Two-surgeon technique for liver transection using precoagulation by a soft-coagulation system and ultrasonic dissection.
OBJECTIVE
A soft-coagulation system (SCS) was introduced as an effective device to reduce blood loss in hepatectomy. Here we evaluated the efficacy of a two-surgeon technique using precoagulation by an SCS and the Cavitron Ultrasonic Surgical Aspirator (CUSA) for liver transection.


METHODS
The 163 patients with liver tumors were divided into two groups (conventional group and two-surgeon group). Liver transection was conducted using saline-coupled bipolar electrocautery and CUSA in 102 patients (conventional group). In 61 patients (the two-surgeon group), a two-surgeon technique using precoagulation by an SCS and CUSA for liver resection was performed.


RESULTS
The median blood loss was significantly less in the two-surgeon group compared to the conventional group (354.8 mL vs. 557.8 mL, respec tively: p = 0.0011). The postoperative hospital stay was significantly shorter in the two-surgeon group compared to the conventional group (12.7 days vs. 15.5 days, p = 0.0035).


CONCLUSIONS
The two-surgeon technique using precoagulation by an SCS and CUSA was significantly reduced blood loss during liver transection, and associated with low morbidity and mortality. This technique may be useful for many hepatobiliary surgeons.
Nobuya
N
Yamada
Ryosuke
R
Amano
Kenjiro
K
Kimura
Akihiro
A
Murata
Masakazu
M
Yashiro
Sayaka
S
Tanaka
Kenichi
K
Wakasa
Kosei
K
Hirakawa
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D004867:Equipment Design; D005260:Female; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality