Randomized clinical trial of the effect of a saline-linked radiofrequency coagulator on blood loss during hepatic resection.
BACKGROUND
Use of a saline-linked radiofrequency coagulator (dissecting sealer) has been suggested to reduce blood loss during hepatic resection. A randomized clinical trial was conducted to assess the effects of using the device on the amount of blood loss.


METHODS
Patients scheduled to undergo hepatic resection were randomly assigned to either use of the dissecting sealer or the clamp crushing method. The primary outcome measure was blood loss during liver parenchymal division. Multivariate analysis was also performed.


RESULTS
Ninety-four consecutive patients underwent hepatic resection and 40 patients were assigned to each group. There were no significant differences between the dissecting sealer and clamp crushing groups in blood loss during liver parenchymal division (median 373 versus 535 ml; P = 0.252) or total intraoperative blood loss (665 versus 733 ml; P = 0.450). Multivariate analysis revealed that use of the dissecting sealer offered no protection against blood loss compared with the clamp crushing method (odds ratio 1.17 (95 per cent confidence interval 0.39 to 3.53); P = 0.777), whereas number of resections, thoracotomy and type of resection had a significant effect.


CONCLUSIONS
Use of a dissecting sealer offered no substantial benefit over the clamp crushing method in reducing blood loss during hepatic resection.
Arita
J
J
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Hasegawa
K
K
Kokudo
N
N
Sano
K
K
Sugawara
Y
Y
Makuuchi
M
M
D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D003250:Constriction; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome
D012965:Sodium Chloride