Retrospective Cohort Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2015; 21(36): 10400-10408
Published online Sep 28, 2015. doi: 10.3748/wjg.v21.i36.10400
Liver resection for hepatocellular carcinoma using a microwave tissue coagulator: Experience of 1118 cases
Kazunari Sasaki, Masamichi Matsuda, Masaji Hashimoto, Goro Watanabe
Kazunari Sasaki, Masamichi Matsuda, Masaji Hashimoto, Goro Watanabe, Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan
Author contributions: Sasaki K, Matsuda M, Hashimoto M and Watanabe G contributed equally to this work; and Sasaki K designed the study and wrote the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest.
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: Kazunari Sasaki, MD, Assistant Professor, Department of Digestive Surgery, Hepatopancreatobiliary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan. sasakikazunari1978@hotmail.com
Telephone: +81-3-35881111 Fax: +81-3-35827068
Received: March 17, 2015
Peer-review started: March 18, 2015
First decision: April 23, 2015
Revised: May 8, 2015
Accepted: July 15, 2015
Article in press: July 15, 2015
Published online: September 28, 2015
Processing time: 194 Days and 12.3 Hours
Abstract

AIM: To present our extensive experience of hepatectomy for hepatocellular carcinoma using a microwave tissue coagulator to demonstrate the effectiveness of this device.

METHODS: A total of 1118 cases (1990-2013) were reviewed, with an emphasis on intraoperative blood loss, postoperative bile leakage and fluid/abscess formation, and adaptability to anatomical resection and hepatectomy with hilar dissection.

RESULTS: The median intraoperative blood loss was 250 mL; postoperative bile leakage and fluid/abscess formation were seen in 3.0% and 3.3% of cases, respectively. Anatomical resection was performed in 275 cases, including 103 cases of hilar dissection that required application of microwave coagulation near the hepatic hilum. There was no clinically relevant biliary tract stricture or any vascular problems due to heat injury. Regarding the influence of cirrhosis on intraoperative blood loss, no significant difference was seen between cirrhotic and non-cirrhotic patients (P = 0.38), although cirrhotic patients tended to have smaller tumors and underwent less invasive operations.

CONCLUSION: This study demonstrated outcomes of an extensive experience of hepatectomy using heat coagulative necrosis by microwave tissue coagulator.

Keywords: Hepatectomy; Hepatocellular carcinoma; Microwave; Microwave tissue coagulator

Core tip: This study represented the perioperative results of 1118 cases of hepatectomy for hepatocellular carcinoma by microwave tissue coagulator in a single institute. Although this study did not include comparative evaluation of two liver parenchyma transection techniques, the precise analysis of more than 1000 cases of hepatectomy over two decades could provide significant information for the readers.