An interventional study of IVC clamping in Surgical Approach & Incisions and Blood Loss, sponsored by Eastern Hepatobiliary Surgery Hospital. Status unknown. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2015-08-06.
Sponsored by Eastern Hepatobiliary Surgery Hospital · Not applicable, Interventional, and Treatment
Anterior approach results in better operative and survival outcomes compared with the conventional approach in patients with large hepatocellular carcinoma (HCC), but anterior approach has the problem of bleeding from the hepatic vein.
Our previous study showed that infrahepatic inferior vena cava (IVC) clamping can reduce blood loss during conventional hepatic resection. The investigators guess infrahepatic IVC clamping may also reduce blood loss in anterior approach right hepatic resection. So the investigators conduct this prospective, randomized, controlled trial to compare anterior approach combined with infrahepatic IVC clamping and anterior approach in major right hepatectomy for large HCC.
Traditionally, mobilisation of the right hemiliver followed by right hepatic vein control before parenchymal transection has been considered the standard approach to a major right hepatectomy. However, this approach is often difficult and hazardous when performing liver resection for large hepatocellular carcinoma (HCC) or for tumors with extrahepatic organ invasion in the right retrohepatic region.In setting of right hepatectomy by an anterior approach,liver mobilisation is performed only at the end of parenchymal transection, when all vascular connections have already been interrupted.The anterior approach was found to be associated with significantly less intraoperative blood loss, less blood transfusions and a lower hospital mortality rate.However,excessive bleeding can occur at the deeper plane of parenchymal transection from the right hepatic vein or middle hepatic vein.
Bleeding from the hepatic veins is closely related to the CVP.Our previous retrospective analysisfound that the infrahepatic inferior vena cava (IVC) clamping is efficacious in reducing CVP without the need of systemic fluid restriction and is associated with significantly less intraoperative blood loss during complex hepatectomy.
The aim of the present study was therefore to evaluate if the application of the anterior approach combined with infrahepatic IVC clamping during right hepatectomy for large HCC reduces intraoperative blood loss.
3,000 studies on the registry are indexed under Hemorrhage; 474 are open to participants now.
This study's planned enrollment of 100 is close to the median of 100 across 1,985 interventional studies indexed under Hemorrhage.
Browse Hemorrhage studies →Eastern Hepatobiliary Surgery Hospital is the lead sponsor of 66 studies on the registry; 13 are open to participants now.
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Exclusion Criteria:
Use anterior approach combined with infrahepatic Inferior Vena Cava clamping in right hepatectomy for HCC patients.
Procedure: IVC clamping
Only use anterior approach in right hepatectomy for HCC patients.
in right hepatectomy,use anterior approach and infrahepatic Inferior Vena Cava clamping.
intraoperative total blood loss
Time frame: participants will be followed for the duration of the entire operation,an expected average of 140 minutes
operation time
Time frame: the duration of the entire operation,an expected average of 140 minutes
intraoperative CVP value
Time frame: participants will be followed for the duration of the parenchymal transection,an expected average of 20 minutes
morbidity and mortality
Time frame: participants will be followed for the duration of the postoperative hospital stay,an expected average of 15 days
postoperative hepatorenal function
Time frame: postoperative day 1,3 and 7
postoperative hospital stay
Time frame: the duration of the postoperative hospital stay,an expected average of 15 days
disease-free survival duration and overall survival duration
Time frame: the duration from operation to recurrence or death,an expected average of 3 years
blood loss during parenchymal transection
Time frame: the duration of the parenchymal transection,an expected average of 20 minutes
No study locations are listed for this record.
This study is status unknown, as verified in Aug 2015. You cannot join it, but the record below documents what was studied.
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Eastern Hepatobiliary Surgery Hospital