Application of solid Carbon dioxide as a novel hemostatic agent on a hepatectomy model in rats

Background: Blood loss and the prolonged operative time for haemostasis is still a great problem after injury or during elective surgery of the liver. Various topical hemostatic agents were introduced to reduce the blood loss. The aim of this study is to evaluate the afficacy of solid carbon dioxide (SoCO2) as a hemostatic agent on hepatectomy model. Materials and Methods: Thirty-two Wistar albino female rats were included in this study. They were divided in four groups of 8 rats. Haematocrit levels were determined preoperatively. Non-anatomic hepatectomy was performed to the left lobe. Hemostasis was provided with gauze tampons in Group-1, with surgical sutures in Group-2 and with asistance of SoCO2 in Group-3. Hemostasis time and blood loss were recorded. Serum haematocrit, liver function tests were determined postoperatively. SoCO2 assisted hemostasis was provided and relaparotomy was performed after 7 days to determine the late effects of SoCO2 in Group-4. Results: Blood loss in Group-1 and Group-2 were statistically significant higher than the Group-3 (119.1 ± 22,4 mg; 80.6 ± 18.9 mg; 36.3 ± 11.1 mg, respectively) (p<0.01). Therewithal hemostasis time in Group-3 was statistically significant shorter than Group-1 and Group-2 (p<0.01). Serum ALT and AST values were increased in first three groups, but did not reveal significant difference between groups (p: 0.045 and p:0.163). ALT and AST values were significantly decreased in Group-4 compared to other groups (p:0.001 and p:0.005, respectively). Conclusions: SoCO2 assisted hemostasis provide bloodless surgical site, reduced blood loss and also shortened hemostasis time. Although further studies are requires, this study reveals that hepatectomies can be performed safer with SoCO2 assistance.