title: Impact of the VIO system in hepatic resection for patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  This study aimed to evaluate a novel surgical device combination [VIO system containing a bipolar clamp (BiClamp) and the monopolar soft-coagulation (SOFT COAG)] in hepatic resection for patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  This study performed 124 hepatic resections for HCC and divided them into 2 groups: 60 patients (Conventional group) underwent liver parenchymal transection using Cavitron Ultrasonic Surgical Aspirator (CUSA) system and saline-coupled bipolar electrocautery for hemostasis; the BiClamp was used with the CUSA system for liver parenchymal transection and SOFT COAG was used with saline-coupled bipolar electrocautery for hemostasis in 64 patients (VIO group).
  
  
  RESULTS
  The median blood loss in the VIO group was 345 mL, which was less than that in the Conventional group (median 548 mL, P = 0.0423). A multivariate logistic regression analysis showed that no use of the VIO system (P = 0.0172) was an independent predictor of intraoperative blood loss, respectively. In patients with liver cirrhosis, the VIO group included a significantly lower proportion of patients with liver cirrhosis that experienced more than 500 mL of intraoperative blood loss in comparison to those in the Conventional group (P = 0.0262).
  
  
  CONCLUSIONS
  The VIO system was safe for hepatic resection and its use was associated with a significant decrease in intraoperative blood loss even in cirrhotic patients.
authors.affiliation: Department of Surgery, Oita Red Cross Hospital, 3-2-37 Chiyomachi, Oita 870-0033, Japan. itoshin@surg2.med.kyushu-u.ac.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Itoh
authors.forename: Kengo
authors.initials: K
authors.lastname: Fukuzawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shitomi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okamoto
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Kenzo
authors.initials: K
authors.lastname: Wakasugi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D004564:Electrocoagulation / Q000295:instrumentation*; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008099:Liver / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D013396:Suction / Q000295:instrumentation; D013525:Surgical Instruments