L Lupo1, A Gallerani, P Panzera, F Tandoi, G Di Palma, V Memeo. 1. Department of Emergency and Organ Transplantation, Institute of General Surgery and Liver Transplantation, University of Bari, piazza Giulio Cesare 12, 70124 Bari, Italy. lupo@clichiru.uniba.it
Abstract
BACKGROUND:Surgical resection remains the treatment of choice for primary and secondary liver cancer. Complications are mainly related to blood loss. Radiofrequency-assisted liver resection (RF-R) has been proposed for parenchymal division as an alternative to clamp crushing in order to reduce blood loss. METHODS:Fifty patients (median age 62 (range 30-82) years) undergoing hepatectomy were randomized to RF-R (24 patients) or the clamp-crushing method (26). In the RF-R group the resection plane was precoagulated by multiple insertion of a planar triple-cooled radiofrequency ablation needle, and then the parenchyma was sectioned using a scalpel. RESULTS: The two groups were well matched in terms of age, sex, liver disease and type of resection. There were no deaths. Eight in the RF-R group developed complications (abscess in six, biliary fistula in three and biliary stenosis in one) compared with none of those who had resection by the crush method (P < 0.001). Two patients with cirrhosis in each group developed decompensation. Blood transfusion was required in eight of 24 patients in the RF-R group and 13 of 26 in the clamp-crushing group (P = 0.079). CONCLUSION:RF-R allows parenchymal resection in a clean surgical field but is associated with a higher rate of postoperative complications than the clamp-crushing technique. (c) 2007 British Journal of Surgery Society Ltd.
RCT Entities:
BACKGROUND: Surgical resection remains the treatment of choice for primary and secondary liver cancer. Complications are mainly related to blood loss. Radiofrequency-assisted liver resection (RF-R) has been proposed for parenchymal division as an alternative to clamp crushing in order to reduce blood loss. METHODS: Fifty patients (median age 62 (range 30-82) years) undergoing hepatectomy were randomized to RF-R (24 patients) or the clamp-crushing method (26). In the RF-R group the resection plane was precoagulated by multiple insertion of a planar triple-cooled radiofrequency ablation needle, and then the parenchyma was sectioned using a scalpel. RESULTS: The two groups were well matched in terms of age, sex, liver disease and type of resection. There were no deaths. Eight in the RF-R group developed complications (abscess in six, biliary fistula in three and biliary stenosis in one) compared with none of those who had resection by the crush method (P < 0.001). Two patients with cirrhosis in each group developed decompensation. Blood transfusion was required in eight of 24 patients in the RF-R group and 13 of 26 in the clamp-crushing group (P = 0.079). CONCLUSION:RF-R allows parenchymal resection in a clean surgical field but is associated with a higher rate of postoperative complications than the clamp-crushing technique. (c) 2007 British Journal of Surgery Society Ltd.
Authors: Nsehniitooh A Mbah; Russell E Brown; Matthew R Bower; Charles R Scoggins; Kelly M McMasters; Robert C G Martin Journal: HPB (Oxford) Date: 2012-02 Impact factor: 3.647
Authors: Danijel A Galun; Predrag Bulajic; Marinko Zuvela; Dragan Basaric; Tatjana Ille; Miroslav N Milicevic Journal: World J Surg Date: 2012-07 Impact factor: 3.352
Authors: Eric T Castaldo; T Mark Earl; Ravi S Chari; D Lee Gorden; Nipun B Merchant; J Kelly Wright; Irene D Feurer; C Wright Pinson Journal: HPB (Oxford) Date: 2008 Impact factor: 3.647