Radiofrequency vessel-sealing system versus the clamp-crushing technique in liver transection: results of a prospective randomized study on 100 consecutive patients.
BACKGROUND
Liver transection is considered a critical factor influencing intra-operative blood loss. A increase in the number of complex liver resections has determined a growing interest in new devices able to 'optimize' the liver transection. The aim of this randomized controlled study was to compare a radiofrequency vessel-sealing system with the 'gold-standard' clamp-crushing technique.


METHODS
From January to December 2012, 100 consecutive patients undergoing a liver resection were randomized to the radiofrequency vessel-sealing system (LF1212 group; N = 50) or to the clamp-crushing technique (Kelly group, N = 50).


RESULTS
Background characteristics of the two groups were similar. There were not significant differences between the two groups in terms of blood loss, transection time and transection speed. In spite of a not-significant larger transection area in the LF1212 group compared with the Kelly group (51.5 versus 39 cm(2) , P = 0.116), the overall and 'per cm(2) ' blood losses were similar whereas the transection speed was better (even if not significantly) in the LF1212 group compared with the Kelly group (1.1 cm(2) /min versus 0.8, P = 0.089). Mortality, morbidity and bile leak rates were similar in both groups.


CONCLUSIONS
The radiofrequency vessel-sealing system allows a quick and safe liver transection similar to the gold-standard clamp-crushing technique.
Department of Surgical Oncology, Institute for Cancer Research and Treament (IRCC), Candiolo (TO), Italy.
Andrea
A
Muratore
Alfredo
A
Mellano
Giuseppe
G
Tarantino
Patrizia
P
Marsanic
Michele
M
De Simone
Fabrizio
F
Di Benedetto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D003250:Constriction; D004867:Equipment Design; D005260:Female; D006488:Hemostasis, Surgical / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome