Liver Transection with Precoagulation Therapy in Liver Cirrhosis: Effective Use of an Energy Device at Hepatectomy

Author:

Kusano Tomokazu1,Aoki Takeshi1,Koizumi Tomotake1,Matsuda Kazuhiro1,Yamada Kosuke1,Nogaki Koji1,Tashiro Yoshihiko1,Wada Yusuke1,Hakozaki Tomoki1,Shibata Hideki1,Tomioka Kodai1,Hirai Takahito1,Yamazaki Tatsuya1,Saito Kazuhiko1,Mitamura Keitaro1,Fujimori Akira1,Koike Reiko1,Enami Yuta1,Murakami Masahiko1

Affiliation:

1. Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan

Abstract

Background Hepatectomy for liver cirrhosis patients requires skillful surgical technique and careful attention because of the fibrotic parenchyma, elevated portal pressure, and impaired coagulation. This report evaluated short- and long-term outcomes for liver cirrhosis patients receiving precoagulation therapy on the parenchymal transection plane, compared with noncoagulation cases. Methods Seventy-three patients diagnosed with cirrhosis via postoperative pathological findings were selected after reviewing 887 hepatectomy patient files. They were divided into a precoagulation group (n = 20) and a noncoagulation group (n = 53). There were no significant differences in patient and tumor factors between 2 groups. Results The precoagulation group had significantly less blood loss compared with noncoagulation group [282 vs 563g (P < 0.05)], shorter operative time [214 vs 276 min (P = 0.06)], and shorter postoperative hospital stays [14.5 vs 22.5 days (P = 0.12)]. The median recurrence free survival rates time in the pre-coagulation group (733 days) was significantly longer than that in the non-coagulation group (400 days) (P < 0.05). Overall survival rates showed rates showed no difference between the 2 groups (P = 0.62). Conclusions Precoagulation therapy may be the a preferred treatment application for hepatectomy patients with severe liver fibrosis.

Publisher

International College of Surgeons

Subject

Surgery

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