The renal sequelae of a novel triphasic approach to blood loss reduction during hepatic resection

Moug, S.J., Smith, D., Wilson, I.S., Leen, E. and Horgan, P.G. (2006) The renal sequelae of a novel triphasic approach to blood loss reduction during hepatic resection. European Journal of Surgical Oncology, 32(4), pp. 435-438. (doi: 10.1016/j.ejso.2006.01.011) (PMID:16520017)

Abstract

Aims: To report our novel triphasic approach to minimising blood loss during hepatic resection and the renal sequelae. Methods: Fifty consecutive patients (median age 63.3 years, range 37–86) underwent hepatic resection. Triphasic approach consisted of: pre-operative bowel preparation with no supplementary fluids; intraoperative intravenous fluid restriction with low central venous pressure (<5 cmH2O) and continuous selective occlusion of the left or right portal structures and corresponding hepatic vein/s. The following variables were analysed: blood loss; transfusion requirements; perioperative renal function; perioperative morbidity and mortality. Results: Median estimated blood loss was 330 mL (range 50–1200). No patient was transfused intraoperatively, with two patients transfused post-operatively. Median intraoperative urine output prior to hepatic re-perfusion was 28.4 mL/h (range 13.3–40.0) with no patient developing renal impairment. Morbidity occurred in 22% of patients with no documented hepatic failure. There was zero 30-day mortality. Conclusions: Pre-operative dehydration and intraoperative fluid restriction combined with continuous selective vascular occlusion minimizes blood loss during hepatic resection with no consequent detriment to renal function.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Horgan, Professor Paul and Moug, Ms Susan
• Authors: Moug, S.J., Smith, D., Wilson, I.S., Leen, E., and Horgan, P.G.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: European Journal of Surgical Oncology
• Publisher: Elsevier
• ISSN: 0748-7983
• Published Online: 07 March 2006