Anatomie resection for severe blunt liver trauma in 100 patients: Significant differences between young and elderly

Abstract

The liver is the organ most commonly injured during blunt abdominal trauma. As our society ages, emergency surgery for active elderly patients increases, but data on aggressive emergency hepatic resection remain scarce in the literature. The purpose of this study was to determine whether the elderly (70 years of age or older) can tolerate major liver injury and subsequent hepatic resection. We investigated 100 patients who were treated by an anatomic resection for severe blunt liver trauma (29 elderly patients who were 70 years of age or older and 71 young patients who were younger than 70 years of age) in a retrospective study. The elderly patients were more severely injured as demonstrated by a higher Injury Severity Score, a lower Glascow Coma Scale, and lower survival (80.3% vs. 65.5%; p < 0.05). The total number of associated injuries was greater in elderly patients. Motor vehicle accidents were responsible for 71.8% of the injuries in the young group, and the predominant mechanism in the elderly patients was also motor vehicle accidents (51.7%). The 71 anatomic hepatic resections performed on the young patients included right hemihepatectomy (n = 45), left lateral segment resection (n = 14), bisegmentectomy (n = 5), and others. The 29 anatomic hepatic resections performed for the elderly patients were right hemihepatectomy (n = 15), left lateral segment resection (n = 5), left hemihepatectomy (n = 4), and others. Pneumonia, subphrenic abscess, and urosepsis occurred at a significantly higher frequency in elderly patients than in young patients. Our data clearly indicated that (1) the mechanism of injury, grade of associated intraabdominal injuries, distribution of surgical procedures, and complications differ significantly between young and elderly patients; and (2) the survival rate (65.5%) in elderly patients may be sufficient to consider anatomic hepatic resection to be a useful, safe procedure.

Comparison of the hemostatic efficiency of Ankaferd Blood Stopper and fibrin glue on a liver laceration model in rats

“…There was no significant difference between the period of hemostasis in Groups 2 and 3, whereas the same period was evidently longer in Group 4 (17 (15-20) sec, 18 (16)(17)(18)(19)(20) sec, 70 (64-74) seconds, respectively; p<0.05). No significant difference was detected between the groups regarding intraabdominal adhesion levels (Group 1: 1 (0-1), Group 2: 2 (1-3), Group 3: 2 (1-3), Group 4: 2 (1-3); p>0.05).…”

“…Fiyat, uygulama kolaylığı ve muhafaza edilme özellikleri de seçimi etkilemektedir. [17,18] Fibrin deriveleri topikal hemostatik olarak denenmiş materyallerdir. Topikal hemostazis başta olmak üzere yapışıklık formasyonu, yara kapanması, fistül tedavisi ve doku yapıştırma gibi birçok cerrahi işlem-de başarıyla kullanılmışlardır.…”

“…ABS ve FY gruplarında topikal hemostaz zamanı arasında anlamlı fark bulunmazken, kontrol grubunda bu süre belirgin olarak daha uzundu, sırasıyla 17 (15)(16)(17)(18)(19)(20) sn, 18 (16)(17)(18)(19)(20) sn, 70 (64-74) sn (p<0,05). Karın içi yapışıklık değerlen-dirmesinde çalışma grupları arasında belirgin farklılık gö-rülmedi, Grup 1: 1 (0-1), Grup 2: 2 (1-3), Grup 3: 2 (1-3), Grup 4: 2 (1-3) (p>0,05).…”

“…Karaciğer laserasyonundan sonra tespit edilen medyan (minimum -maksimum) kanama zamanı değerleri 2. grup için 17 (15)(16)(17)(18)(19)(20) Karın içi yapışıklıkların değerlendirilmesinde yapışıklıklar sıklıkla omentum ile karaciğer ve omentum ile abdominal skar arasındaydı. Medyan (minimum -maksimum) yapışıklık skorları 1., 2., 3. ve 4. grup için sırasıyla 1 (0-1), 2 (1-3), 2 (1-3) ve 2 (1-3) olarak belirlendi.…”

Trauma hepático: análise do tratamento com balão intra-hepático em um hospital universitário de Curitiba

“…The ICU was used by four (57.14%) surviving patients, who stayed in intensive care for a mean of 9.75 days (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). In the group of patients who died, six (54.5%) had stayed in the ICU for 7.5 (1-20) days on average.…”