Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 18;408(1):122.
doi: 10.1007/s00423-023-02853-0.

Impact of obstructive ventilatory impairment on intraoperative bleeding during laparoscopic hepatectomy

Masanori Nakamura  1   2 , Yukiyasu Okamura  3   4   5 , Teiichi Sugiura  1 , Ryo Ashida  1 , Katsuhisa Ohgi  1 , Mihoko Yamada  1 , Shimpei Otsuka  1 , Goro Nakayama  2 , Yasuhiro Kodera  2 , Katsuhiko Uesaka  1
Affiliations

Impact of obstructive ventilatory impairment on intraoperative bleeding during laparoscopic hepatectomy

Masanori Nakamura et al. Langenbecks Arch Surg. .

Abstract

Purpose: An animal model of laparoscopic hepatectomy showed that bleeding from the hepatic vein is influenced by airway pressure. However, there are little research reports on how airway pressure leads to risks in clinical practice. The main objective of this study was to investigate the impact of preoperative forced expiratory volume % in 1 s (FEV1.0%) on intraoperative blood loss in laparoscopic hepatectomy.

Methods: All patients who underwent pure laparoscopic or open hepatectomy from April 2011 to July 2020 were classified into two groups by preoperative spirometry: those with obstructive ventilatory impairment (obstructive group; FEV1.0% < 70%) and those with normal respiratory function (ormal group; FEV1.0% ≥ 70%). Massive blood loss was defined as 400 mL for laparoscopic hepatectomy.

Results: In total, 247 and 445 patients underwent pure laparoscopic and open hepatectomy, respectively. Regarding laparoscopic hepatectomy group, blood loss was significantly greater in the obstructive group (122 vs. 100 mL, P = 0.042). Multivariate analysis revealed that high IWATE criteria which classify the surgical difficulty of laparoscopic hepatectomy (≥ 7, odds ratio (OR): 4.50, P = 0.004) and low preoperative FEV1.0% (< 70%, OR: 2.28, P = 0.043) were independent risk factors for blood loss during laparoscopic hepatectomy. In contrast, FEV1.0% did not affect the blood loss (522 vs. 605 mL, P = 0.113) during open hepatectomy.

Conclusion: Obstructive ventilatory impairment (low FEV1.0%) may affect the amount of bleeding during laparoscopic hepatectomy.

Keywords: FEV1.0%; Laparoscopic hepatectomy; Massive intraoperative bleeding; Obstructive ventilatory impairment; Spirometry.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Wakabayashi G, Cherqui D, Geller DA, Han HS, Kaneko H, Buell JF (2014) Laparoscopic hepatectomy is theoretically better than open hepatectomy: preparing for the 2nd International Consensus Conference on Laparoscopic Liver Resection. J Hepatobiliary Pancreat Sci 21:723–731 - PubMed
    1. Tranchart H, O’Rourke N, Van Dam R et al (2015) Bleeding control during laparoscopic liver resection: a review of literature. J Hepatobiliary Pancreat Sci 22:371–378 - PubMed
    1. Rosen CB, Nagorney DM, Taswell HF et al (1992) Perioperative blood transfusion and determinants of survival after liver resection for metastatic colorectal carcinoma. Ann Surg 216:493–505 - PubMed - PMC
    1. Sitzmann JV, Greene PS (1994) Perioperative predictors of morbidity following hepatic resection for neoplasm. A multivariate analysis of a single surgeon experience with 105 patients. Ann Surg. 219:13–17 - PubMed - PMC
    1. Yamamoto J, Kosuge T, Takayama T et al (1994) Perioperative blood transfusion promotes recurrence of hepatocellular carcinoma after hepatectomy. Surgery 115:303–309 - PubMed

LinkOut - more resources