Radiofrequency-assisted liver resection

SummaryBackgroundSurgical resection remains the treatment of choice for primary, secondary liver cancer and a number of benign liver lesions. Complications are mainly related to blood loss. Radiofrequency-assisted liver resection (RF-LR) has been proposed in order to achieve minimal blood loss during parenchymal transection.Patients and methodsBetween May 2005 and April 2007, 46 consecutive patients with various hepatic lesions underwent RF-LR using Radionics, Cool-TipTM System. There were 28 men and 18 women with median age 65 years (range 54–76 years). Twelve major and 34 minor hepatectomies were performed for various diseases: hepatocellular carcinoma (n=19), metastatic carcinoma (n=23), focal nodal hyperplasia (n=2) and intrahepatic cholangiocarcinoma (ICC) (n=2). Hepatic inflow occlusion was not used.ResultsNo perioperative death was documented. Median blood loss was 100 ml (range 30–300 cm3). Blood transfusion was required postoperatively in one patient. Median transection time was 35 min (15–60 min). Three patients developed biliary fistulas, four patients pleural effusions, one patient hyperbilirubinemia, two pneumonia and four wound infection. The median postoperative hospital stay was 6 days (range 4–10 days). In a median 12 month follow-up (range 3–24 months), four patients with colorectal metastases (CRM) and one patient with ICC developed recurrence.ConclusionsCool-Tip RF device provides a unique, simple and safe method of bloodless liver resections and is indicated in cirrhotic patients with challenging hepatectomies (segment VIII, central resections).