Novel in-line multielectrode radiofrequency ablation considerably reduces blood loss during liver resection in an animal model.
BACKGROUND
Liver resection is widely used in the treatment of primary and secondary liver tumours. One of several important factors associated with mortality both in cirrhotic and non-cirrhotic patients after liver resection is operative blood loss. We evaluated the use of a prototype radiofrequency ablation probe to treat the transection plane prior to liver resection in the sheep model.


METHODS
In-line radiofrequency ablation (RFA) was performed on the liver using a prototype device consisting of 11 electrodes mounted on a 8-cm base. The RITA 1500 generator was used for power delivery. Ultrasonic aspirator (UA) and clamp resection were performed on the liver of sheep with and without in-line RFA. The blood loss was measured by weighing swabs.


RESULTS
A total of 26 liver resections were performed. The mean (SD) blood loss with UA resection was 0.032 g (0.011) versus 0.005 (0.005) g without and with prior in-line RFA, respectively (P = 0.001). The mean (SD) blood loss with clamp resection was 0.087 (0.10) g versus 0.01 (0.008) without and with in-line RFA, respectively (P = 0.155).


CONCLUSIONS
In-line RFA makes liver resection easier with minimal blood loss and may make cirrhotic liver resection easier with minimal blood loss. This is likely to improve the operative safety of liver resection.
Gananadha
Sivakumar
S
University of New South Wales Department of Surgery, St George Hospital, Sydney, Australia.
Morris
David L
DL
D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D017115:Catheter Ablation / Q000295:instrumentation*; D004566:Electrodes; D004867:Equipment Design; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods*; D023421:Models, Animal; D012756:Sheep