Radiofrequency vessel-sealing system versus the clamp-crushing technique in liver transection: results of a prospective randomized study on 100 consecutive patients

HPB (Oxford). 2014 Aug;16(8):707-12. doi: 10.1111/hpb.12207. Epub 2014 Jan 28.

Abstract

Background: Liver transection is considered a critical factor influencing intra-operative blood loss. A increase in the number of complex liver resections has determined a growing interest in new devices able to 'optimize' the liver transection. The aim of this randomized controlled study was to compare a radiofrequency vessel-sealing system with the 'gold-standard' clamp-crushing technique.

Methods: From January to December 2012, 100 consecutive patients undergoing a liver resection were randomized to the radiofrequency vessel-sealing system (LF1212 group; N = 50) or to the clamp-crushing technique (Kelly group, N = 50).

Results: Background characteristics of the two groups were similar. There were not significant differences between the two groups in terms of blood loss, transection time and transection speed. In spite of a not-significant larger transection area in the LF1212 group compared with the Kelly group (51.5 versus 39 cm(2) , P = 0.116), the overall and 'per cm(2) ' blood losses were similar whereas the transection speed was better (even if not significantly) in the LF1212 group compared with the Kelly group (1.1 cm(2) /min versus 0.8, P = 0.089). Mortality, morbidity and bile leak rates were similar in both groups.

Conclusions: The radiofrequency vessel-sealing system allows a quick and safe liver transection similar to the gold-standard clamp-crushing technique.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical / prevention & control*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation*
  • Catheter Ablation / mortality
  • Constriction
  • Equipment Design
  • Female
  • Hemostasis, Surgical / adverse effects
  • Hemostasis, Surgical / instrumentation*
  • Hemostasis, Surgical / methods
  • Hemostasis, Surgical / mortality
  • Hepatectomy / adverse effects
  • Hepatectomy / instrumentation*
  • Hepatectomy / methods
  • Hepatectomy / mortality
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Prospective Studies
  • Time Factors
  • Treatment Outcome