ORIGINAL ARTICLES   

Minerva Chirurgica 2012 October;67(5):415-20

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Microwave assisted liver resection: clinical feasibility study and preliminary results

Percivale A. ¹, Griseri G. ², Gastaldo A. ³, Benasso M. ⁴, Pellicci R. ¹ ✉

¹ Hepatobiliary Unit, Department of Surgery, Santa Corona Hospital, Pietra Ligure, Savona, Italy; ² Hepatobiliary Unit, Department of Surgery, San Paolo Hospital, Savona, Italy; ³ Advanced Biotechnology Unit, Department of Radiology, San Paolo Hospital, Savona, Italy; ⁴ Medical Oncology, Department of Medicine, San Paolo Hospital, Savona, Italy

AIM: The main goal of liver resection for malignant tumors is nowadays represented by properly parenchymal transection and careful control of hemostasis. Applying the concept of precoagulation of liver transection line we developed a new technique that provides the pre coagulation of the resection line using microwaves technologies. The purpose of this study is to evaluate the feasibility of this new liver transection technique demonstrating the high performance of this procedure, the accuracy in terms of squeeze effect on veins and portal branch and in terms of reducing the intra operative blood loss.
METHODS: From December 2010 to January 2012 a total of ten patients (6 men and 4 women) affected by liver metastatic disease from colon rectal cancer and primitive liver cancer were treated (five patients with metastatic colorectal cancer disease and five patient with hepatocellular carcinoma respectively): patients requiring major liver resection were excluded from the present study focusing attention on minor liver resection.
RESULTS: The technique used for the parenchyma transection is similar to those previously described by our group for hepatic radiofrequency assisted liver resection. There was no need for vascular occlusive clamping while during each surgical procedure the underpass of the hepatic hilum was done for safety control of any kind of hepatic bleeding. There was no need for ties and clips excluding the main vascular an bile pedicles that were sutured between ties.
CONCLUSION: In conclusion this study with a small group of patients suggest surgical advantages in terms of statement for best practice in oncologic resection of liver malignancy. It allows a complete resection obtaining a negative pathologic margin, no blood loss and need for blood transfusions factors predicting post operative morbidity and survival, and consistently reducing time of procedure and avoidance of parenchymal ischemia. Further studies should confirm this preliminary data extending surgical indication to major hepatic resection.