Initial Experience with Radiofrequency Ablation (Rfa) Assisted Liver Resection
Daniel Jacoby*, Jooyeun Chung, Karen a. Chojnacki, Francis E. Rosato, Ernest L. Rosato
Thomas Jefferson University Hospital, Philadelphia, PA
Purpose: Although surgical resection is the standard of treatment for liver neoplasm, the traditional resection techniques may be complicated by significant intraoperative blood loss and post-operative complications. We utilized a novel technique that facilitates resection by pre-ablating the line of resection with radiofrequency energy. Standard radiofrequency ablation probes were utilized to generate this line of ablation followed by resection utilizing the CUSA ultrasonic dissector for parenchymal division. We report our initial experience with this new technique and compare the outcomes to patients who underwent traditional approach. Methods: A retrospective review was conducted of 6 patients who underwent RFA-assisted liver resection and comparison was made to the patients who underwent traditional liver resections. The charts were analyzed for patient demographics, estimated blood loss (EBL), length of stay (LOS), and post-operative complications. P-values were determined using Student’s t-test.Results: All study patients completed a successful RFA-assisted liver resection. They were compared to 6 patients who underwent similar resections using a standard crush and clamp liver parenchymal division technique. The study group included 2 segmentectomies and 4 bisegmentectomies. The control group included 1 wedge resection, 1 segmentectomy, 1 bisegmentectomy, and 2 lobectomies. The average age of the study group and of the control group was 48.3 years and 64.5 years, respectively. The mean EBL was significantly lower in the study group (91.7 vs. 1016.7 ml, p<0.01). Significantly reduced LOS was seen in the study group as well (4.5 vs. 9 days, p<0.05). The post-operative complications for the RFA-assisted group included one patient with biloma which required percutaneous drainage. Complications from the control group included wound infection, ileus, and pneumonia. Conclusion: Our initial experience with radiofrequency ablation assisted liver resection indicates that it can be performed safely with significantly less blood loss and a shorter hospital stay.
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