Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center

BMC Gastroenterology

Mayu Fukushima¹  Takanori Sakaguchi²  Atsuko Fukazawa²  Shinya Ida³  Yoshihiro Hiramatsu³  Yoshifumi Morita³  Makoto Takeda³  Hiroya Takeuchi³  Ryuta Muraki³  Ryo Kitajima³  Satoru Furuhashi³  Hirotoshi Kikuchi³  Eisaku Okada⁴ 

[1]Department of Diagnostic Pathology, Hamamatsu University School of Medicine

[2]Department of Gastroenterological Surgery, Iwata City Hospital

[3]Department of Surgery, Hamamatsu University School of Medicine

[4]Faculty of Social Policy and Administration, Hosei University

关键词: Hemostatic device;    Hepatectomy;    Intra-abdominal infection;    Ascites;    Propensity score matching;   

DOI  :  10.1186/s12876-022-02231-y

来源: DOAJ

【 摘 要 】

Abstract Background Various hemostatic devices have been utilized to reduce blood loss during hepatectomy. Nonetheless, a comparison between monopolar and bipolar coagulation, particularly their usefulness or inferiority, has been poorly documented. The aim of this study is to reveal the characteristics of these hemostatic devices. Methods A total of 264 patients who underwent open hepatectomy at our institution from January 2009 to December 2018 were included. Monopolar and bipolar hemostatic devices were used in 160 (monopolar group) and 104 (bipolar group) cases, respectively. Operative outcomes and thermal damage to the resected specimens were compared between these groups using propensity score matching according to background factors. Multivariate logistic regression analysis was performed to identify predictive factors for postoperative complications. Results After propensity score matching, 73 patients per group were enrolled. The monopolar group had significantly lower total operative time (239 vs. 275 min; P = 0.013) and intraoperative blood loss (487 vs. 790 mL; P < 0.001). However, the incidence rates of ascites (27.4% vs. 8.2%; P = 0.002) and grade ≥ 3 intra-abdominal infection (12.3% vs. 2.7%; P = 0.028) were significantly higher in the monopolar group. Thermal damage to the resected specimens was significantly longer in the monopolar group (4.6 vs. 1.2 mm; P < 0.001). Use of monopolar hemostatic device was an independent risk factor for ascites (odds ratio, 5.626, 95% confidence interval 1.881–16.827; P = 0.002) and severe intra-abdominal infection (odds ratio, 5.905, 95% confidence interval 1.096–31.825; P = 0.039). Conclusions Although monopolar devices have an excellent hemostatic ability, they might damage the remnant liver. The use of monopolar devices can be one of the factors that increase the frequency of complications.

【 授权许可】

Unknown