A novel method using the VIO soft-coagulation system for liver resection.
BACKGROUND
The VIO soft-coagulation system (SCS) is a new device for tissue coagulation. The current study evaluated the efficacy of the SCS when used for liver resection.


METHODS
The 252 patients were divided into 2 groups; in 155 patients (conventional group), liver transection was performed using an ultrasonic dissector and saline-coupled bipolar electrocautery for hemostasis. In 97 patients (SCS group), the SCS was used instead of bipolar electrocautery.


RESULTS
The median blood loss and surgical time were less in the SCS group than in the conventional group (350 vs 640 mL, P = .0028; 280 vs 398 min, P < .0001). No significant differences were found in postoperative complications between the SCS group (32.0%) and the conventional group (40.6%). The risk factors for bleeding were nonuse of the SCS (P = .0039), macroscopic vascular invasion of the hepatic tumors (P = .0088), and collagen type IV value in the sera >200 (P = .0250) on multivariate analysis. In a subgroup analysis, in the collagen type IV value >200 subgroup, the tumor diameter >5 cm subgroup, and the inflow nonocclusion subgroup, use of the SCS decreased surgical bleeding (P = .0120, P = .0126, and P = .0032, respectively) and surgical time (P = .0001, P < .0001, and P = .0036, respectively) compared with the conventional group. Furthermore, even in the major hepatectomy group, the SCS use decreased surgical time (P < .0001).


CONCLUSIONS
The SCS is an effective and safe device for decreasing surgical time and surgical bleeding without increasing the rate of bile leakage and causing other complications.
Hirokawa
Fumitoshi
F
Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan. sur122@poh.osaka-med.ac.jp
Hayashi
Michihiro
M
Miyamoto
Yoshiharu
Y
Iwamoto
Mitsuhiko
M
Tsunematsu
Ichiro
I
Asakuma
Mitsuhiro
M
Shimizu
Tetsunosuke
T
Komeda
Koji
K
Inoue
Yoshihiro
Y
Tanigawa
Nobuhiko
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004564:Electrocoagulation; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013997:Time Factors