Perioperative management and outcome of general and abdominal surgery in hemophiliacs

• Published in: The American journal of surgery Vol. 199; no. 5; pp. 702 - 707
• Main Authors: Goldmann, Georg, M.D, Holoborodska, Yaroslava, M.S, Oldenburg, Johannes, M.D, Schaefer, Nico, M.D, Hoeller, Tobias, Ph.D, Standop, Jens, M.D, Kalff, Joerg C., M.D., F.A.C.S, Hirner, Andreas, M.D, Overhaus, Marcus, M.D
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2010; Elsevier; Elsevier Limited
• Subjects: Abdomen; Abdominal surgery; Adolescent; Adult; Aged; Aged, 80 and over; Appendectomy; Biological and medical sciences; Blood Transfusion - methods; Blood Transfusion - statistics & numerical data; Case-Control Studies; Cause of Death; Child; Cholecystectomy; Complications; Digestive System Surgical Procedures - adverse effects; Digestive System Surgical Procedures - methods; Disease; Drains; Factor supply; Female; Follow-Up Studies; General aspects; General Surgery - methods; Hematologic and hematopoietic diseases; Hemophilia; Hemophilia A - diagnosis; Hemophilia A - mortality; Hemophilia A - surgery; Hemorrhoids; Hepatitis; Hernia; Hernias; Hospital Mortality - trends; Humans; Infections; Interdisciplinary aspects; Laparoscopy; Length of Stay; Male; Management; Medical sciences; Middle Aged; Mortality; Pain; Patients; Perioperative Care - methods; Perioperative outcome; Platelet diseases and coagulopathies; Probability; Reference Values; Retrospective Studies; Risk Assessment; Statistics, Nonparametric; Studies; Surgery; Surgical drains; Survival Analysis; Treatment Outcome; Viral infections; Young Adult; Germany; Perioperative outcome; Factor supply; Surgery; Hemophilia; Prognosis; Accessibility; General surgery; Supply; Hemopathy; Genetic disease; Medicine; Perioperative; Clinical management; Evolution; Coagulopathy
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2009.02.018

Abstract Background The aim of the current study was to investigate perioperative management and outcome of surgery in hemophiliacs. Methods Fifty-five hemophiliacs underwent surgery (appendectomy, cholecystectomy, inguinal hernia repair, hemorrhoidectomy). Surgical procedures in hemophiliacs and matched pairs were analyzed for duration of surgery, drainages, hospital stay, factor use (VIII, IX), and complications. Factor substitution was analyzed. Mann–Whitney U and Kruskal-Wallis tests were used ( P < .05). Results No significant differences were found for duration of drains and operation time in hemophiliacs versus matched pairs. Significance for duration of hospital stay compared with controls was found in hemophiliacs for appendectomy, inguinal hernia repair, and hemorrhoidectomy but not for cholecystectomy. In both groups, complications were low without significant differences. Conclusions This study found no significant differences in perioperative data and postoperative outcome in hemophiliacs compared with nonhemophiliacs due to the excellent perioperative interdisciplinary management at our Hemophilia Center with prolonged hospital stay in hemophiliacs.