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- W2894894059 abstract "Background: The aim of the present study was to compare the outcome of combined colorectal and hepatic resections with and without pringle maneuver and to analyse the possible effect of liver-related factors on colonic anastomosis leakage. Methods: 250 Combined colorectal and hepatic resections performed in two european referral centers were stratified according to intraoperative use of Pringle maneuver. 71 procedures with Pringle (Pringle group) were matched with 71 procedures without pringle (NoPringle group) using propensity scores in a 1:1 ratio. Results: The two groups resulted similar in terms of preoperative characteristics (distibution of rectal tumors and neoadjuvant treatments). Intraoperative blood loss was reduced in the Pringle Group (150 ±100 mL) compared with the noPringle group(250 ± 200 mL, p=0.05), while postoperative morbidity (29.5% and 32.4% respectively) and incidence (9.9% in both groups) and severity of colonic fistula. At uni- and multivariate analysis for liver-related factors potentially affecting risk of colonic fistula, a preoperative albumin level < 3.5 g/dL resulted associated with leakage. Extension of liver resection, Pringle maneuver and length of Pringle maneuver did not show a significant correlation with anastomotic leakage. Conclusion: The use of Pringle maneuver in the setting of combined hepatic and colorectal resections allows to maintain a potential advantage in terms of reduction of intraoperative bleeding, without negatively affecting the risk of anastomotic leakage. On the contrary, an impaired synthesis of protein (resulting in a low preoperative level of albumin) seems to affect the risk of leakage, as a result of an ineffective wounds healing." @default.
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- W2894894059 date "2018-09-01" @default.
- W2894894059 modified "2023-10-16" @default.
- W2894894059 title "Pringle maneuver and risk of colonic leakage in combined colorectal and hepatic resections: myth or reality?" @default.
- W2894894059 doi "https://doi.org/10.1016/j.hpb.2018.06.2597" @default.
- W2894894059 hasPublicationYear "2018" @default.
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