J Fritzmann1, J Kirchberg1, D Sturm1, A B Ulrich2, P Knebel2, A Mehrabi2, M W Büchler2, J Weitz1, C Reissfelder3, N N Rahbari3. 1. Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany. 2. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany. 3. Department of Surgery, Mannheim University Medical Centre, University of Heidelberg, Mannheim, Germany.
Abstract
BACKGROUND: Previous studies have demonstrated stapler hepatectomy and use of various energy devices to be safe alternatives to the clamp-crushing technique in elective hepatic resection. In this randomized trial, the effectiveness and safety of stapler hepatectomy were compared with those of parenchymal transection with the LigaSure™ vessel sealing system. METHOD:Patients scheduled for elective liver resection at two tertiary-care centres were randomized during surgery to stapler hepatectomy or transection with the LigaSure™ device. Total intraoperative blood loss was the primary efficacy endpoint. Transection time, duration of operation, perioperative complications and length of hospital stay were recorded as secondary endpoints. RESULTS:A total of 138 patients were analysed, 69 in the LigaSure™ and 69 in the stapler hepatectomy group. Baseline characteristics were well balanced between the groups. Mean intraoperative blood loss was significantly higher in the LigaSure™ group than the stapler hepatectomygroup: 1101 (95 per cent c.i. 915 to 1287) versus 961 (752 to 1170) ml (P = 0·028). The parenchymal transection time was significantly shorter in the stapler group (P = 0·005), as was the total duration of operation (P = 0·027). Surgical morbidity did not differ between the groups, nor did the grade of complications. CONCLUSION:Stapler hepatectomy was associated with reduced blood loss and a shorter duration of operation than the LigaSure™ device for parenchymal transection in elective partial hepatectomy. Registration number: NCT01858987 (http://www.clinicaltrials.gov).
RCT Entities:
BACKGROUND: Previous studies have demonstrated stapler hepatectomy and use of various energy devices to be safe alternatives to the clamp-crushing technique in elective hepatic resection. In this randomized trial, the effectiveness and safety of stapler hepatectomy were compared with those of parenchymal transection with the LigaSure™ vessel sealing system. METHOD:Patients scheduled for elective liver resection at two tertiary-care centres were randomized during surgery to stapler hepatectomy or transection with the LigaSure™ device. Total intraoperative blood loss was the primary efficacy endpoint. Transection time, duration of operation, perioperative complications and length of hospital stay were recorded as secondary endpoints. RESULTS: A total of 138 patients were analysed, 69 in the LigaSure™ and 69 in the stapler hepatectomy group. Baseline characteristics were well balanced between the groups. Mean intraoperative blood loss was significantly higher in the LigaSure™ group than the stapler hepatectomy group: 1101 (95 per cent c.i. 915 to 1287) versus 961 (752 to 1170) ml (P = 0·028). The parenchymal transection time was significantly shorter in the stapler group (P = 0·005), as was the total duration of operation (P = 0·027). Surgical morbidity did not differ between the groups, nor did the grade of complications. CONCLUSION: Stapler hepatectomy was associated with reduced blood loss and a shorter duration of operation than the LigaSure™ device for parenchymal transection in elective partial hepatectomy. Registration number: NCT01858987 (http://www.clinicaltrials.gov).
Authors: Arianeb Mehrabi; Katrin Hoffmann; Alexander Johannes Nagel; Omid Ghamarnejad; Elias Khajeh; Mohammad Golriz; Markus W Büchler Journal: J Gastrointest Surg Date: 2019-02-28 Impact factor: 3.452
Authors: Mohammad Golriz; Anastasia Lemekhova; Elias Khajeh; Omid Ghamarnejad; Mohammed Al-Saeedi; Oliver Strobel; Thilo Hackert; Beat Müller-Stich; Martin Schneider; Christoph Berchtold; Parham Tinoush; Philipp Mayer; De-Hua Chang; Karl Heinz Weiss; Katrin Hoffmann; Arianeb Mehrabi Journal: BMJ Open Date: 2019-10-11 Impact factor: 2.692