Radiofrequency-assisted liver resection

BACKGROUND: Surgical 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 METHODS: Between May 2005 and April 2007, 46 consecutive patients with various hepatic lesions underwent RF-LR using Radionics, Cool-Tip 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. RESULTS: No perioperative death was documented. Median blood loss was 100ml (range 30-300cm(3)). Blood transfusion was required postoperatively in one patient. Median transection time was 35min (15-60min). 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. CONCLUSIONS: Cool-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).