title: Carrier-bound fibrin sealant compared to oxidized cellulose application after liver resection.
abstract: OBJECTIVE
  The aim of the study was to compare the incidence of post-operative complications between those patients that received TachoSil to the transection surface of the liver vs. those that received Surgicel.
  
  
  METHODS
  Retrospective study of a prospective database in a tertiary hospital. Primary endpoints were overall complications. Secondary endpoints were liver surgery-specific composite endpoint, major complications and hospital stay. Uni- and multivariate analysis of predictive factors for complications and subgroup analysis were performed.
  
  
  RESULTS
  One hundred thirty-three liver resections were performed between 9 November 2007 and 2 November 2011: 64 with TachoSil and 69 with Surgicel application. Both groups were equivalent concerning demographic, clinical and major intra-operative data. No significant differences were observed in overall complication rate (62.5% vs. 62.3%), liver surgery-specific composite endpoint (12.5% vs. 18.8%), major complication rate (18.7% vs. 24.6%) and median hospital stay (13 vs. 10 days) for TachoSil and Surgicel application, respectively. Predictive factors for complications in multivariate analysis were: American Society of Anesthesiology Score ≥3 and duration of surgery >240 min. Subgroup analysis found a reduced complication rate with TachoSil for major hepatectomy.
  
  
  CONCLUSIONS
  The results of the present study suggest that the routine use of TachoSil after a liver resection does not reduce the overall complication rate compared with Surgicel application. However, TachoSil may be beneficial in a major hepatectomy.
authors.affiliation: Hôpital Emile Muller, Mulhouse Cedex, France. zachariast@ch-mulhouse.fr
authors.forename: Thomas
authors.initials: T
authors.lastname: Zacharias
authors.forename: Nelio
authors.initials: N
authors.lastname: Ferreira
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002483:Cellulose, Oxidized / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000008:administration & dosage* / Q000009:adverse effects; D005602:France / Q000453:epidemiology; D006489:Hemostatic Techniques / Q000009:adverse effects; D006490:Hemostatics / Q000008:administration & dosage* / Q000009:adverse effects; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013917:Thrombin / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002483:Cellulose, Oxidized; D004338:Drug Combinations; D006490:Hemostatics; C518955:TachoSil; C013695:Surgicel; D005340:Fibrinogen; D013917:Thrombin