Precoagulation with microwave ablation for hepatic parenchymal transection during liver partial resection

Abstract

Purpose: To evaluate the feasibility of precoagulation with microwave ablation (MWA) for hepatic parenchymal transection during liver partial resection. Methods: A total of 66 eligible patients were enrolled in this double-blind, randomized, controlled study. Patients were randomized to receive either the traditional clamp-crushing method (Control group) or the MWA precoagulation method (MWA group) for hepatic parenchymal transection during liver partial resection. The operative time, hepatic portal occlusion time, intraoperative blood loss and transfusion, postoperative complications and recovery outcomes were compared. Results: Compared to the Control group, the MWA group had significantly less intraoperative blood loss. Fewer red blood cell transfusions were observed in the MWA group but without statistical significance. The MWA group showed significantly higher serum alanine aminotransferase and aspartate aminotransferase levels at day 1 postoperatively, but no differences between the MWA and Control groups were found at days 3 and 7. There were no significant differences in terms of operative time, hepatic portal occlusion time, postoperative total bilirubin levels, human albumin solution consumption or length of hospital stay. Postoperative complications such as impaired renal function, pyrexia, admission to ICU, abscess, biliary leakage, intrahepatic and distant tumor recurrence and in-hospital mortality were comparable between the two groups. Conclusion: Precoagulation with MWA reduced intraoperative blood loss with similar postoperative complications, providing a safe, effective, novel alternative for hepatic parenchymal transection during liver partial resection. Additional results from larger series are recommended to confirm these findings.

Effects of microwave ablation on serum Golgi protein 73 in patients with primary liver cancer

“…Therefore, MWA is widely accepted as an effective nonsurgical treatment option for liver cancer of a small size and at an early stage[ 19 - 23 ]. Of note, MWA has been demonstrated to completely destroy tumor cells and has been proposed as a radical treatment for small primary liver cancer (≤ 3 cm in diameter) with a single lesion[ 6 , 22 , 24 ]. In addition, Zhang et al [ 25 ] performed a meta-analysis of 1480 patients and showed that the therapeutic effectiveness of MWA was superior to that of surgical resection for the treatment of small liver cancer (< 3 cm in diameter).…”

Linear radiofrequency ablation using dual switching-control mode achieves rapid and bloodless liver resection, an experimental research

“…Intraoperative bleeding increases the likelihood that transfusion will be required, which in turn increases the increased risk of complications and tumor recurrence [7,8]. Numerous devices are used to reduce bleeding during liver resection, such as ultrasonic surgical aspirators, ultrasonic dissection devices, bipolar electrosurgical devices, microwave assisted surgical devices [9][10][11] and radiofrequency (RF) based devices. Nonetheless, the clinical benefits of these devices have yet to be proven [12].…”