Improvement of surgical results by VIO soft-coagulation system in hepatocellular carcinoma patients who underwent elective hepatectomy

Abstract

Aim and methods: VIO soft-coagulation system is a new generation hemostatic device and surgical results in case of hepatocellular carcinoma (HCC) patients undergoing 335 elective hepatectomy was historically and retrospectively analyzed between 2002 and March 2015. Other hemostatic and cutting devices were also used. Surgical results between VIO-system group (n = 122) and non-VIO (control) group (n = 213) was compared. Results: VIO system was applied since 2010 and its use has been gradually increased (10% in 2010, 55% in 2011 100% since 2012). Age, gender and type of hepatectomy were similar between groups. Although prevalence of the Japanese liver damage grade BC (poorer liver function) in VIO group (n = 19;16%) tended to be lower in comparison with that in control (n = 63;30%) and, however, prevalence of cirrhosis in VIO group (n = 49;40%) was significantly higher than that in control group (n = 113;53%)(p < 0.05). Mean blood loss in VIO group (1041 ml) was significantly lower in comparison with control group (1881 ml)(p < 0.01) and operating time in VIO group (387minutes) was significantly lower in comparison with control group (451minutes)(p < 0.01). Although prevalence of bile leakage and total postoperative morbidity were not significantly different, prevalence of intraabdominal infectious fluid collection in VIO group (n = 9; 7.4%) was higher than that in control group (n = 6;2.8%) (p = 0.05). Eventually, hospital stay duration in VIO (17.9days) was significantly lower in comparison with control group (19.5days) (p < 0.01). Conclusion: VIO system has been frequently used recently because of better surgical records even n case of cirrhosis and, however, abscess formation due to hepatic heat injuries must be concerned.