Factors associated with increased blood loss in patients undergoing radical cystectomy in a contemporary series / 中华外科杂志
Chinese Journal of Surgery
;
(12): 831-834, 2012.
Artículo
en Chino
| WPRIM
| ID: wpr-245781
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate factors predictive of blood loss in radical cystectomy in a contemporary series.</p><p><b>METHODS</b>From December 1996 to December 2008, clinical data of 233 patients who underwent radical cystectomy were reviewed retrospectively. Various preoperative and operative factors were assessed for their association with blood loss using univariate, multivariate regression and correlation analysis.</p><p><b>RESULTS</b>One hundred eighty-one patients underwent open radical cystectomy and 52 cases were treated by laparoscopic radical cystectomy. Overall mean operative time was (339 ± 84) minutes, and mean blood loss was (818 ± 756) ml. On univariate analysis, body mass index (F = 9.039), history of pelvic operation (t = -4.365), anesthetic techniques (t = 3.125), surgical type (t = 6.643), use of Ligasure (t = 6.923), and urethra resection (t = -1.984) correlated with blood loss. However, multiple linear regression showed that body mass index (R(2) = 0.256, P < 0.001), history of pelvic operation (R(2) = 0.222, P < 0.001), use of Ligasure (R(2) = 0.172, P < 0.001), and surgical type (R(2) = 0.271, P = 0.027) were significant predictors of blood loss. The transfusion was required in 176 of 233 patients (75.5%) with a median requirement of (649 ± 569) ml. Likewise logistical regression analysis revealed that older age (OR = 3.2, P = 0.010), female gender (OR = 33.7, P = 0.013), anemia (OR = 6.6, P = 0.039), increased blood loss (OR = 14.3, P < 0.001), open radical cystectomy (OR = 6.4, P = 0.036) and nonuse of Ligasure (OR = 10.1, P < 0.001) were predictors of transfusion need.</p><p><b>CONCLUSIONS</b>Increased body mass index, history of pelvic operation, open radical cystectomy, and non-use of Ligasure were independent predictors of increased blood loss during radical cystectomy. Such a prediction formula has an important role in identifying high risk patient for increased blood loss and transfusion need before radical cystectomy.</p>
Texto completo:
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Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Cirugía General
/
Neoplasias de la Vejiga Urinaria
/
Cistectomía
/
Estudios Retrospectivos
/
Factores de Riesgo
/
Pérdida de Sangre Quirúrgica
/
Métodos
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Chino
Revista:
Chinese Journal of Surgery
Año:
2012
Tipo del documento:
Artículo
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