Radiofrequency-assisted liver resection in cirrhotic patients with hepatocellular carcinoma.
BACKGROUND
Radio-frequency-assisted liver resection has been shown to allow virtually bloodless procedures without the need for vascular exclusion manoeuvres. Our primary end-point was to evaluate safety and feasibility of RF-assisted liver resection in cirrhotic patients with hepatocellular carcinoma. Our second end-point was to assess whether the RF-assisted procedure influence the outcome in terms of morbidity and mortality.


METHODS
A retrospective study was done of 55 cirrhotic patients who underwent RF-assisted liver resection for HCC at our Departments between September 2001 and October 2007.


RESULTS
In the period of study 29 monosegmentectomies, 20 bisegmentectomies, 4 trisegmentectomies and 2 right hepatectomies were carried out. Vascular exclusion manoeuvres were never performed. One patient died post-operatively because of untreatable hepatorenal syndrome. Twelve patients out of 55 experienced 21 complications including complicated pleural effusion, intra-abdominal collection, hepatorenal syndrome, ascites, hematoma and biliary fistula. Post-operative liver failure occurred in one case (1.8%). In patients without post-operative morbidity (n = 43) the 4-year survival rate was 62% versus 24% in patients who experienced post-operative morbidity (n = 12) (P = 0.02).


CONCLUSIONS
RF-assisted liver resection is a safe and feasible procedure associated with lower morbidity and hospital mortality rates even in case of liver cirrhosis.
Curro
Giuseppe
G
Department of Surgical Science, University Hospital of Messina, Messina, Italy.
Jiao
Long
L
Scisca
Claudio
C
Baccarani
Umberto
U
Mucciardi
Massimo
M
Habib
Nagy
N
Navarra
Giuseppe
G
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006526:Hepatitis C; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors