Liver tissue dissection: ultrasonic or RFA energy?

Area of Science:

• Hepatobiliary Surgery
• Surgical Technology
• Oncology

Background:

• Hepatic resection is a critical curative treatment for various liver conditions.
• Liver surgery presents significant technical challenges and risks of complications.
• Advancements in surgical devices and techniques aim to enhance patient outcomes.

Purpose of the Study:

• To compare the efficacy and safety of radio-frequency ablation (RFA) versus ultrasound energy for liver parenchymal division.
• To evaluate key surgical parameters including blood transfusion, Pringle maneuver necessity, dissection time, and postoperative outcomes.

Main Methods:

• Retrospective comparison of two liver parenchymal division techniques: ultrasound energy (Group A) and RFA (Group B).
• Group A: 15 patients (17 resections) for metastatic tumors, hepatomas, cholangiocarcinoma.
• Group B: 21 patients (22 hepatectomies) for metastatic tumors, hepatomas, cholangiocarcinoma.

Main Results:

• Lower blood transfusion rates in RFA group (52%, 1.6 units) vs. ultrasound group (87%, 3.5 units).
• Pringle maneuver was not required in the RFA group, unlike the ultrasound group.
• Shorter mean parenchymal dissection time with RFA (93.18 min) compared to ultrasound (124 min).
• Similar postoperative complication rates (19% RFA vs. 6.7% ultrasound) and zero mortality in both groups.

Conclusions:

• Radio-frequency ablation (RFA) is a reliable and safe alternative for liver resection, usable alone or adjunctively.
• RFA significantly reduces operative time and the need for blood transfusions in liver resections.
• RFA demonstrates potential for improving surgical outcomes in liver surgery.