title: Is the TissueLink dissecting sealer a better liver resection device than clamp-crushing? A meta-analysis and system review.
abstract: OBJECTIVE
  Liver resection is the most effective treatment for selected patients with primary or metastatic hepatic tumor and many liver resection techniques have tried to minimize blood loss. The objective of the present study was to examine whether TissueLink dissection sealer (DS) was superior to clamp-crushing (CC) technique for liver transection or not.
  
  
  METHODS
  MEDLINE, Pubmed, Ovid and Cochrane Library electronic databases were used to search for studies without language and time period restrictions.
  
  
  RESULTS
  Four clinical trials with 276 patients were involved. We evaluated intraoperative blood loss, postoperative morbidity, postoperative biliary leakage, transfusion rate, operation time,hospital stay duration, postoperative mortality,transection time, blood loss in liver transection and pertran section area, transection speed, AST and TBIL and found no statistical differences between the DS and CC groups. Sensitive analysis showed transection time was longer in the former group. In addition, there was no apparent publication bias concerning intraoperative blood loss.
  
  
  CONCLUSIONS
  In summary, we could not draw a firm conclusion that DS is superior to CC in liver resection of transection and the advantage of TissueLink dissecting sealer should be evaluated
authors.affiliation: Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical College, Zhejiang, China. xgzsc@126.com
authors.forename: Shengchu
authors.initials: S
authors.lastname: Zhang
authors.forename: Yihu
authors.initials: Y
authors.lastname: Zheng
authors.forename: Binbi
authors.initials: B
authors.lastname: Wu
authors.forename: Shiqiang
authors.initials: S
authors.lastname: Ji
authors.forename: Zhengping
authors.initials: Z
authors.lastname: Yu
authors.forename: Qiyu
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical / Q000401:mortality / Q000517:prevention & control*; D001803:Blood Transfusion; D016009:Chi-Square Distribution; D003250:Constriction; D004867:Equipment Design; D005260:Female; D006488:Hemostasis, Surgical / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019106:Postoperative Hemorrhage / Q000097:blood / Q000401:mortality / Q000517:prevention & control*; D013523:Surgical Equipment; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D001663:Bilirubin