Περίληψη:
Background: Hepatic resection is the only potential curative treatment
for a wide variety of conditions. However, liver surgery is technically
demanding and closely associated with a number of serious complications.
New devices and techniques are currently being applied in practice,
which will improve the surgical outcome.
Methods: This retrospective study compares two methods of liver
parenchymal division: ultrasound energy, a modern but already widely
used technique, and radio-frequency ablation (RFA), a completely novel
method. The parameters investigated include the amount of blood
transfused, the necessity of the Pringle maneuver, the length of time
required for parenchymal division, and postoperative morbidity and
mortality. The patients were divided into two groups. In one group
(Group A), 15 patients underwent 17 ultrasound-assisted liver
resections, in which ten metastatic tumors, six hepatomas, and one
cholangiocarcinoma were resected. In Group B, 21 patients underwent 22
RFA-assisted hepatectomies in which 11 metastatic tumors, ten hepatomas,
and two cholangiocarcinomas were removed.
Results: Thirteen patients (87%) in Group A and 11 (52%) in Group B
received a transfusion, with an average of 3.5 and 1.6 units of red
blood cells, respectively. The Pringle maneuver was necessary in two
cases in Group A but was unnecessary in Group B. The mean length of time
required for parenchymal dissection was 124 min in Group A and 93.18 min
in Group B. One (6.7%) and four (19%) complications were observed in
Group A and B, respectively (statistically not significant). Mortality
remained zero in both groups.
Conclusions: RFA energy provides a novel reliable and safe alternative
that can be used exclusively or as a supplement to the older techniques.
Both resection time and amount of blood transfusion were reduced in the
RFA group.
Συγγραφείς:
Felekouras, Evangelos
Prassas, Evangelos
Kontos, Michael and
Papaconstantinou, Ioannis
Pikoulis, Emmanouil
Giannopoulos,
Athanasios
Tsigris, Christos
Tzivras, Michael
Bakogiannis,
Chris
Safioleas, Michael
Papalambros, Efstathios
Bastounis,
Elias
