Clamp–crush technique vs. radiofrequency-assisted liver resection for primary and metastatic liver neoplasms

Abstract

Clamp-crush LR is reliable and results in the same amount of blood loss and a shorter operating time compared with RF-LR. Radiofrequency-assisted LR is a unique, simple and safe method of resection, which may be indicated in cirrhotic patients with high MELD scores.

Radiofrequency-Assisted Versus Clamp-Crushing Parenchyma Transection in Cirrhotic Patients with Hepatocellular Carcinoma: A Randomized Clinical Trial

“…Unfortunately, there was one death in the RF-PT group due to large area cerebral embolism 12 days postoperative, which was not associated with the therapy technique. Several studies have shown that RF-PT is equally effective in reducing blood loss as CC-PT [16][17][18][19]. In contrast, the present study demonstrated that blood loss was lower in the RF-PT group than that of the CC-PT group (385 vs. 545 ml).…”

“…Delis et al [16] reported 196 consecutive patients with liver tumors who underwent RF-PT (n = 109) or CC-PT (n = 87), and the rate of bile leak in the RF-PT patients was higher than that of the CC-PT patients (9.17 % vs. 1.1 %, p = 0.04). A RCT completed by Lupo et al [17] indicated that RF-PT was associated with a higher rate of biliary complications (16 %), including bile fistula and biliary stenosis, compared to the CC-PT group.…”

“…A study by Delis et al [16] indicated that the rate of abscess formation was higher in RF-PT than that of CC-PT patients (9.17 vs. 1.1 %, p = 0.04). Another study [14], which included 95 RF-PT cases, also reported a total of 12 (16.9 %) infected collections in the resection line that required percutaneous drainage.…”

“…However, the utilization of RF-PT still remains controversial due to reported complications [12][13][14]. In contrast, several studies [15][16][17], including two meta-analysis reports [18,19], evaluated the traditional clamp-crush parenchyma transection (CC-PT) method and advocated for CC-PT for use in liver resection in cirrhotic patients. The newer methods, including RF-PT, Hydrojet, Ligasure, and Cavitron Ultrasonic Surgical Aspirator (CUSA), have been shown not to offer additional benefits for decreasing the morbidity or the necessity for blood transfusion.…”

Experience with a simple clamp-crush technique devoid of other devices for liver resections in a surgical oncology practice

“…Low average blood loss and an increasingly utilized nonanatomic, parenchyma-sparing approach have enabled postoperative outcomes that appear superior to earlier series 1,3,4,6-8 or are still comparable with recent series in which specific device-based techniques are employed. 2,[9][10][11][12] As also pointed out by others, 2,10 CCH has been a swift modality for transection that allows for short inflow occlusion times without the need for intermittent inflow release or lengthy hemostatic maneuvers during hepatotomy.…”