Abstract
Purpose: To evaluate the impact of using monopolar thermal coagulation based on radiofrequency (RF) currents on intraoperative blood loss during liver resection.Materials and methods: A prospective randomised controlled trial was planned. Patients undergoing hepatectomy were randomised into two groups. In the control group (n = 10), hemostasis was obtained with a combination of stitches, vessel-sealing bipolar RF systems, sutures or clips. In the monopolar radiofrequency coagulation (MRFC) group (n = 18), hemostasis was mainly obtained using an internally cooled monopolar RF electrode.Results: No differences in demographic or clinical characteristics were found between groups. Mean blood loss during liver resection in the control group was more than twice that of the MRFC group (556 ± 471 ml vs. 225 ± 313 ml, p = .02). The adjusted mean bleeding/transection area was also significantly higher in the control group (7.0 ± 3.3 ml/cm2 vs. 2.8 ± 4.0 ml/cm2, p = .006). No significant differences were observed in the rate of complications between the groups.Conclusions: The findings suggest that the monopolar electrocoagulation created with an internally cooled RF electrode considerably reduces intraoperative blood loss during liver resection.
Highlights
Intraoperative blood loss and perioperative transfusion increases mortality and morbidity and reduces long-term survival after hepatic resection in liver tumours [1,2]
28 patients were enrolled in the study, and were randomly allocated to the control group or the monopolar RF coagulation (MRFC) group
Eighty-two patients were subjected to liver resection but were excluded for the following reasons: primary liver tumours (n 1⁄4 54), cyst tumour (n 1⁄4 16) and others (n 1⁄4 12)
Summary
Intraoperative blood loss and perioperative transfusion increases mortality and morbidity and reduces long-term survival after hepatic resection in liver tumours [1,2]. The most important resection techniques generally used today are finger fracture or the crush/clamp technique, Cavitron Ultrasonic Surgical Aspirator (CUSA, Cavitron, Stamford, CT), water-jet technology, stapler, and monopolar and bipolar electrosurgical electrodes [4,5,6,7]. Different sealing devices such as harmonic scalpels, ultrasound scissors, radiofrequency-based monopolar and bipolar vessel-sealing systems have recently gained importance in liver surgery [8,9,10,11,12]. The optimal transection technique has still not been found and using different energy-based devices for different steps of the operation is cumbersome in terms of the flow procedure and a certain degree of skill is required for their proper use [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
