Key result
Prolonged continuous Pringle maneuver reduced perioperative transfusion rates (17.4% vs 32.9%, p=0.034) and intraoperative bleeding (300 vs 400 ml, p<0.001) compared to intermittent maneuver.
Why the study?
Does prolonged continuous Pringle maneuver improve surgical outcomes compared to intermittent Pringle maneuver in patients undergoing complex hepatectomy for HCC?
Cohort (n=142)
Does prolonged continuous Pringle maneuver improve surgical outcomes compared to intermittent Pringle maneuver in patients undergoing complex hepatectomy for HCC?
Prolonged continuous Pringle maneuver improves intraoperative and short-term postoperative outcomes without compromising long-term survival or recurrence rates compared to intermittent Pringle maneuver in HCC patients undergoing complex hepatectomy.
Answers are grounded in this paper and cite their sources.
CPM may reduce operative time and bleeding without survival impact; hypothesis-generating for randomized comparison in complex HCC hepatectomy.
PURPOSE: To explore the differences between prolonged continuous Pringle maneuver (CPM) and prolonged intermittent Pringle maneuver (IPM) in patients with hepatocellular carcinoma (HCC), who underwent complex hepatectomy. METHODS: This retrospective cohort study performed between June 2014 and May 2016 included 142 patients who underwent complex hepatectomy for HCC and concomitant chronic liver disease but with good liver function. Patients were categorized into CPM (n = 69) and IPM groups (n = 73). The differences in these aspects were compared between the two groups which include operation time, intraoperative bleeding, perioperative transfusion, postoperative complications, liver function injury, postoperative overall survival (OS), and tumor recurrence. RESULTS: The cumulative clamping time, operation time, intraoperative bleeding, and perioperative transfusion rates were 38.0, 132 min, 300 ml, and 17.4% in CPM and 40.0, 145 min, 400 ml, and 32.9% in IPM, respectively. There were significant intergroup differences in operation time (p = 0.018), intraoperative bleeding (p < 0.001), and perioperative transfusion rates (p = 0.034). Besides, the postoperative complications and postoperative liver function injury of the CPM group were better than those of IPM. There was no significant intergroup difference in OS (p = 0.908) and tumor recurrence (p = 0.671) between two groups. CONCLUSION: Compared with IPM, CPM with a cumulative clamping time between 30 and 50 min can shorten operation time, reduce intraoperative bleeding and perioperative transfusion, and reduce postoperative complications and postoperative liver function injury in patients who underwent complex hepatectomy for HCC and concomitant liver disease but with good liver function. There was no significant difference in OS and tumor recurrence between two groups.
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Liu et al. (2021) conducted a cohort in Hepatocellular carcinoma with chronic liver disease (n=142). Prolonged continuous Pringle maneuver (CPM) vs. Prolonged intermittent Pringle maneuver (IPM) was evaluated on Perioperative transfusion rates (p=0.034). Prolonged continuous Pringle maneuver reduced perioperative transfusion rates (17.4% vs 32.9%, p=0.034) and intraoperative bleeding (300 vs 400 ml, p<0.001) compared to intermittent maneuver.
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