Symptoms and General Pathology

All Conditions

Neoplasms

Digestive System Diseases

Gland and Hormone Related Diseases

Rare Diseases

Hemorrhage

Pancreatic Neoplasms

Blood Loss, Surgical

Gastrointestinal Neoplasms

Digestive System Neoplasms

Endocrine Gland Neoplasms

Gastrointestinal Diseases

Pancreatic Diseases

Endocrine System Diseases

Intraoperative Complications

Pancreatic Cancer

In the pancreatic enucleation, Kocher Maneuver was routinely performed at first. Then free the left side of the abdominal trunk and superior mesenteric artery, loose tissues easy to free.After Kocher Maneuver and other surgical procedures, the abdominal trunk and superior mesenteric artery exposed. Before resection of pancreatic tumors, a vascular occlusion clamp clip was used to block the root of both the abdominal trunk and superior mesenteric artery to control the pancreatic blood flow.

blocking both the abdominal trunk and superior mesenteric artery in the pancreatic enucleation

Sheng Yan, professor

Bo Zhou, Dr.

Pancreatic enucleation could preserve more healthy pancreatic tissues and functions with a low recurrence risk. However, conventional enucleation can cause significant intraoperative bleeding, especially in which tumors in the pancreatic head, neck, and uncinate process of pancreas, as these tissues are rich in blood supply, mainly including the abdominal trunk and the superior mesenteric artery. In this study, we developed a novel method to control the pancreatic blood flow in laparoscopic enucleation--blocking the abdominal trunk and superior mesenteric artery with vascular occlusion clips in the process of resection, and evaluated its effectiveness and safety.

Between March 2023 and May 2026, patients who underwent laparoscopic pancreatic enucleation by blocking both the abdominal trunk and superior mesenteric artery in the Second Affiliated Hospital of Zhejiang University would be included in our prospective study. Inclusion criteria: 1) benign or borderline tumors diagnosed pathologically, such as pancreatic neuroendocrine tumors, solid pseudopapillary tumors, and cystadenomas, without vascular invasion or distant metastasis;.2) tumors sited in the pancreatic head, neck, and uncinate process of pancreas; 3) blockade of both the abdominal trunk and superior mesenteric artery in the laparoscopic enucleation. Exclusion criteria:1) highly malignant pancreatic tumors, or tumors with infiltration or metastasis; 2) tumors of the body and tail of the pancreas;3) transfer to LPD or laparotomy. Patient characteristic including clinical, biochemical and radiological data will be recorded and analyzed. All patients will provide written informed consent before inclusion.

Enucleation of Pancreatic Tumor by Blocking Abdominal Trunk and Superior Mesenteric Artery

A Prospective Study of Enucleation of Pancreatic Tumor by Blocking Abdominal Trunk and Superior Mesenteric Artery

The IPD in the current study are available from central contact person upon reasonable request.

blockade of both the abdominal trunk and superior mesenteric artery changes the blood loss

Zhejiang University

Director, Head of Hepatology and Pancreatology, Principal Investigator, Clinical Professor.

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Heart and Blood Diseases

Ovarian Neoplasms

Carcinoma, Ovarian Epithelial

Thromboembolism

Postoperative Hemorrhage

Carcinoma

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Genital Neoplasms, Female

Urogenital Neoplasms

Gonadal Disorders

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Ovarian Cancer

Ovarian Epithelial Cancer

Coagulants

All Drugs and Chemicals

Pharmaceutical Solutions

Tranexamic Acid

Antifibrinolytic Agents

Hemostatics

The group of women receiving Tranexamic acid intravenously immediately before the surgery

The group of women receiving saline solution (0.9% NaCl) intravenously immediately before the surgery

Tranexamic acid, 100 mg/ml; 15 mg/kg body weight added to 100 ml 0.9% NaCl solution given as a single dose intravenously immediately prior to skin incision at surgery

Tranexamic acid

0.9% NaCl solution; 0.15 ml/kg body weight added to 100 ml 0.9% NaCl solution. The volume is given intravenously immediate before skin incision at surgery.

