WAYS TO IMPROVE THE QUALITY OF INTRAOPERATIVE HEMOSTASIS IN RELATED HEPATOTRANSPLANTATION

Аннотация

Bleeding is a major complication of liver transplantation and a common cause of significant perioperative morbidity. To improve the results of related transplantation of the right lobe of the liver by improving the technique of stopping bleeding from the resection surface of the liver and veno-prosthetic anastomoses. 33 liver lobe recipients were selected for this study. To assess the effectiveness of the proposed method, two groups were formed: the main group - 18 recipients, the comparison group - 15 recipients. The proposed method for improving local hemostasis from the resection surface area and the suture line of veno-prosthetic anastomoses due to the combined action of two hemostatic agents reduced the duration of the general hemostatic stage of the operation from 87.0±29.9 to 40.3±9.8 minutes. An improved method for increasing the effectiveness of hemostasis in related transplantation is characterized by the combined use of a hemostatic sponge and a powdered composition "Hemoben" impregnated with plasma, which ensures activation and enhancement of the action of both local agents on the resected surface of the liver. Key words: liver transplantation; hemostatic sponges; hemostasis; "Hemoben". The relevance of the problem: Bleeding is a major complication of liver transplantation and a common cause of significant perioperative morbidity. Careful intraoperative hemostasis is required to reduce the risk of bleeding- related complications. Although hemostasis has been achieved by suturing, electrocoagulation, or surgical clamps, several hematopoiesis-promoting aids have been developed over the past two decades. These products are broadly divided into three groups: hemostatic agents for topical use, which cause blood clotting on a bleeding surface, sealants that prevent blood from flowing out of tissues, including vessels, and adhesives that hold tissues together. Intraoperative funds for local hemostasis have become indispensable in the modern surgical treatment of bleeding during operations. 71 THEORETICAL ASPECTS IN THE FORMATION OF PEDAGOGICAL SCIENCES International scientific-online conference The aim of the study is to improve the results of related transplantation of the right lobe of the liver by improving the technique of stopping bleeding from the resection surface of the liver and veno-prosthetic anastomoses. Materials and methods: 33 liver lobe recipients were selected for this study. To assess the effectiveness of the proposed method, two groups were formed: the main group - 18 recipients, the comparison group - 15 recipients. Results: the proposed method for improving local hemostasis from the resection surface area and the suture line of veno-prosthetic anastomoses due to the combined action of two hemostatic agents reduced the duration of the general hemostatic stage of the operation from 87.0±29.9 (95% CI: 70.5-103.5) to 40.3±9.8 minutes (95% CI: 35.4-45.1; t=5.80; p<0.05). Conclusions: An improved method for increasing the effectiveness of hemostasis in related transplantation is characterized by the combined use of a hemostatic sponge and a powdered composition "Hemoben" impregnated with plasma, which ensures activation and enhancement of the action of both local agents on the resected surface of the liver, as well as contributes to the formation of a hemostatic roller and strengthening the suture line of veno- prosthetic anastomoses.