title: Microwave assisted liver resection: clinical feasibility study and preliminary results.
abstract: OBJECTIVE
  The main goal of liver resection for malignant tumors is nowadays represented by properly parenchymal transection and careful control of hemostasis. Applying the concept of precoagulation of liver transection line we developed a new technique that provides the pre coagulation of the resection line using microwaves technologies. The purpose of this study is to evaluate the feasibility of this new liver transection technique demonstrating the high performance of this procedure, the accuracy in terms of squeeze effect on veins and portal branch and in terms of reducing the intra operative blood loss.
  
  
  METHODS
  From December 2010 to January 2012 a total of ten patients (6 men and 4 women) affected by liver metastatic disease from colon rectal cancer and primitive liver cancer were treated (five patients with metastatic colorectal cancer disease and five patient with hepatocellular carcinoma respectively): patients requiring major liver resection were excluded from the present study focusing attention on minor liver resection.
  
  
  RESULTS
  The technique used for the parenchyma transection is similar to those previously described by our group for hepatic radiofrequency assisted liver resection. There was no need for vascular occlusive clamping while during each surgical procedure the underpass of the hepatic hilum was done for safety control of any kind of hepatic bleeding. There was no need for ties and clips excluding the main vascular an bile pedicles that were sutured between ties.
  
  
  CONCLUSIONS
  In conclusion this study with a small group of patients suggest surgical advantages in terms of statement for best practice in oncologic resection of liver malignancy. It allows a complete resection obtaining a negative pathologic margin, no blood loss and need for blood transfusions factors predicting post operative morbidity and survival, and consistently reducing time of procedure and avoidance of parenchymal ischemia. Further studies should confirm this preliminary data extending surgical indication to major hepatic resection.
authors.affiliation: Hepatobiliary Unit, Department of Surgery, Santa Corona Hospital, Pietra Ligure, Savona, Italy. a.percivale@asl2.liguria.it
authors.forename: A
authors.initials: A
authors.lastname: Percivale
authors.forename: G
authors.initials: G
authors.lastname: Griseri
authors.forename: A
authors.initials: A
authors.lastname: Gastaldo
authors.forename: M
authors.initials: M
authors.lastname: Benasso
authors.forename: R
authors.initials: R
authors.lastname: Pellicci
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome