Precoagulation with microwave ablation for hepatic parenchymal transection during liver partial resection
Precoagulation with microwave ablation for hepatic parenchymal transection during liver partial resection
复制标题
肝脏部分切除术中微波消融预凝用于肝实质横断
DOI：
10.1080/02656736.2018.1540799
复制
发表时间：
2019-01-01
影响因子：
3.1
通讯作者：
Kong, Lianbao
中科院分区：
文献类型：
--
作者：
Rao, Zhuqing;Ling, Wei;Kong, Lianbao
摘要目的：目的探讨微波预凝（MWA）在肝部分切除术中肝实质横断的可行性。方法：共66例符合条件的患者入组本双盲、随机、对照研究。患者被随机分配接受传统夹压法（对照组）或MWA预凝法（MWA组）在肝部分切除术中进行肝实质横断。比较两组手术时间、肝门阻断时间、术中出血量、输血量、术后并发症及恢复情况。结果：与对照组相比，MWA组的术中失血量显著减少。MWA组的红细胞输注较少，但无统计学意义。MWA组术后第1天血清丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平显著升高，但MWA组和对照组在第3天和第7天无差异。在手术时间、肝门阻断时间、术后总胆红素水平、人血白蛋白溶液消耗量或住院时间方面无显著差异。两组术后并发症如肾功能受损、发热、入住ICU、脓肿、胆漏、肝内和远处肿瘤复发和住院死亡率相当。结论：MWA预凝减少了术中失血，术后并发症相似，为肝部分切除术中肝实质横断提供了一种安全、有效、新颖的替代方法。建议从更大系列中获得更多结果以证实这些发现。
Abstract Purpose: To evaluate the feasibility of precoagulation with microwave ablation (MWA) for hepatic parenchymal transection during liver partial resection. Methods: A total of 66 eligible patients were enrolled in this double-blind, randomized, controlled study. Patients were randomized to receive either the traditional clamp-crushing method (Control group) or the MWA precoagulation method (MWA group) for hepatic parenchymal transection during liver partial resection. The operative time, hepatic portal occlusion time, intraoperative blood loss and transfusion, postoperative complications and recovery outcomes were compared. Results: Compared to the Control group, the MWA group had significantly less intraoperative blood loss. Fewer red blood cell transfusions were observed in the MWA group but without statistical significance. The MWA group showed significantly higher serum alanine aminotransferase and aspartate aminotransferase levels at day 1 postoperatively, but no differences between the MWA and Control groups were found at days 3 and 7. There were no significant differences in terms of operative time, hepatic portal occlusion time, postoperative total bilirubin levels, human albumin solution consumption or length of hospital stay. Postoperative complications such as impaired renal function, pyrexia, admission to ICU, abscess, biliary leakage, intrahepatic and distant tumor recurrence and in-hospital mortality were comparable between the two groups. Conclusion: Precoagulation with MWA reduced intraoperative blood loss with similar postoperative complications, providing a safe, effective, novel alternative for hepatic parenchymal transection during liver partial resection. Additional results from larger series are recommended to confirm these findings.