Mulpuri Venu Bhargava, Gurijala Prasanth, Yerolla Bhaskar R, Kumar Gokul, Dutt Ashwini
Department of Surgical Gastroenterology, Employee State Insurance Corporation Medical College and Hospital, Hyderabad, IND.
Department of General Surgery, Employee State Insurance Corporation Medical College, Hyderabad, IND.
Cureus. 2021 Dec 3;13(12):e20130. doi: 10.7759/cureus.20130. eCollection 2021 Dec.
Various techniques have been reported to reduce blood loss during a parenchymal transection, and the radiofrequency ablation (RFA) technique is one of them. Owing to the charring of the adjacent liver tissue and the inability to use the conventional RFA techniques near major vessels, this study used a radial fiber of RFA. This technical report thus describes a technique to perform parenchymal transection using a radial fiber as well as its advantages and disadvantages. A radial fiber dissipates the energy radially and it has the added advantage of placing along the same and perpendicular axis of the liver parenchyma; it has been used in three patients in this study. The total intraoperative blood loss was 30-50 ml during parenchymal transection, and the intraoperative duration was 120-170 min. Bile leak was noted in one patient, which was then managed using the conventional treatment. Through the present technique, the fiber can be used in the vicinity of major blood vessels and necrosis and charring can be prevented. Although radial fiber has some advantages, it remains in the preliminary stage and requires further validation.
据报道,有多种技术可减少实质切开术中的失血,射频消融(RFA)技术就是其中之一。由于相邻肝组织会发生炭化,且无法在大血管附近使用传统的RFA技术,本研究采用了RFA的径向纤维。因此,本技术报告描述了一种使用径向纤维进行实质切开的技术及其优缺点。径向纤维沿径向耗散能量,并且具有沿肝实质的同一轴线和垂直轴线放置的额外优势;本研究已将其应用于3例患者。实质切开术中的术中总失血量为30 - 50毫升,手术时间为120 - 170分钟。1例患者出现胆漏,随后采用传统治疗方法处理。通过本技术,纤维可在大血管附近使用,并可防止坏死和炭化。尽管径向纤维有一些优点,但它仍处于初步阶段,需要进一步验证。