New Surgical Technologies Could Facilitate Surgical Hemostasis in Hemophilic Patients

Milcho J. Panovski, Igor V. Fildishevski, Ljubomir Lj. Ognjenovic, Violeta I. Dejanova-Ilijevska

Abstract


BACKGROUND: It’s assumed that surgery in haemophilia can be accomplished these days safely.

AIM: The aim of this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in haemophiliacs.

METHODS: Two patients with mild haemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min before surgery. We used the available surgical technologies and techniques with a proven value in the best clinical practice, to achieve proper and permanent hemostasis. Postoperatively, the replacement therapy and thromboembolic prophylaxis was continued according to the international guidelines for the management of haemophilia.

RESULTS: The operative and post-operative periods were uneventful. No significant differences were found in the operation time in our hemophilic patients versus non-hemophilic patients. Significant differences related to the hospital stay duration were found in both patients compared with controls, due to the necessary replacement therapy.

CONCLUSION: With new surgical technologies, proper and permanent hemostasis can be achieved, without prolonging the operation time.

Keywords


Haemophilia; surgical hemostasis; Perioperative outcome; advanced bipolar technologies; Factor supply

Full Text:

PDF OnlineFirst

References


Bastounis E, Pikoulis E, Leppäniemi A, Alexiou D, Tsigris C, Tsetis A. General surgery in haemophiliac patients. Postgraduet Med J. 2000;76;494-495. https://doi.org/10.1136/pmj.76.898.494 PMid:10908378 PMCid:PMC1741703

Inokawa Y, Sugimoto H, Kanda M, Yamada S, Fujii T, Nomoto S, Takeda S, Suzuki N, Matsushita T, Kodera Y. Hepatectomy for hepatocellular carcinoma in patients with hemophilia. J Hepatobiliary Pancreat Sci. 2014; 21(11):824-8. https://doi.org/10.1002/jhbp.142 PMid:25082726

Shapiro A, Cooper DL. U.S. survey of surgical capabilities and experience with surgical procedures in patients with congenital haemophilia with inhibitors. Haemophilia. 2012; 18(3):400-5. https://doi.org/10.1111/j.1365-2516.2011.02698.x PMid:22168829

Leissinger C, Kruse-Jarres R. General Surgical Management of Patients with Hemophilia. in Textbook of Hemophilia, 3. Editor(s): Christine A. Lee, Erik E. Berntorp, W. Keith Hoots, 2014:197–203.

Rudowski WJ. Major surgery in hemophilia. Moynihan lecture 1980. Ann R Coll Surg Engl. 2981; 63; 110-117.

Karaman MI, Zulfikar B, Özturk MI, Koca O, Akyüz M, Bezgal F. Circumcision in bleeding disorders: improvement of our cost effective method with diathermic knife. Urol J. 2014; 6;11(2):1406-10.

Rodriguez-Merchan EC. Local fibrin glue and chitosan-based dressings in haemophilia surgery. Blood Coagul Fibrinolysis. 2012; 23(6):473-6. https://doi.org/10.1097/MBC.0b013e3283555379 PMid:22688558

Panovski M. Electrosurgery. Tabernakul, Skopje, 2013. PMid:24285353

Ly J, Mittal A, Windsor J. Systematic review and meta-analysis of cutting diathermy versus scalpel for skin incision. Br J Surg. 2012; 99(5):613-20. https://doi.org/10.1002/bjs.8708 PMid:22367850

Aird LN, Brown CJ. Systematic review and meta-analysis of electrocautery versus scalpel for surgical skin incisions. Am J Surg. 2012;204(2):216-21. https://doi.org/10.1016/j.amjsurg.2011.09.032 PMid:22537473

Blanchette VS, Key NS, Ljung LR, Manco-Johnson MJ, van den Berg HM, Srivastava A. Subcommittee on Factor VIII, Factor IX and Rare Coagulation Disorders of the Scientific and Standardization Committee of the International Society on Thrombosis and Hemostasis. Definitions in hemophilia: communication from the SSC of the ISTH. J Thromb Haemost. 2014; 12(11):1935-9. https://doi.org/10.1111/jth.12672 PMid:25059285

