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Int J Hyperthermia. 2019;36(1):146-150. doi: 10.1080/02656736.2018.1540799. Epub 2018 Nov 28.

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

Rao Z1, Ling W2,3, Dai X2,3, Zhang H2,3, Pu L2,3, Wu J2,3, Zhu D2,3, Yang X2,3, Li Z2,3, Lu L2,3, Wang X2,3, Zhou H2,3, Kong L2,3,4.

Author information

1
a Department of Anaesthesiology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China.
2
b Hepatobiliary/Liver Transplantation Center , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China.
3
c Key Laboratory of Liver Transplantation , Chinese Academy of Medical Sciences , Nanjing , China.
4
d Department of General Surgery , Sir Run Run Hospital, Nanjing Medical University , Nanjing , China.

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.

KEYWORDS:

Microwave ablation; hepatic parenchymal transection; liver partial resection

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