Hepatectomy for liver cirrhosis patients requires skillful surgical technique and careful attention caused by the fibrotic parenchyma, elevated portal pressure, and impaired coagulation. This report evaluated short- and long-term outcomes for liver cirrhosis patients receiving pre-coagulation therapy on the parenchymal transection plane, as compared to non-coagulation cases. 73 patients diagnosed with cirrhosis via post-operative pathological findings were selected upon reviewing 887 hepatectomy patient files. They were divided into a pre-coagulation group (n=20) and a non-coagulation group (n=53). There were no significant differences in patient and tumor factors between two groups. Pre-coagulation group had significantly less blood loss compared with non-coagulation group [282 vs 563g (p < 0.05)], shorter operative time [214 vs 276min (p = 0.06)], and shorter postoperative hospital stays [14.5 vs 22.5 days (p = 0.12)]. The median recurrence free survival rates time in the pre-coagulation group (733 days) was significantly longer than that in the non-coagulation group (400 days) (p < 0.05). Overall survival rates showed rates showed no difference among the two groups (p = 0.62). Pre-coagulation therapy may be one of the a preferred treatment application for hepatectomy patients with severe liver fibrosis.
Liver transection with pre-coagulation therapy in liver cirrhosis ~ Effective usage of an energy device at hepatectomy ~
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Tomokazu Kusano, Takeshi Aoki, Tomotake Koizumi, Kazuhiro Matsuda, Kosuke Yamada, Koji Nogaki, Yoshihiko Tashiro, Yusuke Wada, Tomoki Hakozaki, Hideki Shibata, Kodai Tomioka, Takahito Hirai, Tatsuya Yamazaki, Kazuhiko Saito, Keitaro Mitamura, Akira Fujimori, Reiko Koike, Yuta Enami, Masahiko Murakami; Liver transection with pre-coagulation therapy in liver cirrhosis ~ Effective usage of an energy device at hepatectomy ~. Int Surg 2021; doi: https://doi.org/10.9738/INTSURG-D-20-00028.1
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