Radiofrequency-assisted liver resection in cirrhotic patients with hepatocellular carcinoma

Radio-frequency-assisted liver resection has been shown to allow virtually bloodless procedures without the need for vascular exclusion manoeuvres. Our primary end-point was to evaluate safety and feasibility of RF-assisted liver resection in cirrhotic patients with hepatocellular carcinoma. Our second end-point was to assess whether the RF-assisted procedure influence the outcome in terms of morbidity and mortality.

A retrospective study was done of 55 cirrhotic patients who underwent RF-assisted liver resection for HCC at our Departments between September 2001 and October 2007.

In the period of study 29 monosegmentectomies, 20 bisegmentectomies, 4 trisegmentectomies and 2 right hepatectomies were carried out. Vascular exclusion manoeuvres were never performed. One patient died post-operatively because of untreatable hepatorenal syndrome. Twelve patients out of 55 experienced 21 complications including complicated pleural effusion, intra-abdominal collection, hepatorenal syndrome, ascites, hematoma and biliary fistula. Post-operative liver failure occurred in one case (1.8%). In patients without post-operative morbidity (n = 43) the 4-year survival rate was 62% versus 24% in patients who experienced post-operative morbidity (n = 12) (P = 0.02).

RF-assisted liver resection is a safe and feasible procedure associated with lower morbidity and hospital mortality rates even in case of liver cirrhosis.