title: Preliminary report on surgical technique in hepatic parenchymal transection for liver tumors in the elderly: a lesson learned from living-related liver transplantation.
abstract: OBJECTIVE
  Availability of hi-tech surgical devices has elaborated the technique of parenchymal transection during hepatectomy from classic crushing clamp technique 1,2 to a combination of an ultrasonic dissection with special type of cautery 3,4. We have developed a new technique to resect hepatic parenchyma using an ultrasonic surgical aspirator in association with a monopolar floating ball. This combination has been utilized in 42 liver resections.
  
  
  METHODS
  A retrospective analysis of perioperative mortality, length of hospitalization, and blood transfusion during surgery in two patient groups who underwent liver resection was carried out. We divided the patient population into Group A (42 patients), who underwent the new technique, and Group B (107 patients), who experienced the crushing clamp technique. A second analysis was performed, where we divided the same patient population group in Group 1 with age less than 65, and Group 2 including patients older than 65 years.
  
  
  RESULTS
  We found that the new technique reduced length of stay, procedure length, and use of perioperative blood. We determined that the two age groups performed similarly in comparison to LOS, length of procedure, blood use, and complications.
  
  
  CONCLUSIONS
  This enforces the fact that the elderly can receive such surgical treatment without hesitation.
authors.affiliation: Department of Surgery, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione IsMeTT-UPMC, Palermo, Italy. sgruttadauria@ismett.edu
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: Cataldo
authors.initials: C
authors.lastname: Doria
authors.forename: Claudio H
authors.initials: CH
authors.lastname: Vitale
authors.forename: Davide
authors.initials: D
authors.lastname: Cintorino
authors.forename: Carlo Scotti
authors.initials: CS
authors.lastname: Foglieni
authors.forename: John J
authors.initials: JJ
authors.lastname: Fung
authors.forename: Ignazio R
authors.initials: IR
authors.lastname: Marino
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D002425:Cautery; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014463:Ultrasonography