Arya S, Mackenzie H, Hanna GB. Non-vascular experimental and clinical applications of advanced bipolar radiofrequency thermofusion technology in the thorax and abdomen: a systematic review. Surg Endosc. 2015; 29(7):1659-78. https://doi.org/10.1007/s00464-014-3893-z PMid:25407912

Guidelines for the management of hemophilia. 2nd edition. Prepared by the Treatment Guidelines Working Group, on behalf of the World Federation of Hemophilia (WFH) Available from: http:// www.wfh.org

Guidelines for Diagnostic Laparoscopy. SAGES. Available from: http://www.sagescms.org

Lingohr P, Bensoukehal S, Matthaei H, Dohmen J, Nadal J, Vilz TO, Koscielny A, Oldenburg J, Kalff JC, Goldmann G. Value and risk of laparoscopic surgery in hemophiliacs-experiences from a tertiary referral center for hemorrhagic diatheses. Langenbecks Arch Surg. 2014; 399(5):609-18. https://doi.org/10.1007/s00423-014-1185-7 PMid:24691524

Panovski M, Karadzov Z, Velickovski A. Laparoscopic splenectomy: Achieving proper hemostasis. Hepatogastroenetrology. 2006;53 (suppl 1): 100.

Sankaranarayanan G, Resapu RR, Jones DB, Schwaitzberg S, De S. Common Uses and Cited Complications of Energy in Surgery. Surg Endosc. 2013; 27(9): 3056–3072. https://doi.org/10.1007/s00464-013-2823-9 PMid:23609857 PMCid:PMC3755039

Goldmann G, Holoborodska Y, Oldenburg J, Schaefer N, Hoeller T, Standop J, Kalff JC, Hirner A, Overhaus M. Perioperative management and outcome of general and abdominal surgery in hemophiliacs. Am J Surg. 2010; 199:702–707. https://doi.org/10.1016/j.amjsurg.2009.02.018 PMid:19837387

Coppola A, Windyga J, Tufano A, Yeung C, Di Minno MN. Treatment for preventing bleeding in people with haemophilia or other congenital bleeding disorders undergoing surgery. Cochrane Database Syst Rev. 2015; 9;(2):CD009961. https://doi.org/10.1002/14651858.cd009961.pub2

Hazendonk HC, Lock J, Mathôt RA, Meijer K, Peters M, Laros-van Gorkom BA, van der Meer FJ, Driessens MH, Leebeek FW, Fijnvandraat K, Cnossen MH. Perioperative treatment of hemophilia A patients: blood group O patients are at risk of bleeding complications. J Thromb Haemost. 2016; 14(3):468-78. https://doi.org/10.1111/jth.13242 PMid:26714028

Macario A, Dexter F, Sypal J, Cosgriff N, Heniford BT. Operative time and other outcomes of the electrothermal bipolar vessel sealing system (LigaSure) versus other methods for surgical hemostasis: a meta-analysis. Surg Innov. 2008;15(4):284-91. https://doi.org/10.1177/1553350608324933 PMid:18945705

Janssen PF, Brölmann HA, Huirne JA. Effectiveness of electrothermal bipolar vessel-sealing devices versus other electrothermal and ultrasonic devices for abdominal surgical hemostasis: a systematic review. Surg Endosc. 2012;26(10):2892-901. https://doi.org/10.1007/s00464-012-2276-6 PMid:22538684

Rodriguez-Merchan EC. Surgical wound healing in bleeding disorders. Haemophilia. 2012;18(4):487-90. https://doi.org/10.1111/j.1365-2516.2012.02760.x PMid:22335628

Aryal KR, Wiseman D, Siriwardena AK, Bolton-Maggs PH, Hay CR, Hill J. General Surgery in patients with a bleeding diathesis: how we do it. World J Surg. 2011;35(12):2603-10. https://doi.org/10.1007/s00268-011-1265-6 PMid:21953125




DOI: http://dx.doi.org/10.3889/oamjms.2017.062

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Refbacks

  • There are currently no refbacks.




Copyright (c) 2017 Milcho J. Panovski, Igor V. Fildishevski, Ljubomir Lj. Ognjenovic, Violeta I. Dejanova-Ilijevska

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 



Published by: Id Design 2012/DOOEL Skopje, Republic of Macedonia