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Usefulness of vessel-sealing devices combined with crush clamping method for hepatectomy: A retrospective cohort study


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Title: Usefulness of vessel-sealing devices combined with crush clamping method for hepatectomy: A retrospective cohort study
Authors: Nanashima, Atsushi / Abo, Takafumi / Arai, Junichi / Takagi, Katsunori / Matsumoto, Hirofumi / Takeshita, Hiroaki / Tsuchiya, Tomoshi / Nagayasu, Takeshi
Issue Date: 2013
Publisher: Elsevier BV
Citation: International Journal of Surgery, 11(9), pp.891-897; 2013
Abstract: Background: Blood loss during resection of the hepatic parenchyma in hepatectomy can be minimized using vessel-sealing (VS) devices. Some sealing devices were retrospectively compared to evaluate the efficacy of each device for controlling blood loss, transection time and postoperative complications in hepatectomy as a cohort study. Methods: Between 2005 and September 2012, hepatectomy was underwent in 150 patients using one of three types of LigaSure™ (Dolphin Tip Laparoscopic Instrument, Precise or Small Jaw) or the Harmonic Focus or Ace ultrasonic dissecting sealer. Results were compared to crush-clamping alone as the control method by the historical study (n=81). Results: Irrespective of the vessel-sealing device used for underlying chronic hepatitis, blood loss, blood transfusion rate, operating time and transection time were significantly reduced in the VS group compared with controls (p<0.05). Rates of postoperative bile leakage and intra-abdominal abscess formation were significantly lower in the VS group than in controls (p<0.05). Comparing devices, LigaSure Small Jaw and Harmonic Focus showed lower blood loss, shorter transection time and reduced rates of post-hepatectomy complications, in turn resulting in shorter hospital stays (p<0.05). Tendencies toward uncontrolled ascites and bile leakage were only concern with the use of Harmonic Focus. Satisfactory surgical results were achieved using the sealing device for laparoscopic hepatectomy. Conclusions: The use of energy sealing devices improves surgical results and avoids hepatectomy-related complications. Adequate use of vessel sealers is necessary for safe and rapid completion of hepatic resection.
Keywords: Bloodless / morbidity / Cohort study / Crush clamping / Hepatectomy / Vessel sealing
URI: http://hdl.handle.net/10069/34027
ISSN: 17439191
DOI: 10.1016/j.ijsu.2013.07.012
Rights: © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved. / NOTICE: this is the author’s version of a work that was accepted for publication in International Journal of Surgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Journal of Surgery, 11, 9(2013)
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/34027

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