Precoagulation with microwave ablation for hepatic parenchymal transection during liver partial resection

Rao, Zhuqing; Ling, Wei; Dai, Xinzheng; Zhang, Hui; Pu, Liyong; Wu, Junli; Zhang, Deming; Yang, Xiaopei; Li, Zhi; Lu, Ling; Wang, Xuehao; Zhou, Haoming; Kong, Lianbao

doi:10.1080/02656736.2018.1540799

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…Therefore, MWA is widely accepted as an effective nonsurgical treatment option for liver cancer of a small size and at an early stage[ 19 - 23 ]. Of note, MWA has been demonstrated to completely destroy tumor cells and has been proposed as a radical treatment for small primary liver cancer (≤ 3 cm in diameter) with a single lesion[ 6 , 22 , 24 ]. In addition, Zhang et al [ 25 ] performed a meta-analysis of 1480 patients and showed that the therapeutic effectiveness of MWA was superior to that of surgical resection for the treatment of small liver cancer (< 3 cm in diameter).…”

Section: Discussionmentioning

confidence: 99%

Effects of microwave ablation on serum Golgi protein 73 in patients with primary liver cancer

Xu¹,

Wei²,

Zhang³

et al. 2022

WJG

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BACKGROUND Microwave ablation (MWA) is an effective treatment option for patients with primary liver cancer. However, it has been reported that the MWA procedure induces a hepatic inflammatory response and injury, which may negatively affect the efficacy of MWA. As such, the discovery of reliable markers to monitor the patient’s response to MWA is needed. Golgi protein 73 (GP73) has been shown to be associated with chronic liver disease. To date, the potential value of serum GP73 in the dynamic monitoring during MWA of liver cancer remains unclear. AIM To examine the effects of MWA on the serum levels of GP73 in patients with primary liver cancer. METHODS A total of 150 primary liver cancer patients with a single small lesion (≤ 3 cm in diameter) were retrospectively enrolled spanning the period between January 2016 and October 2018. All of the patients received MWA for the treatment of primary liver cancer. Serum GP73, alpha-fetoprotein (AFP), and widely used liver biochemical indicators [serum albumin, total bilirubin (TBIL), alanine aminotransferase (ALT), and aspartate aminotransferase (AST)] were compared before MWA and at different time points, including 1, 2, and 4 wk following the ablation procedure. RESULTS Complete tumor ablation was achieved in 95.33% of the patients at 1 mo after MWA. The 1-, 2-, and 3-year disease-free survival rates were 74.67%, 59.33%, and 54.00%, respectively. The serum AFP levels were significantly decreased at 1, 2, and 4 wk after MWA; they returned to the normal range at 12 wk after MWA; and they remained stable thereafter during follow-up in those cases without recurrence. In contrast, the serum GP73 levels were significantly increased at 1 and 2 wk after MWA. The serum GP73 levels reached the peak at 2 wk after MWA, started to decline after hepatoprotective treatment with glycyrrhizin and reduced glutathione, and returned to the pretreatment levels at 12 and 24 wk after MWA. Notably, the changes of serum GP73 in response to MWA were similar to those of TBIL, ALT, and AST. CONCLUSION Serum GP73 is markedly increased in response to MWA of liver cancer. Thus, serum GP73 holds potential as a marker to monitor MWA-induced inflammatory liver injury in need of amelioration.

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Section: Discussionmentioning

confidence: 99%

Effects of microwave ablation on serum Golgi protein 73 in patients with primary liver cancer

Xu¹,

Wei²,

Zhang³

et al. 2022

WJG

View full text Add to dashboard Cite

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“…Intraoperative bleeding increases the likelihood that transfusion will be required, which in turn increases the increased risk of complications and tumor recurrence [7,8]. Numerous devices are used to reduce bleeding during liver resection, such as ultrasonic surgical aspirators, ultrasonic dissection devices, bipolar electrosurgical devices, microwave assisted surgical devices [9][10][11] and radiofrequency (RF) based devices. Nonetheless, the clinical benefits of these devices have yet to be proven [12].…”

