Abstract:

Background. Surgical resection is the most effective therapy for liver cancer. Intraoperative blood loss during liver resection remains a major concern due to association with higher postoperative complications. The InLine radiofrequency ablation device (ILRFA) has achieved promising results in liver surgery with minimal blood loss and no increase of postoperative complications. In this multicentre controlled study, 108 patients undergoing liver resection were investigated. Patients and methods. A total of 108 patients underwent liver resections in 4 medical centres; the prospective sequential cohort study consisted of 54 ILRFA and 54 ultrasonic surgical aspirator transections as the control group. Results. The type of liver resection performed was very similar in both groups. The median number of RFA deployments was 3 (range 1-12) with a median coagulation time of 9 (range 3-36) min. Median blood loss was 165±20 ml (range 5-675) in the ILRFA and 654±83 ml (range 80-3600) in the control group (p<0.001). The median transection time was 27 (2-219) min in the ILRFA group and 35 (5-62) min in controls. Conclusions. Our study indicates that ILRFA device for liver transection is effective in reducing blood loss and is safe. Precoagulation before parenchymal transection appears to be a valid concept in liver surgery. The avoidance of vascular inflow occlusion during parenchymal transection could also be of value.

Keywords: liver cancer; ILRFA; ultrasonic surgical aspirator; blood loss

Document Type: Research article

DOI: 10.1080/13651820701377091

Affiliations: 1: University of New South Wales, Department of Surgery, St George Hospital, Sydney, Australia 2: Clinic of General, Visceral, Vascular and Pediatric Surgery, University Hospital of the Saarland, Homburg/Saar, Germany 3: Department of Surgery, University of Hawaii and Kuakini Medical Center, Honolulu, HI, USA 4: Mithoefer Center for Rural Surgery, Bassett Healthcare, Cooperstown, NY, USA