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Int J Hyperthermia. 2016 Oct 5:1-7. [Epub ahead of print]

Impact of monopolar radiofrequency coagulation on intraoperative blood loss during liver resection: a prospective randomised controlled trial.

Author information

1
a Cancer Research Group HBP , Fundación Instituto Mar de Investigaciones Médicas , Barcelona , Spain.
2
b Apeiron Medical , Valencia , Spain.
3
c General Surgery Department , Hospital del Mar , Barcelona , Spain.
4
d Department of Electronic Engineering , Universitat Politècnica de València , Valencia , Spain.
5
e Clinical Chemistry , Laboratori de Referència de Catalunya, Hospital del Mar , Barcelona , Spain.
6
f Medicine and Surgery of Animals Department, Facultat de Veterinària , Universitat Autònoma de Barcelona , Bellaterra , Spain.
7
g Hepatobiliary and Liver Transplant Surgical Unit , St. Vincent's University Hospital , Dublin , Ireland.

Abstract

PURPOSE:

To evaluate the impact of using monopolar thermal coagulation based on radiofrequency (RF) currents on intraoperative blood loss during liver resection.

MATERIALS AND 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/cm2 vs. 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.

KEYWORDS:

Bleeding; cooled electrode; liver surgery; monopolar RF coagulation; surgical resection

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