Background. In liver surgery, clamp-crushing (CC) procedure has been shown to be the most efficient system for liver transection. Recently, it has been suggested that radiofrequency-assisted liver resection (RFALR) may be more advantageous, but sufficient evidence has yet to be accumulated. Method. The control group was constituted by 32 patients undergoing CC liver transection. The study group included 13 patients undergoing RFALR with a new fully automated radiofrequency generator supplying a comb-shaped bipolar multielectrode device. Results. RFALR allowed a faster hepatic transection and reduced both surgical time and intraoperative blood loss. RFALR was the only independent prognostic indicator of bleeding during liver transection. No significant liver damage and postoperative complications, particularly biliary leakage and stenosis, were experienced in the RFALR group. Conclusion. Compared with the CC procedure, this bipolar device was shown to be safe and effective in liver resections, allowing a very clean surgical field without increase of postoperative complications.
DelisSKakoyiannisATassopoulosN. Clamp-crush technique vs. radiofrequency-assisted liver resection for primary and metastatic liver neoplasms. HPB (Oxford). 2009;11:339-344.
2.
AgrawalSBelghitiJ. Oncologic resection for malignant tumors of the liver. Ann Surg. 2011;253:656-665.
3.
WeberJCNavarraGJiaoLNichollsJPJensenSLHabibNA. New technique for liver resection using heat coagulative necrosis. Ann Surg. 2002;236:560-563.
4.
KamiyamaTNakanishiKYokooH. Perioperative management of hepatic resection toward zero mortality and morbidity: analysis of 793 consecutive cases in a single institution. J Am Coll Surg. 2010;211:443-449.
5.
LupoLGalleraniAPanzeraPTandoiFDi PalmaGMemeoV. Randomized clinical trial of radiofrequency-assisted versus clamp-crushing liver resection. Br J Surg. 2007;94:287-291.
6.
TorzilliGMakuuchiMInohueK. The vascular control in liver resection: revisitation of a controversial issue. Hepatogastroenterology. 2002;49:28-31.
7.
KoobyDAStockmanJBen-PoratL. Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases. Ann Surg. 2003;237:860-870.
8.
IbrahimSChenCLLinCC. Intraoperative blood loss is a risk factor for complications in donors after living donor hepatectomy. Liver Transpl. 2006;12:950-957.
9.
YamashitaYHamatsuTRikimaruT. Bile leakage after hepatic resection. Ann Surg. 2001;233:45-50.
10.
CastaldoETEarlMChariRS. A clinical comparative analysis of crush/clamp, stapler, and dissecting sealer hepatic transection methods. HPB (Oxford). 2008;10:321-326.
11.
PoonRT. Current techniques of liver transection. HPB (Oxford). 2007;9:166-173.
12.
LinTYChenKMLiuTK. Total right hepatic lobectomy for primary hepatoma. Surgery. 1960;48:1048-1060.
13.
LinTY. A simplified technique for hepatic resection: the crush method. Ann Surg. 1974;180:285-290.
14.
BismuthHHoussinDCastaingD. Major and minor segmentectomies “reglees” in liver surgery. World J Surg. 1982;6:10-24.
15.
HodgsonWJMorganJByrneDDelGuercioLR. Hepatic resections for primary and metastatic tumors using the ultrasonic surgical dissector. Am J Surg. 1992;163:246-250.
16.
BaerHUStainSCGuastellaTMaddernGJBlumgartLH. Hepatic resection using a water jet dissector. HPB Surg. 1993;6:189-196.
17.
GertschPPelloniAGuerraAKrpoA. Initial experience with the harmonic scalpel in liver surgery. Hepatogastroenterology. 2000;47:763-766.
18.
AritaJHasegawaKKokudoNSanoKSugawaraYMakuuchiM. Randomized clinical trial of the effect of a saline-linked radiofrequency coagulator on blood loss during hepatic resection. Br J Surg. 2005;92:954-959.
19.
IkedaMHasegawaKSanoK. The vessel sealing system (LigaSure) in hepatic resection: a randomized controlled trial. Ann Surg. 2009;250:199-203.
20.
