A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study
Abstract The objective of this study was to evaluate the clinical feasibility of a new technique for liver resection based on a radiofrequency-assisted (485 kHz) device that has shown high performance in the animal setting in both transection speed and blood loss per transection area. Eight patients...
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creator | Burdío, Fernando, M.D Grande, Luis, M.D Berjano, Enrique, Ph.D Martinez-Serrano, Maria, M.D Poves, Ignasi, M.D Burdío, José M., Ph.D Navarro, Ana, M.D Güemes, Antonio, M.D |
description | Abstract The objective of this study was to evaluate the clinical feasibility of a new technique for liver resection based on a radiofrequency-assisted (485 kHz) device that has shown high performance in the animal setting in both transection speed and blood loss per transection area. Eight patients with colorectal hepatic metastasis underwent 11 partial hepatectomies using the proposed technique for both parenchyma division and hemostasis. Main outcome measures were blood loss per transection area and transection speed. No other instruments (including sutures or clips) were used in any of the cases; temporary vascular occlusion performed was not performed. No blood transfusions were required and no mortality or morbidity linked to the hepatic procedure were observed. The median blood loss per transection area and the median transection speed were .79 mL/cm2 (range, .05–7.37 mL/cm2 ) and 1.28 cm2 /min (range, .49–1.87 mL/cm2 ), respectively. During the follow-up period (range, 4–12 mo) no late complications were detected and postoperative patients were free from hepatic recurrence. The proposed radiofrequency-assisted device was shown to achieve parenchymal division and hemostasis simultaneously, resulting in extremely reduced blood loss. |
doi_str_mv | 10.1016/j.amjsurg.2010.02.020 |
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Eight patients with colorectal hepatic metastasis underwent 11 partial hepatectomies using the proposed technique for both parenchyma division and hemostasis. Main outcome measures were blood loss per transection area and transection speed. No other instruments (including sutures or clips) were used in any of the cases; temporary vascular occlusion performed was not performed. No blood transfusions were required and no mortality or morbidity linked to the hepatic procedure were observed. The median blood loss per transection area and the median transection speed were .79 mL/cm2 (range, .05–7.37 mL/cm2 ) and 1.28 cm2 /min (range, .49–1.87 mL/cm2 ), respectively. During the follow-up period (range, 4–12 mo) no late complications were detected and postoperative patients were free from hepatic recurrence. The proposed radiofrequency-assisted device was shown to achieve parenchymal division and hemostasis simultaneously, resulting in extremely reduced blood loss.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2010.02.020</identifier><identifier>PMID: 20864082</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aspartate Aminotransferases - blood ; Bilirubin - blood ; Biopsy ; Blood ; Blood Loss, Surgical ; Blood transfusion ; Catheter Ablation - instrumentation ; Clinical trials ; Complications ; Dissection ; Extreme values ; Feasibility Studies ; Female ; Hemostasis ; Hemostasis, Surgical - instrumentation ; Hemostatics ; Hepatectomy - instrumentation ; Hospitals ; Humans ; Laparoscopy ; Liver ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Liver resection ; Liver surgery ; Male ; Medical equipment ; Medical imaging ; Metastases ; Metastasis ; Morbidity ; Multivariate analysis ; NMR ; Nuclear magnetic resonance ; Occlusion ; Parenchyma ; Patients ; Radio frequency ; Radiofrequency ablation ; Software ; Surgeons ; Surgery ; Sutures ; Tomography</subject><ispartof>The American journal of surgery, 2010-12, Vol.200 (6), p.e75-e80</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 1, 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-dc2ba549d843382f8c0146dc3093f88bada5f968fd174a63bfc3fe3abf4a1bfa3</citedby><cites>FETCH-LOGICAL-c447t-dc2ba549d843382f8c0146dc3093f88bada5f968fd174a63bfc3fe3abf4a1bfa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961010002783$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20864082$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Burdío, Fernando, M.D</creatorcontrib><creatorcontrib>Grande, Luis, M.D</creatorcontrib><creatorcontrib>Berjano, Enrique, Ph.D</creatorcontrib><creatorcontrib>Martinez-Serrano, Maria, M.D</creatorcontrib><creatorcontrib>Poves, Ignasi, M.D</creatorcontrib><creatorcontrib>Burdío, José