title: Effectiveness of a new carrier-bound fibrin sealant versus argon beamer as haemostatic agent during liver resection: a randomised prospective trial.
abstract: OBJECTIVE
  A new carrier-bound fibrin sealant, TachoSil, is expected to be efficacious and safe as a haemostatic treatment in hepatic resection.
  
  
  METHODS
  A prospective, randomised, open and controlled multicentre trial with intraoperative as well as postoperative assessment of efficacy and a 1 month follow-up period.
  
  
  METHODS
  Tertiary care centres.
  
  
  METHODS
  One hundred and twenty-one patients requiring secondary haemostasis during planned liver resection. Patients with coagulation disorders and patients with persistent major bleeding after primary haemostatic measures were excluded.
  
  
  METHODS
  Application of either carrier-bound fibrin sealant (n=59) or argon beamer (argon beam coagulator) (n=62) as secondary haemostatic treatment.
  
  
  METHODS
  Time to intraoperative haemostasis.
  
  
  RESULTS
  There was a significant superiority of TachoSil over argon beamer with regard to time to haemostasis (3.9 min, median 3.0, range 3-20 min vs 6.3 min, median 4.0, range 3-39 min) (P=0.0007). Haemoglobin concentration of drainage fluid was significantly lower on day 2 after surgery in TachoSil patients (1.1 mmol/l) than in argon beamer patients (2.3 mmol/l) (P=0.012). Overall, the frequency and causality of adverse events did not differ between the two treatment groups.
  
  
  CONCLUSIONS
  TachoSil is superior to argon beamer in obtaining effective and fast intraoperative haemostasis. The safety data show TachoSil to be tolerable and safe for haemostatic treatment in liver resection.
authors.affiliation: Department of General Surgery and Transplantation, University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany. frilling@uni-essen.de
authors.forename: Andrea
authors.initials: A
authors.lastname: Frilling
authors.forename: Gregor A
authors.initials: GA
authors.lastname: Stavrou
authors.forename: Hans-Jörg
authors.initials: HJ
authors.lastname: Mischinger
authors.forename: Bernard
authors.initials: B
authors.lastname: de Hemptinne
authors.forename: Mogens
authors.initials: M
authors.lastname: Rokkjaer
authors.forename: Jürgen
authors.initials: J
authors.lastname: Klempnauer
authors.forename: Anders
authors.initials: A
authors.lastname: Thörne
authors.forename: Beat
authors.initials: B
authors.lastname: Gloor
authors.forename: Susanne
authors.initials: S
authors.lastname: Beckebaum
authors.forename: Mohamed F A
authors.initials: MF
authors.lastname: Ghaffar
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: D004337:Drug Carriers; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000627:therapeutic use*; D006498:Hepatectomy; D006801:Humans; D017075:Laser Coagulation; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D004337:Drug Carriers; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics
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