Two different methods for donor hepatic transection: cavitron ultrasonic surgical aspirator with bipolar cautery versus cavitron ultrasonic surgical aspirator with radiofrequency coagulator-A randomized controlled trial.
The aim of this study was to compare the Cavitron ultrasonic surgical aspirator (CUSA) with bipolar cautery (BP) to CUSA with a radiofrequency coagulator [TissueLink (TL)] in terms of efficacy and safety for hepatic transection in living donor liver transplantation. Twenty-four living liver donors (n = 12 for each group) were randomized to undergo hepatic transection using CUSA with BP or CUSA with TL. Blood loss during parenchymal transection and speed of transection were the primary endpoints, whereas the degree of postoperative liver injury and morbidity were secondary endpoints. Median blood loss during liver transection was significantly lower in the TL group than in the BP group (195.2 +/- 84.5 versus 343.3 +/- 198.4 mL; P = 0.023), and liver transection was significantly faster in the TL group than in the BP group (0.7 +/- 0.2 versus 0.5 +/- 0.2 cm(2)/minute; P = 0.048). Significantly fewer ties were required during liver transection in the TL group than in the BP group (15.8 +/- 4.8 versus 22.8 +/- 7.9 ties; P = 0.023). The morbidity rates were similar for the 2 groups. In conclusion, CUSA with TL is superior to CUSA with BP for donor hepatectomy in terms of blood loss and speed of transection with no increase in morbidity.
El Moghazy
Walid M
WM
Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Kyoto University, Kyoto, Japan. moghazyw@gmail.com
Hedaya
Mohammed S
MS
Kaido
Toshimi
T
Egawa
Hiroto
H
Uemoto
Shinji
S
Takada
Yasutsugu
Y
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002425:Cautery / Q000295:instrumentation* / Q000379:methods; D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D011184:Postoperative Period; D011846:Radio Waves; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation* / Q000379:methods; D014463:Ultrasonography
D002097:C-Reactive Protein