Reduced Blood Loss with Intraoperative Artery Ligation During Angiofibroma Excision

Abstract

Background: Juvenile Nasopharyngeal Angiofibroma (JNA) is a rare, highly vascularized tumor primarily affecting males during early puberty. Recurrent epistaxis and anemia are common presentations. Intraoperative artery ligation has been proposed as a strategy to minimize blood loss during JNA excision surgeries. This study aims to explore the correlation between intraoperative artery ligation and blood loss in JNA excision surgeries. Objective: To investigate the association between intraoperative artery ligation and blood loss during surgical excision of Juvenile Nasopharyngeal Angiofibroma. Methodology: This retrospective comparative study analyzed medical records of 12 patients who underwent JNA excision surgeries in ENT Unit I of Jinnah Hospital, Lahore. Two groups were compared: patients with intraoperative artery ligation and a control group without this intervention. Stratified Random Sampling was employed, and data, including demographics, clinical presentation, diagnostic information, surgical details, intraoperative blood loss, operative time, blood transfusions, and postoperative complications, were collected. Statistical analysis was performed using SPSS version 23, and a p-value below 0.05 was considered significant. Results: Patients with intraoperative artery ligation showed a focused blood loss distribution. 50% experienced 251-750ml, and none exceeding 750ml. In contrast, the non-ligation group showed a broader range, with 50% experiencing blood loss beyond 750ml. The mean blood loss in the ligation group was 375ml (SD=250ml), while the non-ligation group had a mean of 916.67ml (SD=401.83ml). Statistical analysis confirmed a significant association (p < 0.05) between intraoperative artery ligation and
reduced blood loss. The study suggests that intraoperative artery ligation contributes to a more controlled and moderate blood loss in JNA excision surgeries.
Conclusion: This retrospective comparative study reveals a significant correlation between intraoperative artery ligation and reduced blood loss in Juvenile Nasopharyngeal Angiofibroma excision surgeries. Patients with intraoperative artery ligation demonstrated a more controlled and focused distribution of blood loss, emphasizing its potential efficacy in managing hemorrhage during surgery. The study contributes valuable insights into the application of intraoperative artery ligation in JNA surgeries, providing clinicians with a potential strategy to minimize blood loss and improve surgical outcomes.