我们比较了69例行LigaSure受者肝切除术的受者(LigaSure组)和118例行单极电灼受者肝切除术的受者的手术结果。基于14项基线特征和可能影响术后出血的因素,采用最近邻法以1:1的比例进行倾向评分匹配(PSM)。
共对187例成年受者进行了回顾性研究。在倾向评分匹配分析中,LigaSure组的出血率和感染并发症发生率显著低于单极电灼组(3/69,4.35%对13/69,18.8%;P = 0.015;1/69,1.45%对9/69,13.0%;P = 0.017)。LigaSure组术后住院时间较短(平均:23.1±16.1天对39.6±58.2天;P = 0.024)。
使用LigaSure进行受者肝切除术因再次手术率低、术后出血及与出血相关的继发感染而住院时间短。