Hammersmith Hospital, Liver and Pancreas Surgery, Imperial College London, London, UK.
Ann Surg Oncol. 2011 Nov;18(12):3391. doi: 10.1245/s10434-011-1804-2. Epub 2011 Jun 24.
The only curative procedure to date for liver tumors is surgical resection, which remains a major procedure with marked morbidity and mortality. Radiofrequency (RF) has increasingly been used for both ablation and resection. On the basis of this technique, a new bipolar RF device, Habib 4X, has been developed and used clinically. We present our technique of liver resection with this device in a patient with colorectal liver metastases.
A patient with situs inversus who had colorectal liver metastases in her left lobe underwent left lateral segmentectomy with the new device, a four-electrode bipolar resection device that uses RF energy for tissue necrosis. After laparotomy and intraoperative ultrasound, the plane resection was marked 1 cm away from the edge of the lesion. Coagulative desiccation was performed along this plane using this sealer connected to a RF generator. The necrosed band of parenchyma was then divided with a scalpel and resection completed.
The length of the procedure was 105 minutes; resection time was 35 minutes. Total blood loss was 100 ml. No blood transfusions were required, and the patient was not admitted to the intensive care unit after surgery. The patient was discharged 10 days after surgery without any surgical complications.
We think that RF-assisted liver resection with this new device is safe and effective. It is quicker than conventional RF and may reduce overall hospital stay in liver resection patients.
迄今为止，治疗肝脏肿瘤的唯一根治性方法是手术切除，但它仍然是一种具有显著发病率和死亡率的主要方法。射频（RF）越来越多地用于消融和切除。在此技术的基础上，开发了一种新型的双极 RF 设备——Habib 4X，并已在临床上使用。我们介绍了一位结直肠癌肝转移患者使用该设备进行肝切除术的技术。
一位患有内脏反位的患者，其左叶有结直肠癌肝转移，使用新型四极双极切除设备——Habib 4X 进行左外侧段切除术，该设备使用 RF 能量使组织坏死。剖腹手术和术中超声后，在距病变边缘 1cm 的位置标记平面切除术。使用与 RF 发生器相连的密封剂沿此平面进行凝固干燥。然后用手术刀将坏死的肝实质带分开，完成切除。
手术过程耗时 105 分钟，切除时间 35 分钟。总失血量为 100ml，无需输血，术后患者未入住重症监护病房。患者术后 10 天出院，无手术并发症。
我们认为，使用这种新设备进行 RF 辅助肝切除是安全有效的。它比传统的 RF 更快，可以减少肝切除患者的总住院时间。
