Major hepatectomy without blood transfusion: report of 51 cases.
BACKGROUND
Blood transfusion has been found to be a devastating factor for outcomes of hepatectomy. This study was to assess the value of major hepatectomy without blood transfusion.


METHODS
We retrospectively studied 51 patients who had undergone major hepatectomy without blood transfusion, including 29 patients with primary liver cancer, from August 1997 to December 2000. Sixty patients undergoing major hepatectomy with blood transfusion including 48 patients with primary liver cancer served as controls. Hepatectomy was performed through normothermic interruption of the porta hepatis. Intraoperative ultrasonography was performed to define tumor margins, and an ultrasound dissector was used to dissect liver parenchyma.


RESULTS
In the study group, the operative mortality and morbidity and 1-, 2-, and 3-year recurrence rates were 0%, 9.8%, 24.1%, 27.6% and 31.0%, respectively. In the control group, they were 3.3%, 28.3%, 43.5%, 54.3% and 58.7%, respectively. Significant differences were seen in morbidity and recurrence rates of patients with liver cancer between the two groups (P < 0.05).


CONCLUSIONS
Major hepatectomy without blood transfusion can reduce postoperative morbidity and recurrence rate of patients with liver cancer.
Rui
Jing-an
JA
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100032, China. rlzhou@mail.bjmu.edu.cn
Zhou
Li
L
Liu
Fu-di
FD
Chu
Qing-fu
QF
Wang
Shao-bin
SB
Chen
Shu-guang
SG
Qu
Qiang
Q
Wei
Xue
X
Han
Kai
K
Zhang
Ning
N
Zhao
Hai-tao
HT
D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000517:prevention & control