Khan A Z, Bann S D, Pitsinis V, McCall J, Mudan S S
Department of Gastrointestinal Surgery Royal Marsden Hospital Chelsea, London, UK.
Hepatogastroenterology. 2007 Jun;54(76):1167-9.
BACKGROUND/AIMS: With recognition of its benefits, there has been a trend towards minimizing blood loss during hepatic parenchymal transection but no one technique has been shown to be superior to another. We analyzed our experience with using a novel combined technique of saline-linked radiofrequency precoagulation and ultrasonic aspiration for hepatic parenchymal transection.
This combined technique was used in 12 patients for parenchymal transection for metastatic hepatic disease and data was collected prospectively. Total blood loss, bile leaks, parenchymal transection time, hepatic pedicle clamp requirement and 30-day mortality were used as outcome measures.
Four minor and 8 major hepatic resections were performed in twelve patients of who two underwent a synchronous resection of the rectum. The median blood loss was 525 mL (IQR 312.5-1150) in these patients who had a median postoperative stay of 7 days (IQR 7-14). The median parenchymal transection time was 120 minutes (IQR 100-153.75). No patient required portal triad clamping at anytime and there was no mortality.
Combined technique of saline-link radiofrequency ablation and ultrasonic aspiration appears to be comparable to other techniques and should be considered as an alternative.
背景/目的：随着对减少肝实质离断术中失血益处的认识，目前存在一种尽量减少失血的趋势，但尚无一种技术被证明优于其他技术。我们分析了我们使用盐水连接射频预凝血和超声吸引的新型联合技术进行肝实质离断的经验。
该联合技术用于12例转移性肝病患者的实质离断，并前瞻性收集数据。总失血量、胆漏、实质离断时间、肝蒂阻断需求和30天死亡率用作观察指标。
12例患者中，4例行小肝切除术，8例行大肝切除术，其中2例同时行直肠切除术。这些患者的中位失血量为525 mL（四分位间距312.5 - 1150），中位术后住院时间为7天（四分位间距7 - 14）。中位实质离断时间为120分钟（四分位间距100 - 153.75）。无患者在任何时候需要门静脉三联阻断，且无死亡病例。
盐水连接射频消融和超声吸引联合技术似乎与其他技术相当，应被视为一种替代方法。
