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使用射频发生器进行射频辅助肝实质切除术。

Radiofrequency Assisted Hepatic Parenchyma Resection Using Radiofrequent Generator (RF) Generator.

作者信息

Sabanovic Jusuf, Muhovic Samir, Rovcanin Ajdin, Musanovic Safet, Bajramagic Salem, Kulovic Edin

机构信息

Clinic for General and Abdominal Surgery. University Clinical Center Sarajevo (UCCS), Sarajevo, Bosnia and Herzegopvina.

出版信息

Acta Inform Med. 2018 Dec;26(4):265-268. doi: 10.5455/aim.2018.26.265-268.

Abstract

INTRODUCTION

The role of Radio frequent Generator (RF) has been extended from simple tumor ablation to routine hepatic resection. RF energy precoagulates the tissue and thus allows the closure of small blood vessels and bile ducts. The development of surgical techniques and modern technological advances have enabled liver resections to be significantly surgically better controlled in the sense of bleeding, and are more successful and safer for patients. The RF generator has its advantages and disadvantages and as such can be equally used in resective liver surgery.

AIM

Display the intraoperative and postoperative complications among patients that had been subjected to liver resection using a RF generator (RF resection), compared to those that had been subjected to liver resection without the use of RF generators (classical liver resection methods of CC resection).

MATERIAL AND METHODS

The study included 60 patients of both sexes which had resective operative surgery or metastasectomy on the liver due to the basic process. The study was conducted at the Clinic for General and Abdominal Surgery of the Clinical Center of the University of Sarajevo in a four-year period. The study was designed as a comparative study of outcome and postoperative complications of surgical treatment, i.e. resective liver interventions using two operating techniques (RF-liver resection and Classical resection techniques on the liver).

RESULTS

The highest number of surgical procedures was due to colorectal cancer. A slightly smaller number was performed due to primary liver cancer and gallbladder cancer. The highest number of surgical interventions remain on non-anatomic resections. Smaller number remains to large resective operations. The length of hospitalization was significantly correlated with blood loss (r = 713 p = 0,000) and the average hospitalization time ranged from 10.5 to 53.3 days.

CONCLUSION

We have shown that the use of RF generators does not significantly reduce intraoperative and postoperative complications. There is a justification for using both techniques for resection on the liver. The resective liver operation depends mostly on the personal stance and the surgeons training.

摘要

引言

射频发生器(RF)的作用已从简单的肿瘤消融扩展到常规肝切除。射频能量可使组织预先凝固,从而实现小血管和胆管的闭合。手术技术的发展和现代技术进步使肝切除在出血控制方面能得到更好的手术控制,对患者而言更成功、更安全。射频发生器有其优缺点,因此可同样用于肝切除手术。

目的

展示使用射频发生器进行肝切除(射频切除)的患者与未使用射频发生器进行肝切除(传统肝切除方法,如CC切除)的患者术中及术后并发症情况。

材料与方法

该研究纳入了60例因基础疾病接受肝脏切除手术或肝转移瘤切除术的患者,男女不限。研究在萨拉热窝大学临床中心普通及腹部外科诊所进行,为期四年。该研究设计为对手术治疗结果及术后并发症的比较研究,即使用两种手术技术(射频肝切除和传统肝切除技术)进行的肝切除干预。

结果

手术例数最多的是结直肠癌。因原发性肝癌和胆囊癌进行手术的例数略少。手术干预最多的是解剖性切除。大的肝切除手术例数较少。住院时间与失血量显著相关(r = 713,p = 0.000),平均住院时间为10.5至53.3天。

结论

我们已表明,使用射频发生器并不能显著降低术中及术后并发症。两种肝切除技术都有其应用的合理性。肝切除手术主要取决于个人立场和外科医生的培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e47f/6311120/2f9591f78a0a/AIM-26-265-g001.jpg

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