Article

Two different methods for donor hepatic transection: cavitron ultrasonic surgical aspirator with bipolar cautery versus cavitron ultrasonic surgical aspirator with radiofrequency coagulator-A randomized controlled trial.

Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Kyoto University, Kyoto, Japan.
Liver Transplantation (impact factor: 3.39). 02/2009; 15(1):102-5. DOI:10.1002/lt.21658 pp.102-5
Source: PubMed

ABSTRACT The aim of this study was to compare the Cavitron ultrasonic surgical aspirator (CUSA) with bipolar cautery (BP) to CUSA with a radiofrequency coagulator [TissueLink (TL)] in terms of efficacy and safety for hepatic transection in living donor liver transplantation. Twenty-four living liver donors (n = 12 for each group) were randomized to undergo hepatic transection using CUSA with BP or CUSA with TL. Blood loss during parenchymal transection and speed of transection were the primary endpoints, whereas the degree of postoperative liver injury and morbidity were secondary endpoints. Median blood loss during liver transection was significantly lower in the TL group than in the BP group (195.2 +/- 84.5 versus 343.3 +/- 198.4 mL; P = 0.023), and liver transection was significantly faster in the TL group than in the BP group (0.7 +/- 0.2 versus 0.5 +/- 0.2 cm(2)/minute; P = 0.048). Significantly fewer ties were required during liver transection in the TL group than in the BP group (15.8 +/- 4.8 versus 22.8 +/- 7.9 ties; P = 0.023). The morbidity rates were similar for the 2 groups. In conclusion, CUSA with TL is superior to CUSA with BP for donor hepatectomy in terms of blood loss and speed of transection with no increase in morbidity.

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Keywords

2 groups
 
bipolar cautery
 
blood loss
 
BP group
 
Cavitron ultrasonic surgical aspirator
 
donor hepatectomy
 
donor liver transplantation
 
efficacy
 
hepatic transection
 
liver donors
 
liver transection
 
Median blood loss
 
morbidity rates
 
parenchymal transection
 
postoperative liver injury
 
primary endpoints
 
radiofrequency coagulator [TissueLink
 
TL
 
TL group
 
transection