M., Ph.D</creatorcontrib><creatorcontrib>Navarro, Ana, M.D</creatorcontrib><creatorcontrib>Güemes, Antonio, M.D</creatorcontrib><title>A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract The objective of this study was to evaluate the clinical feasibility of a new technique for liver resection based on a radiofrequency-assisted (485 kHz) device that has shown high performance in the animal setting in both transection speed and blood loss per transection area. Eight patients with colorectal hepatic metastasis underwent 11 partial hepatectomies using the proposed technique for both parenchyma division and hemostasis. Main outcome measures were blood loss per transection area and transection speed. No other instruments (including sutures or clips) were used in any of the cases; temporary vascular occlusion performed was not performed. No blood transfusions were required and no mortality or morbidity linked to the hepatic procedure were observed. The median blood loss per transection area and the median transection speed were .79 mL/cm2 (range, .05–7.37 mL/cm2 ) and 1.28 cm2 /min (range, .49–1.87 mL/cm2 ), respectively. During the follow-up period (range, 4–12 mo) no late complications were detected and postoperative patients were free from hepatic recurrence. The proposed radiofrequency-assisted device was shown to achieve parenchymal division and hemostasis simultaneously, resulting in extremely reduced blood loss.</description><subject>Aged</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Bilirubin - blood</subject><subject>Biopsy</subject><subject>Blood</subject><subject>Blood Loss, Surgical</subject><subject>Blood transfusion</subject><subject>Catheter Ablation - instrumentation</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Dissection</subject><subject>Extreme values</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Hemostasis</subject><subject>Hemostasis, Surgical - instrumentation</subject><subject>Hemostatics</subject><subject>Hepatectomy - instrumentation</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Liver</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver resection</subject><subject>Liver surgery</subject><subject>Male</subject><subject>Medical equipment</subject><subject>Medical imaging</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Morbidity</subject><subject>Multivariate analysis</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Occlusion</subject><subject>Parenchyma</subject><subject>Patients</subject><subject>Radio frequency</subject><subject>Radiofrequency ablation</subject><subject>Software</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Sutures</subject><subject>Tomography</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkl2L1DAUhoMo7rj6E5SAF151TJpMm3rhsix-wYIX6nVIk5Od1DYdc9qR_ntTZlZhb4QD-eA5Jznvewh5ydmWM1697bZm6HBOd9uS5TtW5mCPyIaruim4UuIx2TDGyqKpOLsgzxC7fORciqfkomSqkkyVG7Jc0wi_KYZ410MRIk5pHiBOdAK7j-HXDNSPiR5Mgmj3y2CoC8eAYYzUREf3MIw4GQxIQ6R9OEKiCRDslIl31FDbhxis6amHTLWhD9NCcZrd8pw88aZHeHFeL8mPjx--33wubr9--nJzfVtYKeupcLZszU42TkkhVOmVZVxWzgrWCK9Ua5zZ-aZS3vFamkq03goPwrReGt56Iy7Jm1PdQxpzOzjpIaCFvjcRxhm1KrlUtax5Jl8_ILtxTjF_TvOm3HHVMFZnaneibBoRE3h9SGEwadGc6dUa3emzNXq1RrMyB8t5r87V53YA9zfr3osMXJ0AyGocAySNNmTVwYWUBdVuDP994v2DCvfy_4QF8F83GnOC_rbOxzoefN3USog_fxG5xQ</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Burdío, Fernando, M.D</creator><creator>Grande, Luis, M.D</creator><creator>Berjano, Enrique, Ph.D</creator><creator>Martinez-Serrano, Maria, M.D</creator><creator>Poves, Ignasi, M.D</creator><creator>Burdío, José M., Ph.D</creator><creator>Navarro, Ana, M.D</creator><creator>Güemes, Antonio, M.D</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20101201</creationdate><title>A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study</title><author>Burdío, Fernando, M.D ; Grande, Luis, M.D ; Berjano, Enrique, Ph.D ; Martinez-Serrano, Maria, M.D ; Poves, Ignasi, M.D ; Burdío, José M., Ph.D ; Navarro, Ana, M.D ; Güemes, Antonio, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-dc2ba549d843382f8c0146dc3093f88bada5f968fd174a63bfc3fe3abf4a1bfa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Bilirubin - blood</topic><topic>Biopsy</topic><topic>Blood</topic><topic>Blood Loss, Surgical</topic><topic>Blood transfusion</topic><topic>Catheter Ablation - instrumentation</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Dissection</topic><topic>Extreme values</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Hemostasis</topic><topic>Hemostasis, Surgical - instrumentation</topic><topic>Hemostatics</topic><topic>Hepatectomy - instrumentation</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Liver</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver resection</topic><topic>Liver surgery</topic><topic>Male</topic><topic>Medical equipment</topic><topic>Medical imaging</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Morbidity</topic><topic>Multivariate analysis</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Occlusion</topic><topic>Parenchyma</topic><topic>Patients</topic><topic>Radio frequency</topic><topic>Radiofrequency ablation</topic><topic>Software</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Sutures</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Burdío, Fernando, M.D</creatorcontrib><creatorcontrib>Grande, Luis, M.D</creatorcontrib><creatorcontrib>Berjano, Enrique, Ph.D</creatorcontrib><creatorcontrib>Martinez-Serrano, Maria, M.D</creatorcontrib><creatorcontrib>Poves, Ignasi, M.D</creatorcontrib><creatorcontrib>Burdío, José M., Ph.D</creatorcontrib><creatorcontrib>Navarro, Ana, M.D</creatorcontrib><creatorcontrib>Güemes, Antonio, M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burdío, Fernando, M.D</au><au>Grande, Luis, M.D</au><au>Berjano, Enrique, Ph.D</au><au>Martinez-Serrano, Maria, M.D</au><au>Poves, Ignasi, M.D</au><au>Burdío, José M., Ph.D</au><au>Navarro, Ana, M.D</au><au>Güemes, Antonio, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>200</volume><issue>6</issue><spage>e75</spage><epage>e80</epage><pages>e75-e80</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Abstract The objective of this study was to evaluate the clinical feasibility of a new technique for liver resection based on a radiofrequency-assisted (485 kHz) device that has shown high performance in the animal setting in both transection speed and blood loss per transection area. Eight patients with colorectal hepatic metastasis underwent 11 partial hepatectomies using the proposed technique for both parenchyma division and hemostasis. Main outcome measures were blood loss per transection area and transection speed. No other instruments (including sutures or clips) were used in any of the cases; temporary vascular occlusion performed was not performed. No blood transfusions were required and no mortality or morbidity linked to the hepatic procedure were observed. The median blood loss per transection area and the median transection speed were .79 mL/cm2 (range, .05–7.37 mL/cm2 ) and 1.28 cm2 /min (range, .49–1.87 mL/cm2 ), respectively. During the follow-up period (range, 4–12 mo) no late complications were detected and postoperative patients were free from hepatic recurrence. The proposed radiofrequency-assisted device was shown to achieve parenchymal division and hemostasis simultaneously, resulting in extremely reduced blood loss.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>20864082</pmid><doi>10.1016/j.amjsurg.2010.02.020</doi></addata></record> |
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subjects | Aged Aspartate Aminotransferases - blood Bilirubin - blood Biopsy Blood Blood Loss, Surgical Blood transfusion Catheter Ablation - instrumentation Clinical trials Complications Dissection Extreme values Feasibility Studies Female Hemostasis Hemostasis, Surgical - instrumentation Hemostatics Hepatectomy - instrumentation Hospitals Humans Laparoscopy Liver Liver Neoplasms - secondary Liver Neoplasms - surgery Liver resection Liver surgery Male Medical equipment Medical imaging Metastases Metastasis Morbidity Multivariate analysis NMR Nuclear magnetic resonance Occlusion Parenchyma Patients Radio frequency Radiofrequency ablation Software Surgeons Surgery Sutures Tomography |
title | A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study |
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