Section: Introductionmentioning

confidence: 99%

Linear radiofrequency ablation using dual switching-control mode achieves rapid and bloodless liver resection, an experimental research

Hsiao

Yang

Huang

2021

International Journal of Hyperthermia

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Background: Radiofrequency (RF)-assisted devices are widely used for hemostasis during liver resection. This study compared the use of dual switching (DS) versus single switching (SS) control modes for RF-based liver resections in a pig model. Methods: The RF-based system comprised a 200-W generator and three electrodes with 4-cm tips arranged in a linear configuration using an adaptor. Eight Lanyu pigs were used to assess ablation outcomes with electrode spacing of 2 or 3 cm, and ablation durations of 1.5, 2 or 3 min. All combinations were tested in DS and SS modes. Procedures were performed on left lateral, caudal and right anterior liver lobes, and after which transections were performed using a scalpel. Blood loss, complete ablation rate and ablation speed were compared. Results: DS mode was shown to induce significantly less blood loss than SS mode when the electrode spacing was set at 2 cm and the ablation duration was 2 min or 3 min (p¼.010 and .012, respectively). Extended ablation duration and narrow electrode spacing tended to induce less blood loss, regardless of operating mode. Bloodless resection was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 2-3 min. The highest rate of complete ablation (11.3 cm 2 /min) was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 1.5 min. Conclusion: RF-based hepatic resection using DS mode is safe and feasible, resulting in less blood loss than SS mode with a higher rate of complete ablation (i.e., superior ablation efficiency).

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A systematic review and network meta-analysis of parenchymal transection techniques during hepatectomy: an appraisal of current randomised controlled trials

Kamarajah

Bundred

Lin

et al. 2020

HPB

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Background: Major liver resection can lead to significant morbidity and mortality. Blood loss is one of the most important factors predicting a good outcome. Although various transection methods have been reported, there is no consensus on the best technique. This systematic review and network metaanalysis aims to characterise and identify the best reported technique for elective parenchymal liver transection based on published randomised controlled trials (RCT's).Methods: A systematic review was conducted using MEDLINE, EMBASE, and Cochrane Central to identify RCT's up to 5th June 2019 that examined parenchymal transection for liver resection. Data including study characteristics and outcomes including intraoperative (blood loss, operating time) and postoperative measures (overall and major complications, bile leaks) were extracted. Indirect comparisons of all regimens were simultaneously compared using random-effects network meta-analyses (NMA) which maintains randomisation within trials.Results: This study identified 22 RCT's involving 2360 patients reporting ten parenchymal transection techniques. Bipolar cautery has lower blood loss and shorter operating time than stapler (mean difference: 85 mL; 22min) and Tissue Link (mean difference: 66 mL; 29min). Bipolar cautery was ranked first for blood loss and operating time followed by stapler and TissueLink. Harmonic scalpel is associated with lower overall complications than Hydrojet (Odds ratio (OR): 0.48), BiClamp forceps (OR: 0.46) and clamp crushing (OR: 0.41). Conclusion: Bipolar cautery techniques appear to best at reducing blood loss and associated with shortest operating time. In contrast, Harmonic scalpel appears best for overall and major complications.Given the paucity of data and selective outcome reporting, it is still hard to identify what is the best technique for liver resection. Therefore, further high-quality large-scale RCT's are still needed.

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Precoagulation with microwave ablation for hepatic parenchymal transection during liver partial resection

Cited by 5 publications

References 20 publications

Effects of microwave ablation on serum Golgi protein 73 in patients with primary liver cancer

Effects of microwave ablation on serum Golgi protein 73 in patients with primary liver cancer

Linear radiofrequency ablation using dual switching-control mode achieves rapid and bloodless liver resection, an experimental research

A systematic review and network meta-analysis of parenchymal transection techniques during hepatectomy: an appraisal of current randomised controlled trials

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