AyavABachellierPHabibNA. Impact of radiofrequency assisted hepatectomy for reduction of transfusion requirements. Am J Surg. 2007;193:143-148.
21.
MitsuoMTakahiroTYasukoT. Radiofrequency (RF)-assisted hepatectomy may induce severe postoperative liver damage. World J Surg. 2007;31:2208-2212.
22.
KargozaranHWildendorfSKhatriVP. Radiofrequency-assisted hepatectomy using bipolar Inline Multichannel Radiofrequency Device (ILMRD): report of initial experience. Hepatogastroenterology. 2009;56:1496-1500.
23.
PamechaVGurusamyKSSharmaDDavidsonBR. Techniques for liver parenchymal transection: a meta-analysis of randomized controlled trials. HPB (Oxford). 2009;11:275-281.
24.
HaghighiKSWangFKingJDanielSMorrisDL. In-line radiofrequency ablation to minimize blood loss in hepatic parenchymal transection. Am J Surg. 2005;190:43-47.
25.
AyavAJiaoLRDickinsonR. Liver resection with a new multiprobe bipolar radiofrequency device. Arch Surg. 2008;143:396-401.
26.
YaoPChuFDanielS. A multicentre controlled study of the inline radiofrequency ablation device for liver transection. HPB (Oxford). 2007;9:267-271.
27.
D’AngelicaM. Radiofrequency-assisted hepatectomy may induce severe postoperative liver damage. World J Surg. 2007;31:2213-2214.
28.
KurodaSTashiroHKobayashiTOshitaAAmanoHOhdanH. Selection criteria for hepatectomy in patients with hepatocellular carcinoma classified as Child-Pugh class B. World J Surg. 2011;35:834-841.
29.
CouinaudC. Les hepatectomies elargies. In CouinaudC, ed. Le Foie: Etudes Anatomiques et Chirurgicales. Paris, France: Masson; 1957:400-409.
30.
JarnaginWRGonenMFongY. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg. 2002;236:397-406.
31.
AsaharaTKatayamaKItamotoT. Perioperative blood transfusion as a prognostic indicator in patients with hepatocellular carcinoma. World J Surg. 1999;23:676-680.
RauHGWichmannMWSchinkelS. Surgical techniques in hepatic resections: ultrasonic aspirator versus Jet-Cutter: a prospective randomized clinical trial. Zentralbl Chir. 2001;126:586-590.
34.
TakayamaTMakuuchiMKubotaK. Randomized comparison of ultrasonic vs clamp transection of the liver. Arch Surg. 2001;136:922-928.
35.
KooBNKilHKChoiJSKimJYChunDHHongYW. Hepatic resection by the Cavitron Ultrasonic Surgical Aspirator increases the incidence and severity of venous air embolism. Anesth Analg. 2006;103:493-494.
36.
SmyrniotisVArkadopoulosNKostopanagiotouG. Sharp liver transection versus clamp crushing technique in liver resections: a prospective study. Surgery. 2005;137:306-311.
37.
LesurtelMSelznerMPetrowskyHMcCormackLClavienPA. How should transection of the liver be performed? A prospective randomized study in 100 consecutive patients: comparing four different transection strategies. Ann Surg. 2005;242:814-822.
38.
KimKHLeeSG. Usefulness of Kelly clamp crushing technique during hepatic resection. HPB (Oxford). 2008;10:281-284.
39.
NavarraGAyavAWeberJC. Short- and-long term results of intraoperative radiofrequency ablation of liver metastases. Int J Colorectal Dis. 2005;20:521-528.
40.
FerreroARussolilloNViganòLLo TesoriereRMuratoreACapussottiL. Does Pringle maneuver affect survival in patients with colorectal liver metastases?World J Surg. 2010;34:2418-2425.
41.
GiulianteFArditoFPulitanòC. Does hepatic pedicle clamping affect disease-free survival following liver resection for colorectal metastases?Ann Surg. 2010;252:1020-1026.
42.
BerberESipersteinA. Radiofrequency (RF)-assisted hepatectomy may induce severe liver damage. World J Surg. 2008;32:1897-1898.