0.9% NaCl solution

Ulf Leandersson, MD

Laila Falknäs, MD

Preben Kjölhede, MD,PhD

Torsten Johansson, MD, PhD

Helena Zachrisson, MD,PhD

The purpose of the study is to determine if a standardized single dose tranexamic acid given intravenously immediately preoperatively reduces the perioperative bleeding volume and reduces the need of blood transfusion in women undergoing surgery for advanced ovarian cancer.

Tranexamic Acid in Surgery of Advanced Ovarian Cancer

Tranexamic Acid in Surgery of Advanced Ovarian Cancer - a Prospective Randomized Double Blind Placebo Controlled Study

Estimation of total blood loss was based on the estimation of the Hb balance method (Brecher, et al.1997) with the assumption that the body blood volume was normalised on the fifth postoperative day. The haemoglobin level was assessed preoperatively and on the fifth postoperative day. The predicted blood volume (PBV, l) was calculated according to the method described by Nadler et al. (1962), using body weight and height. The extravasation of haemoglobin was calculated taking into account allogenic transfused haemoglobin. Total blood loss perioperatively was related to the patient's preoperative haemoglobin value. Blood loss due to haematomas or a reoperation within the first five days after surgery was also considered.

Total number of RBC-transfused women in each group

Total number of red blood cells (RBC) transfused across all participants

Median number of red blood cells transfused among those who received RBC transfusions

Thromboembolic events including arterial thrombosis, muscle vein thrombosis, superficial and deep venous thrombosis.

Preben Kjolhede, MD, professor

Associate professor

Systematic and non-systematic assessment.

Tranexamic acid

Tranexamic acid: Tranexamic acid, 100 mg/ml; 15 mg/kg body weight added to 100 ml 0.9% NaCl solution given as a single dose intravenously immediately prior to scin incision at surgery

Tranexamic Group

0.9% NaCl solution

0.9% NaCl solution: 0.9% NaCl solution; 0.15 ml/kg body weight added to 100 ml 0.9% NaCl solution. The volume is given intravenously immediate before scin incision at surgery.

Placebo Group

Total

Age, Continuous

<60 years of age

60-69 years of age

>=70 years of age

Age, Customized

Female

Sex/Gender, Customized

Sweden

Region of Enrollment

Height

Weight

Body mass index

Normal weight (BMI<25)

Overweight (BMI 25-29)

Obese (BMI >=30)

Parity

Smokers

Low-dose aspirin medication

Cardiac disease

Arterial hypertension/vascular disease

Diabetes mellitus

Previous hysterectomy

Previous laparotomy

Predicted Blood Volume (PBV)

RBC transfusion preoperatively

The study was not powered for postoperative complications in general. Only 56% of the women participated in the duplex ultrasound assessment of the legs, which was an optional investigation according to the trial protocol. This indicates a risk of bias for the outcome of thromboembolic complications.

Professor Dr. Preben Kjölhede

All patients underwent surgery. A negative value of total blood loss was received when the postoperative haemoglobin level was higher than the preoperative haemoglobin or when a blood transfusion was given, based on the Hb balance method of blood loss calculation.

Perioperative Bleeding Volume

Number of Patients Receiving Blood Transfusions

Number of Units of Red Blood Cells (RBC) Transfused

The group of women receiving saline solution (0.9% NaCl) intravenously immediately before the surgery

0.9% NaCl solution: 0.9% NaCl solution; 0.15 ml/kg body weight added to 100 ml 0.9% NaCl solution. The volume is given intravenously immediate before skin incision at surgery.

