Table 1.
Demographical Data and Hemangioma Characteristics of the Patients
| Variables | Massive Blood Loss Group (n = 24) | Minor Blood Loss Group (n = 116) | P Value |
|---|---|---|---|
| Demographics | |||
| Age (y, Mean ± SD) | 43.5 ± 8.7 | 45.5 ± 9.6 | 0.345 |
| Gender (%) | 0.738 | ||
| Male | 7 (29.2) | 30 (25.9) | |
| Female | 17 (70.8) | 86 (74.1) | |
| BMI (kg/m2) | 0.078 | ||
| < 28 | 19 (79.2%) | 106 (91.4%) | |
| ≥ 28 | 5 (20.8%) | 10 (8.6%) | |
| Abdominal surgery history | 5/24 (20.8%) | 35/116 (30.2%) | 0.357 |
| ASA grading | 0.557 | ||
| < 2 | 18 (75%) | 80 (69%) | |
| ≥ 2 | 6 (25%) | 36 (31%) | |
| Liver cirrhosis | — | 3 (2.6%) | - |
| Diabetes mellitus | 1 (4.2%) | 9 (7.8%) | 0.852 |
| Hypertension | 2 (8.3%) | 14 (12.1%) | 0.864 |
| Cardiovascular disease | — | 3 (2.6%) | - |
| Pulmonary disease | — | 4 (3.4%) | - |
| Smoking | 2 (8.3%) | 14 (12.1%) | 0.864 |
| Alcohol | — | 13 (11.2%) | - |
| Characteristic of Hemangiomas | |||
| Diameter (cm) | 0.344 | ||
| < 15 | 22 (91.7%) | 111 (95.7%) | |
| ≥ 15 | 2 (8.3%) | 5 (4.3%) | |
| Location | < 0.001 | ||
| Other segments | 5 (20.8%) | 83 (71.6%) | |
| I, IVa, VII, VIII | 19 (79.2%) | 33 (28.4%) | |
| Number | |||
| Single | 18 (75%) | 97 (83.6%) | 0.379 |
| Multiple | 6 (25%) | 19 (16.4%) | |
| Involved segments | |||
| ≤ 2 | 17 (70.8%) | 94 (81%) | 0.262 |
| > 2 | 7 (29.2%) | 22 (19%) | |
| Hilar compress | 5/24 (20.8%) | 8/116 (6.9%) | 0.048 |
| Liver vein compress | 16/24 (66.7%) | 27/116 (23.3%) | < 0.001 |
SD, standard deviation; BMI, body mass index; ASA, American Society of Anesthesiologists.
Univariate logistic regression analysis yielded four risk factors associated with the massive blood loss group: location of the hemangioma (P < .001), postcaval or hepatic venous compression (P < .001), hepatic hilar compression (P = .042), and BMI greater than 28 (P = .088). These four were then analyzed by the multifactorial logistic regression model. The specific location of the hemangioma (Couinaud I, IVa, VII, and VIII liver segments) was determined to be the single most important individual risk factor (P = .012) for intraoperative massive blood loss in laparoscopic surgery for hepatic hemangioma (Table 2).