TY - JOUR
T1 - Monopolar floating ball versus bipolar forceps for hepatic resection
T2 - A prospective randomized clinical trial
AU - Torzilli, Guido
AU - Donadon, Matteo
AU - Marconi, Matteo
AU - Procopio, Fabio
AU - Palmisano, Angela
AU - Del Fabbro, Daniele
AU - Botea, Florin
AU - Spinelli, Antonino
AU - Montorsi, Marco
PY - 2008/11
Y1 - 2008/11
N2 - Background: Hepatic transection by Pean-clasia is the mainstream technique that can be used with different coagulators. Monopolar floating ball (MFB) is proposed for liver transection. Whether its value for liver transection is unclear, its efficiency as a coagulator only seems high. We compared in a prospective randomized study the standard Pean-clasia with bipolar forceps (BF) versus Pean-clasia with MFB in patients undergoing hepatic resection. Methods: Seventy-six patients scheduled for hepatectomy were randomized in two groups, according to the coagulator device: group A (MFB, n = 38) and group B (BF, n = 38). The two groups were homogeneous in terms of tumor presentation and background liver features. Blood loss, blood transfusions, transection time, number of ligatures, drain discharge, drain bilirubin levels at third, fifth, and seventh postoperative day, and postoperative morbidity and mortality were prospectively evaluated. Results: No significant differences between groups A and B were seen in terms of blood transfusions (11.5% versus 16.5%; p = 0.450), blood loss/cm2 (mean 7.2 versus 7.6 ml; p = 0.450), transection time/cm2 (mean 2.1 versus 2.3; p = 0.070), number of ligatures/cm2 (mean 0.7 versus 0.7; p = 1), drain discharge (mean 55 versus 66.7 ml; p = 0.451), and drain bilirubin levels (mean 1.9 versus 2.1 mg/dl; p = 0.664). No mortality or major morbidity was recorded in both groups. Conclusions: This study showed that association of Pean-clasia with MFB was safe and minimized the blood loss during hepatic resection. However, MFB did not offer significant benefits over BF, while its cost is not negligible.
AB - Background: Hepatic transection by Pean-clasia is the mainstream technique that can be used with different coagulators. Monopolar floating ball (MFB) is proposed for liver transection. Whether its value for liver transection is unclear, its efficiency as a coagulator only seems high. We compared in a prospective randomized study the standard Pean-clasia with bipolar forceps (BF) versus Pean-clasia with MFB in patients undergoing hepatic resection. Methods: Seventy-six patients scheduled for hepatectomy were randomized in two groups, according to the coagulator device: group A (MFB, n = 38) and group B (BF, n = 38). The two groups were homogeneous in terms of tumor presentation and background liver features. Blood loss, blood transfusions, transection time, number of ligatures, drain discharge, drain bilirubin levels at third, fifth, and seventh postoperative day, and postoperative morbidity and mortality were prospectively evaluated. Results: No significant differences between groups A and B were seen in terms of blood transfusions (11.5% versus 16.5%; p = 0.450), blood loss/cm2 (mean 7.2 versus 7.6 ml; p = 0.450), transection time/cm2 (mean 2.1 versus 2.3; p = 0.070), number of ligatures/cm2 (mean 0.7 versus 0.7; p = 1), drain discharge (mean 55 versus 66.7 ml; p = 0.451), and drain bilirubin levels (mean 1.9 versus 2.1 mg/dl; p = 0.664). No mortality or major morbidity was recorded in both groups. Conclusions: This study showed that association of Pean-clasia with MFB was safe and minimized the blood loss during hepatic resection. However, MFB did not offer significant benefits over BF, while its cost is not negligible.
KW - Blood transfusion
KW - Liver dissection
KW - Liver surgery
KW - Liver tumors
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U2 - 10.1007/s11605-008-0663-z
DO - 10.1007/s11605-008-0663-z
M3 - Article
C2 - 18766414
AN - SCOPUS:54349119123
VL - 12
SP - 1961
EP - 1966
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
IS - 11
ER -