title: Impact of monopolar radiofrequency coagulation on intraoperative blood loss during liver resection: a prospective randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the impact of using monopolar thermal coagulation based on radiofrequency (RF) currents on intraoperative blood loss during liver resection.
  
  
  METHODS
  A prospective randomised controlled trial was planned. Patients undergoing hepatectomy were randomised into two groups. In the control group (n = 10), hemostasis was obtained with a combination of stitches, vessel-sealing bipolar RF systems, sutures or clips. In the monopolar radiofrequency coagulation (MRFC) group (n = 18), hemostasis was mainly obtained using an internally cooled monopolar RF electrode.
  
  
  RESULTS
  No differences in demographic or clinical characteristics were found between groups. Mean blood loss during liver resection in the control group was more than twice that of the MRFC group (556 ± 471 ml vs. 225 ± 313 ml, p = .02). The adjusted mean bleeding/transection area was also significantly higher in the control group (7.0 ± 3.3 ml/cm2vs. 2.8 ± 4.0 ml/cm2, p = .006). No significant differences were observed in the rate of complications between the groups.
  
  
  CONCLUSIONS
  The findings suggest that the monopolar electrocoagulation created with an internally cooled RF electrode considerably reduces intraoperative blood loss during liver resection.
authors.affiliation: a Cancer Research Group HBP , Fundación Instituto Mar de Investigaciones Médicas , Barcelona , Spain.|b Apeiron Medical , Valencia , Spain.
authors.forename: Rita
authors.initials: R
authors.lastname: Quesada
authors.affiliation: c General Surgery Department , Hospital del Mar , Barcelona , Spain.
authors.forename: Ignasi
authors.initials: I
authors.lastname: Poves
authors.affiliation: d Department of Electronic Engineering , Universitat Politècnica de València , Valencia , Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Berjano
authors.affiliation: e Clinical Chemistry , Laboratori de Referència de Catalunya, Hospital del Mar , Barcelona , Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Vilaplana
authors.affiliation: f Medicine and Surgery of Animals Department, Facultat de Veterinària , Universitat Autònoma de Barcelona , Bellaterra , Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Andaluz
authors.affiliation: f Medicine and Surgery of Animals Department, Facultat de Veterinària , Universitat Autònoma de Barcelona , Bellaterra , Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Moll
authors.affiliation: g Hepatobiliary and Liver Transplant Surgical Unit , St. Vincent's University Hospital , Dublin , Ireland.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Dorcaratto
authors.affiliation: c General Surgery Department , Hospital del Mar , Barcelona , Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Grande
authors.affiliation: c General Surgery Department , Hospital del Mar , Barcelona , Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Burdio
keywords: Bleeding; cooled electrode; liver surgery; monopolar RF coagulation; surgical resection