University of New South Wales, Department of Surgery, St George Hospital, Sydney, Australia.
HPB (Oxford). 2007;9(4):267-71. doi: 10.1080/13651820701377091.
Surgical resection is the most effective therapy for liver cancer. Intraoperative blood loss during liver resection remains a major concern due to association with higher postoperative complications. The InLine radiofrequency ablation device (ILRFA) has achieved promising results in liver surgery with minimal blood loss and no increase of postoperative complications. In this multicentre controlled study, 108 patients undergoing liver resection were investigated.
A total of 108 patients underwent liver resections in 4 medical centres; the prospective sequential cohort study consisted of 54 ILRFA and 54 ultrasonic surgical aspirator transections as the control group.
The type of liver resection performed was very similar in both groups. The median number of RFA deployments was 3 (range 1-12) with a median coagulation time of 9 (range 3-36) min. Median blood loss was 165+/-20 ml (range 5-675) in the ILRFA and 654+/-83 ml (range 80-3600) in the control group (p<0.001). The median transection time was 27 (2-219) min in the ILRFA group and 35 (5-62) min in controls.
Our study indicates that ILRFA device for liver transection is effective in reducing blood loss and is safe. Precoagulation before parenchymal transection appears to be a valid concept in liver surgery. The avoidance of vascular inflow occlusion during parenchymal transection could also be of value.
手术切除是治疗肝癌最有效的方法。由于与更高的术后并发症相关,肝切除术中的术中出血量仍然是一个主要关注点。INLINE 射频消融设备(ILRFA)在肝外科手术中取得了令人瞩目的成果,出血量少,术后并发症无增加。在这项多中心对照研究中,对 108 例接受肝切除术的患者进行了研究。
共有 108 例患者在 4 个医疗中心接受肝切除术;前瞻性序贯队列研究包括 54 例 ILRFA 和 54 例超声手术吸引器横断作为对照组。
两组患者的肝切除术类型非常相似。RFA 部署的中位数为 3(范围 1-12),中位凝固时间为 9(范围 3-36)分钟。ILRFA 组的中位出血量为 165+/-20ml(范围 5-675),对照组为 654+/-83ml(范围 80-3600)(p<0.001)。ILRFA 组的中位横断时间为 27(2-219)分钟,对照组为 35(5-62)分钟。
我们的研究表明,ILRFA 肝横断设备可有效减少出血,且安全。肝实质横断前的预凝固似乎是肝外科的一个有效概念。在实质横断过程中避免血管流入闭塞也可能具有价值。