Ayav Ahmet, Jiao Long R, Habib Nagy A
Department of Surgical Oncology, Imperial College London, Faculty of Medicine, Hammersmith Campus, London, UK.
Dig Surg. 2007;24(4):314-7. doi: 10.1159/000103664. Epub 2007 Jul 27.
Liver surgery carries the risk of intraoperative bleeding. In order to avoid bleeding, transection of the liver can be performed after coagulating the parenchyma by using monoplolar or bipolar radiofrequency energy.
236 consecutive patients underwent liver resection with the radiofrequency-assisted technique using either a monopolar or a bipolar device. Data were collected prospectively to assess the outcome including, intraoperative blood loss, blood transfusion requirement, morbidity and mortality rates.
There were 41 major hepatectomies and 195 minor resections. Overall mean intraoperative blood loss was 157 +/- 240 ml, while mean blood loss during liver transection was 90 +/- 105 ml. 10 patients (4%) received blood transfusion. 50 patients (21%) developed postoperative complications including 5 bile leaks (2%). The mortality rate was 2.1%. No patient was reoperated for postoperative haemorrhage or bile leak. The mean postoperative stay was 11 +/- 10 days.
The radiofrequency-assisted liver resection technique offers hepatobiliary surgeons an additional method for performing liver resections with minimal blood loss, low transfusion requirement, and low morbidity and mortality rates.
肝脏手术存在术中出血风险。为避免出血,可在使用单极或双极射频能量凝固肝实质后进行肝横断术。
236例连续患者采用单极或双极设备的射频辅助技术进行肝切除术。前瞻性收集数据以评估结果,包括术中失血量、输血需求、发病率和死亡率。
共进行41例大肝切除术和195例小切除术。总体平均术中失血量为157±240ml,而肝横断术中平均失血量为90±105ml。10例患者(4%)接受输血。50例患者(21%)发生术后并发症,包括5例胆漏(2%)。死亡率为2.1%。无患者因术后出血或胆漏再次手术。术后平均住院时间为11±10天。
射频辅助肝切除技术为肝胆外科医生提供了一种额外的肝切除方法,具有失血少、输血需求低、发病率和死亡率低的特点。