title: Liver resection for hepatocellular carcinoma using a microwave tissue coagulator: Experience of 1118 cases.
abstract: OBJECTIVE
  To present our extensive experience of hepatectomy for hepatocellular carcinoma using a microwave tissue coagulator to demonstrate the effectiveness of this device.
  
  
  METHODS
  A total of 1118 cases (1990-2013) were reviewed, with an emphasis on intraoperative blood loss, postoperative bile leakage and fluid/abscess formation, and adaptability to anatomical resection and hepatectomy with hilar dissection.
  
  
  RESULTS
  The median intraoperative blood loss was 250 mL; postoperative bile leakage and fluid/abscess formation were seen in 3.0% and 3.3% of cases, respectively. Anatomical resection was performed in 275 cases, including 103 cases of hilar dissection that required application of microwave coagulation near the hepatic hilum. There was no clinically relevant biliary tract stricture or any vascular problems due to heat injury. Regarding the influence of cirrhosis on intraoperative blood loss, no significant difference was seen between cirrhotic and non-cirrhotic patients (P = 0.38), although cirrhotic patients tended to have smaller tumors and underwent less invasive operations.
  
  
  CONCLUSIONS
  This study demonstrated outcomes of an extensive experience of hepatectomy using heat coagulative necrosis by microwave tissue coagulator.
authors.affiliation: Kazunari Sasaki, Masamichi Matsuda, Masaji Hashimoto, Goro Watanabe, Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Kazunari Sasaki, Masamichi Matsuda, Masaji Hashimoto, Goro Watanabe, Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Kazunari Sasaki, Masamichi Matsuda, Masaji Hashimoto, Goro Watanabe, Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Kazunari Sasaki, Masamichi Matsuda, Masaji Hashimoto, Goro Watanabe, Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D004867:Equipment Design; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013523:Surgical Equipment; D013997:Time Factors; D016896:Treatment Outcome
keywords: Hepatectomy; Hepatocellular carcinoma; Microwave; Microwave tissue coagulator