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SHR Neuro Cancer Cardio Lipid Metab Microb

Rahbari, NN; Elbers, H; Koch, M; Vogler, P; Striebel, F; Bruckner, T; Mehrabi, A; Schemmer, P; Büchler, MW; Weitz, J.
Randomized clinical trial of stapler versus clamp-crushing transection in elective liver resection.
Br J Surg. 2014; 101(3):200-207 Doi: 10.1002/bjs.9387
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Co-authors Med Uni Graz: Schemmer Peter
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Abstract:: Various devices have been developed to facilitate liver transection and reduce blood loss in liver resections. None of these has proven superiority compared with the classical clamp-crushing technique. This randomized clinical trial compared the effectiveness and safety of stapler transection with that of clamp-crushing during open liver resection. Patients admitted for elective open liver resection between January 2010 and October 2011 were assigned randomly to stapler transection or the clamp-crushing technique. The primary endpoint was the total amount of intraoperative blood loss. Secondary endpoints included transection time, duration of operation, complication rates and resection margins. A total of 130 patients were enrolled, 65 to clamp-crushing and 65 to stapler transection. There was no difference between groups in total intraoperative blood loss: median (i.q.r.) 1050 (525-1650) versus 925 (450-1425) ml respectively (P = 0·279). The difference in total intraoperative blood loss normalized to the transection surface area was not statistically significant (P = 0·092). Blood loss during parenchymal transection was significantly lower in the stapler transection group (P = 0·002), as were the parenchymal transection time (mean(s.d.) 30(21) versus 9(7) min for clamp-crushing and stapler transection groups respectively; P < 0·001) and total duration of operation (mean(s.d.) 221(86) versus 190(85) min; P = 0·047). There were no significant differences in postoperative morbidity (P = 0·863) or mortality (P = 0·684) between groups. Stapler transection is a safe technique but does not reduce intraoperative blood loss in elective liver resection compared with the clamp-crushing technique. NCT01049607 (http://www.clinicaltrials.gov). © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.
Find related publications in this database (using NLM MeSH Indexing): Analysis of Variance -; Blood Loss, Surgical - prevention & control; Constriction -; Female -; Hepatectomy - methods; Humans -; Liver Diseases - surgery; Male -; Middle Aged -; Operative Time -; Perioperative Care - methods; Postoperative Complications - etiology; Surgical Stapling -; Treatment Outcome -