Can a small ultrasonic dissector equipped for electrocautery improve the results of hepatic resection?
OBJECTIVE
In liver surgery, blood loss during hepatic transection is important. The use of an ultrasonic dissector was not always superior to conventional clamp crushing for performing hepatic parenchymal transections. The purpose of this study is to evaluate the effect of an ultrasonic dissector equipped with electrocautery in hepatic surgery.


METHODS
A prospective study was conducted in 66 consecutive patients who underwent a partial hepatectomy using a new small ultrasonic dissector equipped for electrocautery. To evaluate the effectiveness of using the new instrument, the surgical outcomes were compared with those of historical control.


RESULTS
The surgical outcomes of procedures using the new ultrasonic dissector were comparable to those of patients in the conventional ultrasonic dissector group; median blood loss, transection time, transection speed, percentage of tumor exposure at surgical margin, morbidity rate. The number of technical errors and the percentage of patients with an incomplete landmark appearance were lower in the new dissector group, but the differences were not significant. The distribution of hepatectomy grades also did not differ significantly.


CONCLUSIONS
The surgical outcome of hepatectomies performed using an ultrasonic dissector cannot be significantly improved by the addition of an eletrocautery function to the dissector.
Seyama
Yasuji
Y
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan. SEYAMAY-SUR@h.u-tokyo.ac.jp
Makuuchi
Masatoshi
M
Takayama
Tadatoshi
T
Cescon
Matteo
M
Kokudo
Norihiro
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016022:Case-Control Studies; D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014465:Ultrasonics; D014463:Ultrasonography