Radiofrequency (RF)-assisted hepatectomy may induce severe postoperative liver damage.
BACKGROUND
Radiofrequency (RF) ablation for the treatment of the section line prior to liver resection has been proposed as a way to reduce blood loss during hepatectomy. Our group compared hepatectomy with and without RF ablation to determine whether this technique actually reduces blood loss during liver resection and whether it affects the perioperative outcome.


METHODS
Of 151 patients who underwent a hepatectomy between January 2002 and October 2005 at the Division of Gastrointestinal Surgery in the Department of Surgery of Saitama Medical University, 48 who had a partial hepatectomy or resection of a portion of liver smaller than a single Couinaud segment were included in the study. Twenty patients who had RF-assisted hepatectomy [RF (+) group] and 28 patients who had hepatectomy without ablation [RF (-) group] were studied to compare the rates of intraoperative blood loss and the effects of RF ablation on the perioperative outcome.


RESULTS
Intraoperative blood loss was significantly reduced in the RF (+) group. In contrast, the alanine aminotransferase activity in the RF (+) group was significantly elevated immediately after the operation. There was no significant difference in the incidence of postoperative complications between the groups, although bile leakage did occur in three RF (+) patients.


CONCLUSIONS
Our results demonstrate that the RF ablation technique can be a useful way to reduce surgical blood loss. In view of its association with severe postoperative liver damage, the technique must be applied with caution. The danger may be especially relevant to patients with chronic liver disease and decreased liver reserve.
Mitsuo
Miyazawa
M
Department of Surgery, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298, Japan. miyazawa@saitama-med.ac.jp
Takahiro
Torii
T
Yasuko
Toshimitsu
T
Masayasu
Aikawa
A
Katsuya
Okada
O
Nozomi
Shinozuka
S
Yoshihide
Otani
O
Isamu
Koyama
K
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged
D000410:Alanine Transaminase; D001663:Bilirubin