title: Liver tissue dissection: ultrasonic or RFA energy?
abstract: BACKGROUND
  Hepatic resection is the only potential curative treatment for a wide variety of conditions. However, liver surgery is technically demanding and closely associated with a number of serious complications. New devices and techniques are currently being applied in practice, which will improve the surgical outcome.
  
  
  METHODS
  This retrospective study compares two methods of liver parenchymal division: ultrasound energy, a modern but already widely used technique, and radio-frequency ablation (RFA), a completely novel method. The parameters investigated include the amount of blood transfused, the necessity of the Pringle maneuver, the length of time required for parenchymal division, and postoperative morbidity and mortality. The patients were divided into two groups. In one group (Group A), 15 patients underwent 17 ultrasound-assisted liver resections, in which ten metastatic tumors, six hepatomas, and one cholangiocarcinoma were resected. In Group B, 21 patients underwent 22 RFA-assisted hepatectomies in which 11 metastatic tumors, ten hepatomas, and two cholangiocarcinomas were removed.
  
  
  RESULTS
  Thirteen patients (87%) in Group A and 11 (52%) in Group B received a transfusion, with an average of 3.5 and 1.6 units of red blood cells, respectively. The Pringle maneuver was necessary in two cases in Group A but was unnecessary in Group B. The mean length of time required for parenchymal dissection was 124 min in Group A and 93.18 min in Group B. One (6.7%) and four (19%) complications were observed in Group A and B, respectively (statistically not significant). Mortality remained zero in both groups.
  
  
  CONCLUSIONS
  RFA energy provides a novel reliable and safe alternative that can be used exclusively or as a supplement to the older techniques. Both resection time and amount of blood transfusion were reduced in the RFA group.
authors.affiliation: First Department of Surgery, University of Athens, Laiko General Hospital, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Felekouras
authors.forename: Evangelos
authors.initials: E
authors.lastname: Prassas
authors.forename: Michael
authors.initials: M
authors.lastname: Kontos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papaconstantinou
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Pikoulis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: Christos
authors.initials: C
authors.lastname: Tsigris
authors.forename: Michael
authors.initials: M
authors.lastname: Tzivras
authors.forename: Chris
authors.initials: C
authors.lastname: Bakogiannis
authors.forename: Michael
authors.initials: M
authors.lastname: Safioleas
authors.forename: Efstathios
authors.initials: E
authors.lastname: Papalambros
authors.forename: Elias
authors.initials: E
authors.lastname: Bastounis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014464:Ultrasonic Therapy