Perioperative management and outcome of general and abdominal surgery in hemophiliacs

Goldmann, Georg; Holoborodska, Yaroslava; Oldenburg, Johannes; Schaefer, Nico; Hoeller, Tobias; Standop, Jens; Kalff, Joerg C.; Hirner, Andreas; Overhaus, Marcus

doi:10.1016/j.amjsurg.2009.02.018

« Previous Next »The American Journal of Surgery
Volume 199, Issue 5 , Pages 702-707, May 2010

Perioperative management and outcome of general and abdominal surgery in hemophiliacs

Georg Goldmann, M.D.
- Institute for Experimental Hematology and Transfusion Medicine, University of Bonn, Bonn, Germany
- G.G. and Y.H. contributed equally to this work.
Yaroslava Holoborodska, M.S.
- Department of General, Visceral, Thoracic, and Vascular Surgery, University of Bonn, Bonn, Germany
- G.G. and Y.H. contributed equally to this work.
Johannes Oldenburg, M.D.
- Institute for Experimental Hematology and Transfusion Medicine, University of Bonn, Bonn, Germany
Nico Schaefer, M.D.
- Department of General, Visceral, Thoracic, and Vascular Surgery, University of Bonn, Bonn, Germany
Tobias Hoeller, Ph.D.
- Institute for Medical Biometrics, Informatics and Epidemiology, University of Bonn, Bonn, Germany
Jens Standop, M.D.
- Department of General, Visceral, Thoracic, and Vascular Surgery, University of Bonn, Bonn, Germany
Joerg C. Kalff, M.D., F.A.C.S.
- Department of General, Visceral, Thoracic, and Vascular Surgery, University of Bonn, Bonn, Germany
Andreas Hirner, M.D.
- Department of General, Visceral, Thoracic, and Vascular Surgery, University of Bonn, Bonn, Germany
Marcus Overhaus, M.D.
- Department of General, Visceral, Thoracic, and Vascular Surgery, University of Bonn, Bonn, Germany
- Corresponding author. Tel.: +49 228 287 15857; fax: +49 228 287 14856

Received 3 December 2008; received in revised form 3 February 2009 published online 19 October 2009.

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.

Keywords: Hemophilia, Surgery, Perioperative outcome, Factor supply