The Influence of Resection Size and Pringle Maneuver on Operating Time and Intraoperative Bleeding in Patients with Colorectal Metastases in the Liver

Stefan Petrovski; Aleksandar Serafimov; Marija Karakolevska-Ilova; Elena Joveva; Lidija Petrovska; Ljubica Adzi-Andov

doi:10.3889/oamjms.2023.11600

Authors

Stefan Petrovski Faculty of Medical Sciences, Goce Delcev University, Shtip, Macedonia; Clinical Hospital Stip, Shtip, Macedonia
Aleksandar Serafimov Faculty of Medical Sciences, Goce Delcev University, Shtip, Macedonia; Clinical Hospital Stip, Shtip, Macedonia https://orcid.org/0000-0003-3638-1397
Marija Karakolevska-Ilova Faculty of Medical Sciences, Goce Delcev University, Shtip, Macedonia; Clinical Hospital Stip, Shtip, Macedonia
Elena Joveva Faculty of Medical Sciences, Goce Delcev University, Shtip, Macedonia; Clinical Hospital Stip, Shtip, Macedonia https://orcid.org/0000-0001-9659-1535
Lidija Petrovska Faculty of Medical Sciences, Goce Delcev University, Shtip, Macedonia; Clinical Hospital Stip, Shtip, Macedonia https://orcid.org/0009-0000-0684-9177
Ljubica Adzi-Andov Faculty of Medical Sciences, Goce Delcev University, Shtip, Macedonia; Specialized Hospital for Gynecology and Obstetrics Dr. Organdziski Stip, Shtip, Macedonia

DOI:

https://doi.org/10.3889/oamjms.2023.11600

Keywords:

Pringle maneuver, Intraoperative bleeding, Colorectal metastases, Resection size

Abstract

BACKGROUND: The extent of the resection, whether clamped or non-clamping resection is factor that influences the operating time and intraoperative bleeding, the development of modern techniques for vascular control and resection, and determine of lesser blood loss, morbidity, and mortality.

AIM: The aim of this study was to determine the experience of General and Hepatobiliary Surgery Clinic at Aleksandrovska Hospital Sofia, Republic of Bulgaria in the treatment of patients with colorectal metastases in the liver and to compare literature reports on the influence of the extent of resection and Pringle maneuver (IPM) on operating time and perioperative bleeding.

MATERIALS AND METHODS: This retrospective study covers the time period from January 01, 2006, until December 31, 2015. A total of 239 patients were included, from which: 179 patients were treated with radical surgery, 5 with palliative intervention, and 55 were subjected on operability exploration.

RESULTS: The use of the IPM for vascular control insignificantly influenced the prolonged operative time, while intraoperative blood loss was significantly lower in patients with Pringle <15 min. There was no association between IPM and resection type, while intraoperative blood loss and operating time were significantly greater in patients with major resection.

CONCLUSION: Resection size is directly proportional to operating time and perioperative blood loss, but it does not significantly influence perioperative morbidity. The IPM does not influence operating time, while blood loss is significantly lower in the group of patients with Pringle <15 min.

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