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使用双极射频设备(Habib®)进行肝切除术的可行性

The Feasibility of Hepatic Resections Using a Bipolar Radiofrequency Device (Habib®).

作者信息

Civil Osman, Kement Metin, Okkabaz Nuri, Haksal Mustafa, Gezen Cem, Oncel Mustafa

机构信息

Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey.

Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey ; Department of General Surgery, Medipol University Hospital, Istanbul, Turkey.

出版信息

Indian J Surg. 2015 Aug;77(4):276-82. doi: 10.1007/s12262-015-1295-7. Epub 2015 Jun 5.

Abstract

The bipolar radiofrequency device (Habib®) has been recently introduced in order to reduce intraoperative bleeding for a safe hepatic resection as an alternative to the conventional tools. However, indications, perioperative findings, and outcome of the device for hepatic resections remain and deserve to be analyzed. The current study aims to analyze the feasibility of the bipolar radiofrequency device (Habib®) for hepatic resections. Information of the patients that underwent hepatic resection using with the Habib® device between 2007 and 2011 was abstracted. Patient, disease, and operation-related findings and perioperative data were investigated. A total of 71 cases (38 [53.5 %] males, mean age was 56.8 ± 11.9) were analyzed. Metastatic disease (n = 55; 77.5 %) was the leading indication followed by primary liver and biliary malignancies (n = 7; 9.9 %), hemangioma (n = 5; 7 %), hydatid disease (n = 3; 2.8 %), and hepatic gunshot trauma (n = 1; 1.4 %). Metastasectomy was the most commonly performed procedure (n = 31; 56.3 %), but in 24 (77.4 %) cases, it was performed in addition to extended resections. Other procedures in the study patients include segmentectomy in 17, bisegmentectomy in 19, trisegmentectomy in 17, right or left hepatectomy in 8, and extended right/left hepatectomy in 3. The mean (±SD) operation time was 241.7 ± 78.2 min. The median amount of bleeding was 300 cc (range 25-2500), and 23 (32.4 %) cases required perioperative transfusion. The median hospitalization period was 5 days (range 1-47). Lengthened drainage (n = 9, 12.7 %) and intraabdominal abscess (n = 8, 11.23 %) were the most common problems. Hepatic resections using the Habib® device seem to be feasible in cases with primary and metastatic hepatic lesions and benign liver masses and even those with hepatic trauma. It may lessen the amount of intraoperative hemorrhage, although lengthened drainage and intraabdominal abscess were the major postoperative problems in these cases.

摘要

双极射频设备(Habib®)最近已被引入,以减少肝切除术中的出血,作为传统工具的替代方法来实现安全的肝切除术。然而,该设备用于肝切除的适应证、围手术期表现及结果仍有待分析。本研究旨在分析双极射频设备(Habib®)用于肝切除术的可行性。提取了2007年至2011年间使用Habib®设备进行肝切除患者的信息。对患者、疾病、手术相关表现及围手术期数据进行了调查。共分析了71例患者(38例[53.5%]为男性,平均年龄56.8±11.9岁)。转移性疾病(n = 55;77.5%)是主要适应证,其次是原发性肝脏和胆道恶性肿瘤(n = 7;9.9%)、血管瘤(n = 5;7%)、包虫病(n = 3;2.8%)和肝枪伤(n = 1;1.4%)。肝转移瘤切除术是最常施行的手术(n = 31;56.3%),但在24例(77.4%)患者中,该手术是在扩大切除的基础上进行的。本研究患者的其他手术包括17例段切除术、19例双段切除术、17例三段切除术、8例右半肝或左半肝切除术以及3例扩大右/左半肝切除术。平均(±标准差)手术时间为241.7±78.2分钟。术中出血量中位数为300毫升(范围25 - 2500毫升),23例(32.4%)患者需要围手术期输血。住院时间中位数为5天(范围1 - 47天)。引流时间延长(n = 9,12.7%)和腹腔内脓肿(n = 8,11.23%)是最常见的问题。使用Habib®设备进行肝切除术对于原发性和转移性肝病变、肝脏良性肿块甚至肝外伤患者似乎是可行的。尽管引流时间延长和腹腔内脓肿是这些病例的主要术后问题,但它可能会减少术中出血量。

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