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Impact of blood transfusion on early outcome of liver resection for colorectal hepatic metastases
Author(s) -
Gruttadauria Salvatore,
Saint Georges Chaumet Maureen,
Pagano Duilio,
Marsh J. Wallis,
Bartoccelli Carlo,
Cintorino Davide,
Arcadipane Antonio,
Vizzini Giovanni,
Spada Marco,
Gridelli Bruno
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21796
Subject(s) - medicine , surgery , hepatectomy , blood transfusion , concomitant , malignancy , grading (engineering) , resection , blood loss , colorectal cancer , complication , incidence (geometry) , cancer , civil engineering , physics , optics , engineering
Background The use of intra‐operative blood transfusion has been associated with worse surgical outcome in patients undergoing liver resection for malignancy. Methods In a series of 127 consecutive patients who underwent partial liver resection for colorectal metastases, between July 1999 and March 2010, we studied, post‐operative 90 days surgical outcome using Clavien multi‐tier grading system, and the effect of a variety of related factors, including type of resection, surgical technique used, concomitant colo‐rectal resection, non‐tumoral hepatic histological findings, site of primary tumor, and comorbidities, on the incidence of intra‐operative blood transfusion. Results Patients who received blood transfusions during their liver resection were more likely to have a longer post‐operative length of stay, to experience Clavien Grade IIIa or worse complication. Undergoing a major resection and the presence of portal fibrosis in the non‐tumoral liver tissue were both correlated with an increase in intra‐operative blood transfusions. Conclusion These clinical findings suggest that although several significant factors do not seem to influence the short‐term outcome of surgery, it is important to be aware of the deleterious effects of the type of resection performed and the presence of portal fibrosis on blood loss during partial liver resection. J. Surg. Oncol. 2011; 103:140–147. © 2010 Wiley‐Liss, Inc.