title: Risk Factors Associated with Intraoperative Major Blood Loss during Resection of Hepatocellular Carcinoma.
abstract: OBJECTIVE
  Intraoperative blood loss is an independent predictor of recurrence and survival after resection of hepatocellular carcinoma (HCC). The aim of this study was to identify the risk factors associated with intraoperative major blood loss in patients undergoing liver resection for HCC.
  
  
  METHODS
  Clinicopathologic data and perioperative outcomes of 386 patients who underwent liver resection for HCC were retrospectively reviewed. The patients were divided into high (> 1,000 mL) and low (51,000 mL) blood loss groups according to the intraoperative blood loss. Intraoperative blood loss,more than 1,000 mL was defined as major blood loss. The risk factors associated with intraoperative major blood loss were analyzed by univariate and multivariate analyses.
  
  
  RESULTS
  Vascular invasion, major hepatectomy and prolonged operation time were risk factors associated with intraoperative major blood loss during resection of HCC on multivariate analysis. Moreover, HCC patients with intraoperative major blood loss had prolonged hospital stay, higher incidence of postoperative complication and mortality compared with patients' with blood loss 1,000 mL.
  
  
  CONCLUSIONS
  Vascular invasion, major hepatectomy and prolonged operation time are independent predictors of intraoperative major blood loss during resection of HCC.
authors.forename: Jing-song
authors.initials: JS
authors.lastname: Chen
authors.forename: Jiong-qiang
authors.initials: JQ
authors.lastname: Huang
authors.forename: Xi-lin
authors.initials: XL
authors.lastname: Chen
authors.forename: Gao-fang
authors.initials: GF
authors.lastname: Zhan
authors.forename: Ju-tao
authors.initials: JT
authors.lastname: Feng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000628:therapy; D006498:Hepatectomy; D006499:Hepatic Artery / Q000473:pathology; D006503:Hepatic Veins / Q000473:pathology; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000628:therapy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D047368:Tumor Burden
chemical_list: D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase