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LigaSure Use Decreases Intraoperative Blood Loss Volume and Blood Transfusion Volume in Sarcoma Surgery

Levine, Nicole L. BA; Zhang, Yidan MD; Hoang, Bang H. MD; Yang, Rui MD; Jurkowski, Zachary H. BS; Roth, Michael E. MD; Gill, Jonathan B. MD; Lo, Yungtai PhD; Eisenberg, Ruth E. MS; Bekarev, Mikhail MD; Gorlick, Richard MD; Geller, David S. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: November 15, 2019 - Volume 27 - Issue 22 - p 841-847
doi: 10.5435/JAAOS-D-18-00144
Research Article

Introduction: The LigaSure system has been successfully used in thoracic and abdominal surgery. However, to date, its use in the resection of sarcomas has not been systematically studied. We aimed to determine whether the use of the LigaSure system reduces blood loss and blood transfusion volumes in sarcoma surgery.

Methods: One hundred forty-two consecutive patients who underwent sarcoma surgeries between July 2010 and October 2016 were included. Conventional electrocautery alone (n = 91) and with LigaSure (n = 51) were compared. Case-matched samples (n = 46) from each group were additionally compared.

Results: The use of the LigaSure system resulted in a significant decrease in mean intraoperative blood loss (P = 0.02) and blood transfusion volume (P = 0.04). Likewise, a significant decrease in both mean and median intraoperative blood loss (P = 0.003; P < 0.0001) was seen with LigaSure in the case-matched analysis. In the soft-tissue sarcoma subgroup, a significant decrease was observed in mean hemoglobin reduction (P = 0.03) and mean intraoperative blood loss with LigaSure (P = 0.04). No adverse perioperative complications attributed to the LigaSure system were identified.

Conclusions: The LigaSure vessel sealing and dividing system is a safe and effective hemostatic tool for deep dissection in bone and soft-tissue sarcoma surgery.

Level of Evidence: Level III, therapeutic study

From the Albert Einstein College of Medicine (Ms. Levine), Musculoskeletal Tumor Center, Beijing Key Laboratory for Musculoskeletal Tumors, Peking University People's Hospital (Dr. Zhang), the Department of Orthopaedic Surgery, Montefiore Medical Center, (Dr. Hoang, Dr. Yang, Dr. Bekarev, and Dr. Geller), the Tulane University School of Medicine (Mr. Jurkowski), Division of Pediatrics, University of Texas, MD Anderson Cancer Center (Dr. Roth, Dr. Gill, and Dr. Gorlick), and the Department of Epidemiology & Population Health, Albert Einstein College of Medicine, (Dr. Lo and Ms. Eisenberg).

Correspondence to Dr. Geller:

None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Ms. Levine, Dr. Zhang, Dr. Hoang, Dr. Yang, Mr. Jurkowski, Dr. Roth, Dr. Gill, Dr. Lo, Ms. Eisenberg, Dr. Bekarev, Dr. Gorlick, and Dr. Geller.

Copyright 2019 by the American Academy of Orthopaedic Surgeons.
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