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

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Techniques
• Surgical Oncology

Background:

• Liver partial resection is a common procedure for treating liver tumors and other conditions.
• Hepatic parenchymal transection is a critical step in liver resection, often associated with significant blood loss.
• Traditional methods like clamp-crushing carry risks of bleeding and complications.

Purpose of the Study:

• To assess the feasibility and efficacy of microwave ablation (MWA) for precoagulation during hepatic parenchymal transection in liver partial resections.
• To compare MWA precoagulation with the traditional clamp-crushing method.

Main Methods:

• A double-blind, randomized controlled study involving 66 patients undergoing liver partial resection.
• Patients were randomized into two groups: traditional clamp-crushing (Control) and MWA precoagulation (MWA).
• Key outcomes measured included operative time, blood loss, transfusion requirements, and postoperative complications.

Main Results:

• The MWA group demonstrated significantly reduced intraoperative blood loss compared to the Control group.
• While red blood cell transfusions were fewer in the MWA group, this difference was not statistically significant.
• Postoperative liver enzyme levels (AST, ALT) were transiently higher in the MWA group at day 1 but normalized by day 7. No significant differences were observed in operative time, hospital stay, or overall postoperative complications.

Conclusions:

• Precoagulation with MWA is a safe and effective alternative for hepatic parenchymal transection during liver partial resection, significantly reducing intraoperative blood loss.
• MWA offers comparable postoperative outcomes to traditional methods, with potential benefits in blood management.
• Larger studies are warranted to further validate these findings and establish MWA as a standard technique.