[Surgical techniques in hepatic resections: Ultrasonic aspirator versus Jet-Cutter. A prospective randomized clinical trial].
OBJECTIVE
For all resection-techniques of liver tissue intra- and post-operative blood-loss remains an important problem. Two novel resection-techniques the ultrasound-aspirator (CUSA) and the water-jet dissector (Jet-Cutter) appear to offer significant advantages regarding this problem. Aim of the present prospective clinical study was the comparison of these dissection techniques.


METHODS
Prospective randomized study with the end points blood-loss, length of surgery, tissue trauma and long-term survival.


RESULTS
Significant differences between both procedures with Jet-Cutter (n = 31) versus ultrasonic surgical aspirator CUSA (n = 30) were observed regarding length of resection and complete liver ischemia time (Pringle-time). Here significant advantages of the jet-cutter-technique were observed with 28 +/- 11 minutes length of resection versus 46 +/- 19 minutes and 29 +/- 12 minutes Pringle-time versus 39 +/- 16 minutes. Furthermore, significant fewer blood transfusions were required following jet-cutter-resection with a mean of 1.5 blood units vs. 2.5 blood units using the CUSA. No differences were observed regarding postoperative long-term survival.


CONCLUSIONS
The jet-cutter-technique is a fast and safe surgical procedure for liver resections and offers an attractive therapeutic alternative for various indications in liver surgery.
Rau
H G
HG
Chirurgische Klinik und Poliklinik, der Ludwig-Maximilians-Universität München, Klinikum Grosshadern, Germany.
Wichmann
M W
MW
Schinkel
S
S
Buttler
E
E
Pickelmann
S
S
Schauer
R
R
Schildberg
F W
FW
D016063:Blood Loss, Surgical; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D013525:Surgical Instruments; D014465:Ultrasonics; D014463:Ultrasonography
Wasserstrahldissektion bei Leberresektion: Ultraschallaspirator versus Jet-Cutter - Eine prospektiv randomisierte Studie -