000169071 001__ 169071
000169071 005__ 20260218135106.0
000169071 0247_ $$2doi$$a10.12998/wjcc.v7.i17.2477
000169071 0248_ $$2sideral$$a114014
000169071 037__ $$aART-2019-114014
000169071 041__ $$aeng
000169071 100__ $$aPérez Navarro, Guillermo
000169071 245__ $$aAnalysis of the postoperative hemostatic profile of colorectal cancer patients subjected to liver metastasis resection surgery
000169071 260__ $$c2019
000169071 5060_ $$aAccess copy available to the general public$$fUnrestricted
000169071 5203_ $$aBACKGROUND Liver resection surgery has advanced greatly in recent years, and the adoption of fasttrack programs has yielded good results. Combination anesthesia (general anesthesia associated to epidural analgesia) is an anesthetic-analgesic strategy commonly used for the perioperative management of patients undergoing surgery of this kind, though there is controversy regarding the coagulation alterations it may cause and which can favor the development of spinal hematomas. AIM To study the postoperative course of liver resection surgery, an analysis was made of the outcomes of liver resection surgery due to colorectal cancer metastases in our centre in terms of morbiditymortality and hospital stay according to the anesthetic technique used (general vs combination anesthesia). METHODS A prospective study was made of 61 colorectal cancer patients undergoing surgery due to liver metastases under general and combination anesthesia between January 2014 and October 2015. The patient characteristics, intraoperative variables, postoperative complications, evolution of hemostatic parameters, and stay in intensive care and in hospital were analyzed. RESULTS A total of 61 patients were included in two homogeneous groups: general anesthesia (n = 30) and combination anesthesia (general anesthesia associated to epidural analgesia) (n = 31). All patients had normal coagulation values before surgery. The international normalized ratio (INR) in both the general and combination anesthesia groups reached maximum values at 2448 h (mean 1.37 and 1.45 vs 1.39 and 1.41, respectively), followed by a gradual decrease. There was less intraoperative bleeding in the combination anesthesia group (769 mL) than in the general anesthesia group (1200 mL) (P < 0.05). Of the 61 patients, 38.8% in the general anesthesia group experienced some respiratory complication vs 6.6% in the combination anesthesia group (P < 0.001). The time to gastrointestinal tolerance was significantly correlated to the type of anesthesia, though not so the stay in critical care or the time to hospital discharge. CONCLUSION Epidural analgesia in liver resection surgery was seen to be safe, with good results in terms of pain control and respiratory complications, and with no associated increase in complications secondary to altered hemostasis.
000169071 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttps://creativecommons.org/licenses/by-nc/4.0/deed.es
000169071 590__ $$a1.013$$b2019
000169071 591__ $$aMEDICINE, GENERAL & INTERNAL$$b120 / 165 = 0.727$$c2019$$dQ3$$eT3
000169071 592__ $$a0.282$$b2019
000169071 593__ $$aMedicine (miscellaneous)$$c2019$$dQ3
000169071 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000169071 700__ $$0(orcid)0000-0001-9440-8282$$aPascual Bellosta Ana María$$uUniversidad de Zaragoza
000169071 700__ $$0(orcid)0000-0002-2378-8668$$aOrtega Lucea, Sonia María$$uUniversidad de Zaragoza
000169071 700__ $$0(orcid)0000-0002-2466-0711$$aSerradilla Martín, Mario$$uUniversidad de Zaragoza
000169071 700__ $$0(orcid)0000-0001-7964-1166$$aRamírez Rodríguez, José Manuel$$uUniversidad de Zaragoza
000169071 700__ $$0(orcid)0000-0003-2462-1904$$aMartínez Ubieto, Javier$$uUniversidad de Zaragoza
000169071 7102_ $$11004$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía,Ginecol.Obstetr.$$cÁrea Cirugía
000169071 773__ $$g7, 17 (2019), 2477-2486$$pWorld j. clin. cases$$tWorld Journal of Clinical Cases$$x2307-8960
000169071 8564_ $$s870845$$uhttps://zaguan.unizar.es/record/169071/files/texto_completo.pdf$$yVersión publicada
000169071 8564_ $$s2030440$$uhttps://zaguan.unizar.es/record/169071/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000169071 909CO $$ooai:zaguan.unizar.es:169071$$particulos$$pdriver
000169071 951__ $$a2026-02-18-12:23:39
000169071 980__ $$aARTICLE