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一项多中心上市后临床研究,以确认PuraStat®在开放性肝切除术中控制出血的安全性和性能。

A multi-center post-market clinical study to confirm safety and performance of PuraStat® in the management of bleeding during open liver resection.

作者信息

Nahm Christopher B, Popescu Irinel, Botea Florin, Fenwick Stephen, Fondevila Constantine, Bilbao Itxarone, Reim Daniel, Toogood Giles J

机构信息

Western Clinical School, Faculty of Medical and Health Sciences, The University of Sydney, Sydney, Australia; St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Surgical Innovations Unit, Westmead Hospital, Sydney, Australia.

Institutul Clinic Fundeni - Centrul de Chirurgie Generala si Transplant Hepatic, Bucharest, Romania.

出版信息

HPB (Oxford). 2022 May;24(5):700-707. doi: 10.1016/j.hpb.2021.09.020. Epub 2021 Oct 6.

Abstract

BACKGROUND

PuraStat® is a non-bioactive haemostatic agent that has demonstrated efficacy in a number of different surgical procedures. We performed a prospective multi-centre post-market study to evaluate the efficacy and safety of PuraStat® in liver resections performed for metastatic tumors.

METHODS

This was a prospective cohort study. Patients undergoing liver resection for metastatic tumor were screened for eligibility, and included if they were ≥18 years old, undergoing open liver resection, had normal liver function, and required application of PuraStat® for haemostasis where standard haemostatic techniques were either insufficient or impractical. The primary endpoint was "time to haemostasis" (TTH). Secondary endpoints included blood loss, total postoperative drainage volume, transfusion of blood products, and ease of use.

RESULTS

Eighty patients were included for analysis in the intention to treat population. 207 bleeding sites were treated with PuraStat. Of these, 190 (91.7%) bleeding sites reached haemostasis after PuraStat® application. Mean TTH (mm:ss) was 1:01 (SD 1:06, range 0:09-6:55). Ease of use of the product was described as either "excellent" or "good" in 78 (98.8%) patients. No serious adverse events were identified.

CONCLUSION

This study confirms the safety, efficacy and ease of use of PuraStat® in the management of bleeding in liver surgery.

摘要

背景

PuraStat®是一种无生物活性的止血剂,已在多种不同的外科手术中显示出疗效。我们进行了一项前瞻性多中心上市后研究,以评估PuraStat®在转移性肿瘤肝切除术中的疗效和安全性。

方法

这是一项前瞻性队列研究。对因转移性肿瘤接受肝切除术的患者进行资格筛查,纳入标准为年龄≥18岁、接受开放性肝切除术、肝功能正常,且在标准止血技术不足或不实用时需要使用PuraStat®进行止血。主要终点是“止血时间”(TTH)。次要终点包括失血量、术后总引流量、血液制品输注情况和易用性。

结果

80例患者纳入意向性治疗人群进行分析。207个出血部位使用PuraStat进行治疗。其中,190个(91.7%)出血部位在使用PuraStat®后实现止血。平均止血时间(分钟:秒)为1:01(标准差1:06,范围0:09 - 6:55)。78例(98.8%)患者将该产品的易用性描述为“优秀”或“良好”。未发现严重不良事件。

结论

本研究证实了PuraStat®在肝手术出血管理中的安全性、有效性和易用性。

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