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一种新的用于肝切除术中实质分离和止血的单器械技术:临床可行性研究。

A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study.

机构信息

Department of Surgery, Hospital del Mar, Passeig Maritim 2529 08003, Barcelona, Spain.

出版信息

Am J Surg. 2010 Dec;200(6):e75-80. doi: 10.1016/j.amjsurg.2010.02.020.

Abstract

The objective of this study was to evaluate the clinical feasibility of a new technique for liver resection based on a radiofrequency-assisted (485 kHz) device that has shown high performance in the animal setting in both transection speed and blood loss per transection area. Eight patients with colorectal hepatic metastasis underwent 11 partial hepatectomies using the proposed technique for both parenchyma division and hemostasis. Main outcome measures were blood loss per transection area and transection speed. No other instruments (including sutures or clips) were used in any of the cases; temporary vascular occlusion performed was not performed. No blood transfusions were required and no mortality or morbidity linked to the hepatic procedure were observed. The median blood loss per transection area and the median transection speed were .79 mL/cm² (range, .05-7.37 mL/cm²) and 1.28 cm²/min (range, .49-1.87 mL/cm²), respectively. During the follow-up period (range, 4-12 mo) no late complications were detected and postoperative patients were free from hepatic recurrence. The proposed radiofrequency-assisted device was shown to achieve parenchymal division and hemostasis simultaneously, resulting in extremely reduced blood loss.

摘要

本研究旨在评估一种新的肝切除术技术的临床可行性,该技术基于一种射频辅助(485 kHz)设备,该设备在动物研究中显示出在切割速度和每单位切割面积的出血量方面具有出色的性能。8 名结直肠癌肝转移患者接受了 11 例部分肝切除术,采用了提出的技术进行肝实质分割和止血。主要观察指标为每单位切割面积的出血量和切割速度。在任何情况下都未使用其他器械(包括缝线或夹);未进行临时血管闭塞。未输血,未观察到与肝手术相关的死亡率或发病率。每单位切割面积的中位数出血量和中位数切割速度分别为.79 mL/cm²(范围,.05-7.37 mL/cm²)和 1.28 cm²/min(范围,.49-1.87 mL/cm²)。在随访期间(4-12 个月),未发现晚期并发症,术后患者无肝复发。拟议的射频辅助设备被证明可以同时实现实质分割和止血,从而显著减少出血量。

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