The Placebo Group

The group of women receiving Tranexamic acid intravenously immediately before the surgery

Tranexamic acid: Tranexamic acid, 100 mg/ml; 15 mg/kg body weight added to 100 ml 0.9% NaCl solution given as a single dose intravenously immediately prior to skin incision at surgery

The Tranexamic Acid Group

Participants who received RBC transfusions

Median Number of Transfused Units of Red Blood Cells (RBC)

Information about postoperative events after discharge retrieved in patient file for the patients with withdrew consent prior to 5-weeks follow-up.

56% of the patients underwent lower extremity duplex ultrasound.

Number of Patients With Clinically or Radiologically Verified Thromboembolic Events Within 5 Weeks Postoperatively

Overall Study

Musculoskeletal Diseases

Neoplasm Metastasis

Spinal Neoplasms

Neoplasms, Second Primary

Neoplastic Processes

32 patients with spinal metastasis/metastases will undergo arteriography and receive transcatheter arterial embolization of spinal metastasis/metastases 0-48 hours prior to surgery.

32 patients with spinal metastasis/metastases will undergo arteriography of spinal metastasis/metastases without receiving transcatheter arterial embolization prior to surgery.

Arteriography and transcatheter arterial embolization of spinal metastasis/metastases 0-48 hours prior to surgery.

Arteriography and preoperative embolization

Arteriography of spinal metastasis/metastases without transcatheter arterial embolization prior to surgery.

Arteriography

Lars Lönn, MD, Ph.d.

The main purpose of this study is to assess the efficacy of preoperative embolization in decreasing operative blood loss, decreasing the need for intraoperative transfusion and facilitate surgical resection in metastatic spine surgery. Furthermore the study aims at describing the vascularity in a series of spinal metastasis, and to correlate this with perioperative blood loss.

Preoperative Embolization in Surgical Treatment of Spinal Metastases.

Preoperative Embolization in Surgical Treatment of Spinal Metastases. A Randomized Controlled Trial.

Defined as the amount of time (measured in minutes) from skin incision to skin closure.

Rigshospitalet, Denmark

Blood and Lymph Conditions

Anemia

Hematologic Diseases

People with a preoperative hematocrit less than 0.39

People with a preoperative hematocrit greater than or equal to 0.39

The objective is to measure the adjusted association between preoperative anemia and total hospital costs. We hypothesize that patients with anemia before surgery will have higher hospitalization costs than people without anemia.

This study will examine the association between preoperative anemia (hematocrit less than 0.39; low blood counts) and hospital total costs from elective colorectal surgery. Total costs will be defined as the combination of direct and indirect costs ascertained using standardized patient-level costing algorithms (i.e. the standard way that hospital measure their costs). Adjustment will be made for factors that are likely to influence both the presence of anemia and costs of care.

Association of Anemia With Hospital Costs in Elective Colorectal Surgery

Direct and indirect costs accrued during the index hospitalization

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Enucleation of Pancreatic Tumor by Blocking Abdominal Trunk and Superior Mesenteric Artery	NCT06164769	Tumor of Pancre... Surgical Blood ...	blocking both t...	14 Years - 70 Years	Zhejiang University
Tranexamic Acid in Surgery of Advanced Ovarian Cancer	NCT00740116	Ovarian Cancer	Tranexamic acid 0.9% NaCl solut...	18 Years -	University Hospital, Linkoeping
Tranexamic Acid in Surgery of Advanced Ovarian Cancer	NCT00740116	Ovarian Cancer	Tranexamic acid 0.9% NaCl solut...	18 Years -	University Hospital, Linkoeping
Preoperative Embolization in Surgical Treatment of Spinal Metastases.	NCT01365715	Spinal Metastas...	Arteriography a... Arteriography	18 Years -	Rigshospitalet, Denmark
Association of Anemia With Hospital Costs in Elective Colorectal Surgery	NCT03476707	Surgery Surgical Blood ... Anemia Colon Cancer Economic Proble...	Anemia	18 Years -	Ottawa Hospital Research Institute

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