title: Electrothermal bipolar coagulation decreases the rate of red blood cell transfusions for pelvic exenterations.
abstract: BACKGROUND
  We evaluated whether electrothermal bipolar coagulation (Ligasure) for pelvic exenterations decreases operative morbidity.
  
  
  METHODS
  All cases of pelvic exenterations, for all malignancies, performed at Moffitt Cancer Center from 1999 to 2008, were identified through retrospective review of medical records. Estimated blood loss (EBL), transfusion, operative time, hospital stay, and complications were compared between Ligasure cases and non-Ligasure cases.
  
  
  RESULTS
  Seventy-five patients underwent identified. Ligasure was used in 29/75 (39%) cases and standard techniques in 46/75 (61%) cases. Primary malignancy was gynecologic in 31/75(40%) cases (18/29, 62% Ligasure cases, 13/46, 26% non-Ligasure cases). Patients undergoing gynecologic exenteration received fewer intraoperative packed red blood cell (PRBC) transfusions in the Ligasure group (mean = 2.8 U), compared to the non-Ligasure group (mean = 3.8 U; P < 0.0001). The EBL was less for Ligasure cases (1,815 ml vs. 2,205 ml; P = 0.4). For all patients, Ligasure cases had lower mean transfusion (2.7 U vs. 3.2 U; P = 0.32), and EBL (1,662 ml vs. 1,843 ml; P = 0.5). The mean operating time was similar (492 min vs. 502 min). There were no cases of re-operation for hemorrhage in either group.
  
  
  CONCLUSIONS
  Use of electrothermal bipolar coagulation for gynecologic exenterative surgery is associated with significantly lower blood transfusions, and may decrease blood loss and transfusion in non-gynecologic exenterative surgery.
authors.affiliation: Division of Gynecological Oncology, Department of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, Florida 33612, USA.
authors.forename: Nisha
authors.initials: N
authors.lastname: Bansal
authors.forename: William S
authors.initials: WS
authors.lastname: Roberts
authors.forename: Sachin M
authors.initials: SM
authors.lastname: Apte
authors.forename: Johnathan M
authors.initials: JM
authors.lastname: Lancaster
authors.forename: Robert M
authors.initials: RM
authors.lastname: Wenham
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D004564:Electrocoagulation / Q000379:methods*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery; D010385:Pelvic Exenteration; D012189:Retrospective Studies