Retrospective Cohort Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2015; 21(35): 10159-10165
Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10159
Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study
Fan Zhang, Jun Yan, Xiao-Bin Feng, Feng Xia, Xiao-Wu Li, Kuan-Sheng Ma, Ping Bie
Fan Zhang, Jun Yan, Xiao-Bin Feng, Feng Xia, Xiao-Wu Li, Kuan-Sheng Ma, Ping Bie, Institute of Hepatobiliary Surgery, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China
Author contributions: Ma KS and Bie P designed the study; Feng XB, Xia F and Li XW performed the study and collected all patient materials; Yan J was responsible for the statistical analysis and edited the manuscript; Zhang F participated in the entire study and composed the manuscript.
Institutional review board statement: Approval from the Ethics Committee of First Affiliated Hospital, the Third Military Medical University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kuan-Sheng Ma, MD, Professor, Institute of Hepatobiliary Surgery, Southwest Hospital, the Third Military Medical University, No. 30, Gaotanyan, Chongqing 400038, China. makuansheng@vip.sina.com
Telephone: +86-23-68765812 Fax: +86-23-68765812
Received: January 31, 2015
Peer-review started: February 1, 2015
First decision: March 10, 2015
Revised: March 27, 2015
Accepted: April 16, 2015
Article in press: April 16, 2015
Published online: September 21, 2015
Abstract

AIM: To assess the efficiency and safety of radiofrequency-assisted hepatectomy in patients with hepatocellular carcinoma (HCC) and cirrhosis.

METHODS: From January 2010 to December 2013, 179 patients with HCC and cirrhosis were recruited for this retrospective study. Of these, 100 patients who received radiofrequency-assisted hepatectomy (RF+ group) were compared to 79 patients who had hepatectomy without ablation (RF- group). The primary endpoint was intraoperative blood loss. The secondary endpoints included liver function, postoperative complications, mortality, and duration of hospital stay.

RESULTS: The characteristics of the two groups were closely matched. The Pringle maneuver was not used in the RF+ group. There was significantly less median intraoperative blood loss in the RF+ group (300 vs 400 mL, P = 0.01). On postoperative days (POD) 1 and 5, median alanine aminotransferase was significantly higher in the RF+ group than in the RF- group (POD 1: 348.5 vs 245.5, P = 0.01; POD 5: 112 vs 82.5, P = 0.00), but there was no significant difference between the two groups on POD 3 (260 vs 220, P = 0.24). The median AST was significantly higher in the RF+ group on POD 1 (446 vs 268, P = 0.00), but there was no significant difference between the two groups on POD 3 and 5 (POD 3: 129.5 vs 125, P = 0.65; POD 5: 52.5 vs 50, P = 0.10). Overall, the rate of postoperative complications was roughly the same in these two groups (28.0% vs 17.7%, P = 0.11) except that post hepatectomy liver failure was far more common in the RF+ group than in the RF- group (6% vs 0%, P = 0.04).

CONCLUSION: Radiofrequency-assisted hepatectomy can reduce intraoperative blood loss during liver resection effectively. However, this method should be used with caution in patients with concomitant cirrhosis because it may cause severe liver damage and liver failure.

Keywords: Hepatocellular carcinoma, Blood loss, Radiofrequency-assisted hepatectomy, Complications, Cirrhosis

Core tip: The purpose of this study was to assess the efficiency and safety of radiofrequency-assisted hepatectomy in patients with hepatocellular carcinoma and cirrhosis. Radiofrequency-assisted hepatectomy can reduce intraoperative blood loss during liver resection effectively. However, this method should be used with caution in patients with concomitant cirrhosis because it may cause severe liver damage and even liver failure.