Comparative analysis of vascular bulldog clamps used in laparoscopic liver resection

Intraperitoneal and Extraperitoneal Pringle Hepatic Hilar Occlusion in Laparoscopic Liver Resection: A Prospective Randomized Controlled Study

OBJECTIVE

This prospective randomized controlled study was conducted to evaluate the safety and efficacy of the Pringle hepatic hilar occlusion with a bulldog clamp in laparoscopic liver resection.

METHODS

From March 1, 2020 to July 31, 2021, 80 patients were enrolled, including 40 undergoing intraperitoneal Pringle maneuver (IPM) and 40 extraperitoneal Pringle maneuver (EPM). The observation indices included basic preoperative clinical characteristics and intraoperative and postoperative liver function indices.

RESULTS

There were no significant differences in the basic characteristics or types of hepatectomy, intraoperative blood loss, intraoperative blood transfusion, or hepatectomy time between the IPM and EPM groups. However, the blocking and operation time in the IPM group was shorter than that in the EPM group. There were no significant differences in alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels on the first day after surgery or in total bilirubin (TBIL) or albumin (ALB) levels on the first, third, or fifth days after surgery. However, C-reactive protein (CRP) levels on the first and third days, ALT and AST levels on the third and fifth days were lower, and hospital stay after surgery was shorter in the IPM group than in the EPM group.

CONCLUSION

IPM using bulldog clamps is simple, safe, and effective. The inflammatory reaction is less severe, the degree of liver function injury is lower, and recovery is faster.

Development and Validation of a Nomogram for Predicting Albumin Transfusion After Spinal Tuberculosis Surgery: Based on Propensity Score Matching Analysis

BACKGROUND

There have been few literature reports on the use of perioperative parameters to predict the risk of albumin transfusion after spinal tuberculosis surgery based on the application of nomogram and propensity score matching (PSM) analysis.

OBJECTIVE

The purpose was to predict the risk of albumin transfusion after spinal tuberculosis surgery based on a combination of PSM and nomogram.

METHODS

The clinical data of the patients were collected in our hospital, including preoperative clinical data, preoperative laboratory tests, and postoperative clinical data. All data were divided into 2 groups, including the albumin transfusion group and the non-albumin transfusion group. The PSM analysis was used to adjust the baseline data of the 2 groups. The nomogram was further constructed. The practicability and predictive ability of the model were evaluated.

RESULTS

A total of 494 cases were collected in this article; 102 pairs by PSM analysis were used to construct the nomogram. There were statistical differences in surgical approach, aspartate aminotransferase/alanine aminotransferase levels, drainage, and kyphosis by logistic analysis, and these parameters were included in the construction of the nomogram. The C-index of the prediction model was 0.734. The area under the curve was 0.73 and the net benefit was between 0.13 and 0.99. The calculated C-index was 0.71 by the internal verification method.

CONCLUSIONS

The PSM analysis had a good matching effect and the nomogram had a good predictive ability. Surgical approach, aspartate aminotransferase/alanine aminotransferase levels, drainage, and kyphosis might be predictors of albumin transfusion after spinal tuberculosis surgery.