Varshney Subodh, Sharma Sandesh, Kapoor Sorabh, Sewkani Ajit, Naik Saleem, Vyas Swarna, Jain Gourav, Tiwari Nischal, Maudar K K
Department of Surgical Gastroenterology and Clinical Nutrition Bhopal Memorial Hospital and Research Centre, Bhopal, India.
Hepatogastroenterology. 2007 Jul-Aug;54(77):1539-41.
BACKGROUND/AIMS: Radiofrequency has been used recently for bloodless liver resection. We studied the safety and feasibility of using RF energy for liver parenchymal transection in 8 patients.
We performed eight (n=8) open RF assisted liver resection for various malignancies. There were 5 men and 3 women, with mean age of 56.5 years (range 20-80 years).
All patients had successful liver resection. The mean operating time for liver resection was 45 minutes (range 25-60 min). The average blood loss for wedge resections and segmentectomies was 30 mL (range 10-100 mL). None of the patients required postoperative transfusion. Three out of eight patients developed minor complications in the form of intra-abdominal abscesses which were managed by USG guided drainage of abscess in two patients and one patient had open surgical drainage of the subhepatic abscess.
RF assisted liver resection is safe and effective with minimal blood loss for minor liver resections. Though the procedure is slightly more time consuming presently, with further improvement in technology and needles, the operative time may be reduced for this technique. RF assisted liver resection should be avoided in the presence of overt local sepsis.
背景/目的:射频技术近来已用于无血肝切除术。我们研究了在8例患者中使用射频能量进行肝实质离断的安全性和可行性。
我们对各种恶性肿瘤患者进行了8例(n = 8)开放性射频辅助肝切除术。其中男性5例,女性3例,平均年龄56.5岁(范围20 - 80岁)。
所有患者均成功完成肝切除术。肝切除的平均手术时间为45分钟(范围25 - 60分钟)。楔形切除术和肝段切除术的平均失血量为30毫升(范围10 - 100毫升)。所有患者术后均无需输血。8例患者中有3例出现轻微并发症,表现为腹腔内脓肿,其中2例通过超声引导下脓肿引流处理,1例接受了肝下脓肿开放手术引流。
射频辅助肝切除术对于小型肝切除术而言安全有效,失血极少。尽管目前该手术耗时略长,但随着技术和穿刺针的进一步改进,手术时间可能会缩短。存在明显局部感染时应避免使用射频辅助肝切除术。