Τίτλος:
Clamp-crush technique vs. radiofrequency-assisted liver resection for
primary and metastatic liver neoplasms
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Several techniques for liver resection have been developed.
We compared radiofrequency-assisted (RF) and clamp-crush (CC) liver
resection (LR) in terms of blood loss, operating time and short-term
outcomes in primary and metastatic tumour resection.
Methods: From 2002 to 2007, 196 consecutive patients with primary or
metastatic hepatic tumours underwent RF-LR (n = 109; group 1) or CC-LR
(n = 87; group 2) in our unit. Primary endpoints were intraoperative
blood loss (and blood transfusion requirements) and total operative
time. Secondary endpoints included postoperative complications,
mortality and intensive care unit (ICU) and hospital stay. Data were
collected retrospectively on all patients with primary or secondary
liver lesions.
Results: Blood loss was similar (P = 0.09) between the two groups of
patients with the exception of high MELD score (> 9) cirrhotic patients,
in whom blood loss was lower when RF-LR was used (P < 0.001). Total
operative time and transection time were shorter in the CC-LR group (P =
0.04 and P = 0.01, respectively), except for high MELD score (> 9)
cirrhotic patients, in whom total operation and transection times were
shorter when RF-LR was used (P = 0.04). Rates of bile leak and abdominal
abscess formation were higher after RF-LR (P = 0.04 for both).
Conclusions: Clamp-crush LR is reliable and results in the same amount
of blood loss and a shorter operating time compared with RF-LR.
Radiofrequency-assisted LR is a unique, simple and safe method of
resection, which may be indicated in cirrhotic patients with high MELD
scores.
Συγγραφείς:
Delis, Spiros
Bakoyiannis, Andreas
Tassopoulos, Nikos and
Athanassiou, Kostas
Papailiou, John
Brountzos, Elisa N. and
Madariaga, Juan
Papakostas, Pavlos
Dervenis, Christos
Εκδότης:
Elsevier Sci Ltd, Exeter, United Kingdom
Λέξεις-κλειδιά:
Liver resection; radiofrequency-assisted technique; Kelly clamp-crush
technique; MELD score
DOI:
10.1111/j.1477-2574.2009.00058.x
