Digestive Diseases and Sciences

, Volume 58, Issue 3, pp 835–840

Radiofrequency-Assisted Versus Clamp-Crushing Parenchyma Transection in Cirrhotic Patients with Hepatocellular Carcinoma: A Randomized Clinical Trial

  • Min Li
  • Wei Zhang
  • Yi Li
  • Peizhi Li
  • Jinzheng Li
  • Jianping Gong
  • Yongjun Chen
Original Article

DOI: 10.1007/s10620-012-2394-y

Cite this article as:
Li, M., Zhang, W., Li, Y. et al. Dig Dis Sci (2013) 58: 835. doi:10.1007/s10620-012-2394-y

Abstract

Background

Surgical resection remains the optimal therapy for cirrhotic patients with hepatocellular carcinoma (HCC) that are not suitable for liver transplantation (LT). Recently, various innovative techniques for liver resection have been developed.

Aim

The aim of the study was to compare radiofrequency-assisted parenchyma transection (RF-PT) with the traditional clamp-crushing (CC) technique to explore the preferred therapy in cirrhotic patients with HCC.

Methods

From January 2009 to December 2010, 75 cirrhotic patients with HCC who underwent hepatectomy were randomized to RF-PT (group 1, n = 38) or CC-PT (group 2, n = 37) groups. The primary endpoint was intraoperative blood loss. The secondary endpoints included hepatic transection time, total operating time, postoperative morbidity, mortality, length of intensive care unit and hospital stays, and liver function.

Results

The characteristics of the two patient groups were closely matched. The Pringle maneuver was not used in RF-PT patients. The blood loss of the RF-PT group, total or during transection, was significantly lower than that of the CC-PT group (385 vs. 545 ml, p = 0.001; 105 vs. 260 ml, p = 0.000, respectively). Compared with CC-PT patients, the morbidity of the RF-PT group was lower though not statistically significant (28.9 vs. 38.8 %, p = 0.197). One death occurred in the RF-PT group 12 days postoperative due to a large area cerebral embolism.

Conclusion

RF-PT is a safe and feasible surgical resection method for patients with cirrhosis and concomitant HCC. In addition, RF-PT results in lower blood loss and lower morbidity than the CC technique during liver resection.

Keywords

Hepatocellular carcinoma (HCC)Radiofrequency-assisted parenchyma transection (RF-PT)Intensive care unit (ICU)Clamp-crushing (CC)

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Min Li
    • 1
    • 2
  • Wei Zhang
    • 2
  • Yi Li
    • 2
  • Peizhi Li
    • 1
  • Jinzheng Li
    • 1
  • Jianping Gong
    • 1
  • Yongjun Chen
    • 2
  1. 1.Department of Hepatobiliary Surgery2nd College of Clinical Medicine of Chongqing University of Medical ScienceChongqingChina
  2. 2.Digestive Disease CenterSuining Central HospitalSuiningChina