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Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis

Purpose: To assess the pattern of intra-operative blood loss at various surgical stages comparing between single and two surgeons. Methods: Lenke 1 and 2 adolescent idiopathic scoliosis (AIS) patients who underwent instrumented posterior spinal fusion (PSF) surgery from two centres between June 2014...

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Main Authors: Kwan, Mun Keong, Chiu, Chee Kidd, Chan, Chris Yin Wei
Format: Article
Published: Springer Verlag (Germany) 2017
Subjects:
R Medicine
Online Access:http://eprints.um.edu.my/17656/
http://dx.doi.org/10.1007/s00586-016-4803-y
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spelling my.um.eprints.176562019-12-06T06:10:46Z http://eprints.um.edu.my/17656/ Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis Kwan, Mun Keong Chiu, Chee Kidd Chan, Chris Yin Wei R Medicine Purpose: To assess the pattern of intra-operative blood loss at various surgical stages comparing between single and two surgeons. Methods: Lenke 1 and 2 adolescent idiopathic scoliosis (AIS) patients who underwent instrumented posterior spinal fusion (PSF) surgery from two centres between June 2014 and December 2015 were prospectively recruited into this study. The patients were grouped into Group 1 (single surgeon) and Group 2 (two surgeons). One to one matching using ‘prospective propensity score-matched cohort patient sampling method’ was done. The surgery was divided into six stages: stage 1—exposure, stage 2—screw insertion, stage 3—release, stage 4—correction, stage 5—corticotomies and bone grafting and stage 6—closure. Results: A total of 116 patients were recruited. Of 86 patients who were operated by the two surgeons, 30 patients were matched with 30 patients that were operated by a single surgeon. Operation duration was significantly longer in Group 1 (257.3 ± 51.4 min) compared to Group 2 (164.0 ± 25.7 min). The total blood loss was significantly higher in Group 1 (1254.7 ± 521.5 mL) compared to Group 2 (893.7 ± 518.4 mL). Total blood loss/level fused was significantly higher in Group 1 (117.5 ± 42.8 mL/level) compared to Group 2 (82.6 ± 39.4 mL/level). Group 1 had significantly higher blood loss and blood loss/level fused for stages 1, 2 and 3. Group 2 had lower incidence of allogenic blood transfusion. Conclusions: In PSF surgery for AIS patients, two-surgeon strategy was associated with shorter operation duration, lesser blood loss and lower incidence of allogenic blood transfusion. Springer Verlag (Germany) 2017 Article PeerReviewed Kwan, Mun Keong and Chiu, Chee Kidd and Chan, Chris Yin Wei (2017) Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis. European Spine Journal, 26 (1). pp. 155-161. ISSN 0940-6719 http://dx.doi.org/10.1007/s00586-016-4803-y doi:10.1007/s00586-016-4803-y
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Kwan, Mun Keong
Chiu, Chee Kidd
Chan, Chris Yin Wei
Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis
description Purpose: To assess the pattern of intra-operative blood loss at various surgical stages comparing between single and two surgeons. Methods: Lenke 1 and 2 adolescent idiopathic scoliosis (AIS) patients who underwent instrumented posterior spinal fusion (PSF) surgery from two centres between June 2014 and December 2015 were prospectively recruited into this study. The patients were grouped into Group 1 (single surgeon) and Group 2 (two surgeons). One to one matching using ‘prospective propensity score-matched cohort patient sampling method’ was done. The surgery was divided into six stages: stage 1—exposure, stage 2—screw insertion, stage 3—release, stage 4—correction, stage 5—corticotomies and bone grafting and stage 6—closure. Results: A total of 116 patients were recruited. Of 86 patients who were operated by the two surgeons, 30 patients were matched with 30 patients that were operated by a single surgeon. Operation duration was significantly longer in Group 1 (257.3 ± 51.4 min) compared to Group 2 (164.0 ± 25.7 min). The total blood loss was significantly higher in Group 1 (1254.7 ± 521.5 mL) compared to Group 2 (893.7 ± 518.4 mL). Total blood loss/level fused was significantly higher in Group 1 (117.5 ± 42.8 mL/level) compared to Group 2 (82.6 ± 39.4 mL/level). Group 1 had significantly higher blood loss and blood loss/level fused for stages 1, 2 and 3. Group 2 had lower incidence of allogenic blood transfusion. Conclusions: In PSF surgery for AIS patients, two-surgeon strategy was associated with shorter operation duration, lesser blood loss and lower incidence of allogenic blood transfusion.
format Article
author Kwan, Mun Keong
Chiu, Chee Kidd
Chan, Chris Yin Wei
author_facet Kwan, Mun Keong
Chiu, Chee Kidd
Chan, Chris Yin Wei
author_sort Kwan, Mun Keong
title Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis
title_short Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis
title_full Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis
title_fullStr Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis
title_full_unstemmed Single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in Lenke 1 and 2 adolescent idiopathic scoliosis
title_sort single vs two attending senior surgeons: assessment of intra-operative blood loss at different surgical stages of posterior spinal fusion surgery in lenke 1 and 2 adolescent idiopathic scoliosis
publisher Springer Verlag (Germany)
publishDate 2017
url http://eprints.um.edu.my/17656/
http://dx.doi.org/10.1007/s00586-016-4803-y
_version_ 1654960675753033728
score 13.211869

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