Delis Spiros G, Madariaga Juan, Bakoyiannis A, Dervenis Ch
Liver Surgical Unit, A Surgical Clinic, Agia Olga Hospital, 3-5 Agias Olgas str., Athens, Greece.
World J Gastroenterol. 2007 Feb 14;13(6):826-9. doi: 10.3748/wjg.v13.i6.826.
Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. Recently new technologies are applied in the field of liver surgery, having one goal: safer and easier liver operations. The aim of this article is to address the issue of bloodless liver resection using radiofrequency energy. Radionics, Cool-tip System and Tissue Link are some of the devices which are using radiofrequency energy. All information included in this article, refers to these devices in which we have personal experience in our unit of liver surgery. These devices take advantage of its unique combination of radiofrequency current and internal electrode cooling to perform sealing of the small vessels and biliary radicals. Dissection is also feasible with the cool-tip probe. For the purposes of this study patient sex, age, type of disease and type of surgical procedure in association with the duration of parenchymal transection, blood loss, length of hospital stay, morbidity and mortality were analyzed. Cool-tip RF device may provide a unique, simple and rather safe method of bloodless liver resections if used properly. It is indicated mostly in cirrhotic patients with challenging hepatectomies (segment VIII, central resections). The total operative time is eliminated and the average blood loss is significantly decreased. It is important to note that this technique should not be applied near the hilum or the vena cava to avoid damage of these structures.
肝切除术是一项要求很高的手术,尽管由经验丰富的肝脏外科医生进行,但仍可能出现危及生命的并发症。最近,新技术被应用于肝脏手术领域,其目标只有一个:使肝脏手术更安全、更容易。本文旨在探讨使用射频能量进行无血肝切除术的问题。射频仪器、冷循环射频消融系统和组织连接设备是一些使用射频能量的装置。本文包含的所有信息均指我们肝脏外科团队有个人使用经验的这些装置。这些装置利用射频电流和内部电极冷却的独特组合来封闭小血管和胆管。使用冷循环射频消融探针进行解剖也是可行的。为了本研究的目的,分析了患者的性别、年龄、疾病类型、手术方式以及实质切开时间、失血量、住院时间、发病率和死亡率。如果使用得当,冷循环射频设备可能提供一种独特、简单且相当安全的无血肝切除方法。它主要适用于进行具有挑战性肝切除术(如Ⅷ段、中央切除)的肝硬化患者。总手术时间减少,平均失血量显著降低。需要注意的是,该技术不应在肝门或腔静脉附近应用,以免损伤这些结构。