Department of Surgery, University of California Davis, Davis, 4501 X Street, Suite OP 512 Pavilion, Sacramento, CA 95817, USA.
Eur J Surg Oncol. 2012 Jun;38(6):531-6. doi: 10.1016/j.ejso.2012.02.181. Epub 2012 Mar 28.
Liver resection is indicated for several primary and secondary liver lesions. We follow up our earlier experience with the use of InLine Multichannel Radiofrequency Device (ILMRD, Resect Medical Inc., Fremont, CA) a device that produces coagulative necrosis along the transection plane.
The records of 68 consecutive patients who underwent liver resection for primary and metastatic liver tumors from August 2000 to December 2008 were reviewed. Data analyzed include demographic data as well as complexity of liver resection, intra-operative blood loss, use of portal triad clamping and transfusion of blood. Postoperative outcomes measured were morbidity, hospital and ICU length of stay.
The median estimated blood loss was 150 mL in the ILMRD group compared to 400 mL in the non-ILMRD group (p < 0.0001). Median length of stay was decreased in the ILMRD group by a day (7 vs. 8 p < 0.003). There was a significant decrease in frequency of parenchymal clamp time (57% vs 84%, p < 0.001) and median total portal triad clamp time (2.5 vs 30 min p < 0.0001). We also noted a significant decrease in the median portal triad clamp time (0 vs 25 min, p < 0.001) used during the parenchymal transection phase. Furthermore, use of the ILMRD device allowed us to perform more complex hepatic resections.
Use of ILMRD to perform radiofrequency-assisted hepatic resection was associated with a significant decrease in intra-operative blood loss and earlier discharge from the hospital despite increasing complexity of resections and decreased use of portal triad clamping.
肝切除术适用于多种原发性和继发性肝病变。我们随访了我们之前使用 InLine 多通道射频设备（ILMRD，Resect Medical Inc.，加利福尼亚州弗里蒙特）的经验，该设备可在横断平面上产生凝固性坏死。
回顾了 2000 年 8 月至 2008 年 12 月期间因原发性和转移性肝肿瘤而行肝切除术的 68 例连续患者的记录。分析的数据包括人口统计学数据以及肝切除术的复杂性、术中失血量、门脉三联夹闭和输血的使用。术后结果测量包括发病率、住院和 ICU 住院时间。
ILMRD 组的中位估计失血量为 150 毫升，而非 ILMRD 组为 400 毫升（p < 0.0001）。ILMRD 组的中位住院时间减少了一天（7 对 8，p < 0.003）。实质夹闭时间的频率（57%对 84%，p < 0.001）和总门脉三联夹闭时间的中位数（2.5 对 30 分钟，p < 0.0001）显著降低。我们还注意到实质横断阶段中位门脉三联夹闭时间（0 对 25 分钟，p < 0.001）显著降低。此外，使用 ILMRD 设备可进行更复杂的肝切除术。
使用 ILMRD 进行射频辅助肝切除术与术中失血量显著减少相关，尽管手术复杂性增加且门脉三联夹闭减少，但出院时间更早。
