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crush clamp and liver resection

Zu-Bing Chen, Feng Qin, Zi Ye, Shi-Qiang Shen, Wei Li, You-Ming Ding, Qin-Yong Hu, Yi Ma
PURPOSE: This study aimed to evaluate the safety and effectiveness of microwave-ablation-assisted liver resection (MW-LR) and clamp crushing liver resection (CC-LR) in cirrhotic patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: From July 2005 to January 2015, cirrhotic HCC patients who underwent CC-LR (n = 191) or MW-LR (n = 112) were retrospectively analyzed. We compared morbidity, mortality, disease-free survival time, and overall survival time between the CC-LR and MW-LR groups...
January 21, 2018: International Journal of Hyperthermia
Petros Ypsilantis, Maria Lambropoulou, Miroslav Milicevic, Predrag Bulajic, Anastasios Karayiannakis, Dimitrios Zacharoulis, Constantinos Simopoulos
BACKGROUND: The aim of the present study was to microscopically assess the tissue-sparing potential of contemporary radiofrequency-assisted liver resection (RF-LR) techniques. METHODS: Twenty-four pigs were subjected to either (1) partial hepatectomy (PH) using the sequential-coagulate-cut (SCC) technique (group SCC, n = 6) using a monopolar electrode, the technique using the bipolar electrode Habib-4X (group H, n = 6) or the "crush-clamp" technique (group CC, n = 6); or (2) sham operation (group Sham, n = 6)...
December 2017: Journal of Hepato-biliary-pancreatic Sciences
Takatsugu Yamamoto, Takahiro Uenishi, Kazuhisa Kaneda, Masato Okawa, Shogo Tanaka, Shoji Kubo
INTRODUCTION: Laparoscopic hepatectomy is difficult because surgeons must perform the transection using many (four and more) energy devices and without direct manual maneuvers. Here we introduce hepatic transection by the classical method with a few (two or three) energy devices. MATERIALS AND SURGICAL TECHNIQUE: We performed laparoscopic hepatectomy for 40 patients with hepatic tumor and liver dysfunction. For parenchymal transection, we used bipolar radiofrequency coagulation forceps connected to a voltage-controlled electrosurgical generator and ultrasonic dissector...
February 2017: Asian Journal of Endoscopic Surgery
Jiang Ming Chen, Wei Geng, Song Zhang, Fu Bao Liu, Hong Chuan Zhao, Yi Jun Zhao, Guo Bin Wang, Sheng Xue Xie, Xiao Ping Geng
BACKGROUND: The aim of this trial was to compare the efficacy and safety of BiClamp forceps with the "gold-standard" clamp-crushing technique for open liver resection. METHODS: From October 2014 to May 2016, 86 consecutive patients scheduled to undergo hepatic resection were randomized to a BiClamp forceps group (n = 43) or to a clamp-crushing technique group (n = 43). RESULTS: Background characteristics of the two groups were closely matched...
March 2017: Journal of Hepato-biliary-pancreatic Sciences
Elisabetta Moggia, Benjamin Rouse, Constantinos Simillis, Tianjing Li, Jessica Vaughan, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Liver resection is a major surgery with significant mortality and morbidity. Specialists have tested various methods in attempts to limit blood loss, transfusion requirements, and morbidity during elective liver resection. These methods include different approaches (anterior versus conventional approach), use of autologous blood donation, cardiopulmonary interventions such as hypoventilation, low central venous pressure, different methods of parenchymal transection, different methods of management of the raw surface of the liver, different methods of vascular occlusion, and different pharmacological interventions...
October 31, 2016: Cochrane Database of Systematic Reviews
Constantinos Simillis, Tianjing Li, Jessica Vaughan, Lorne A Becker, Brian R Davidson, Kurinchi S Gurusamy
INTRODUCTION: Intraoperative haemorrhage remains one of the major risks during liver resection, and perioperative blood loss and blood transfusion are important factors affecting perioperative morbidity and mortality. The aim of this study is to compare treatment strategies aiming to decrease blood loss during hepatectomy. METHODS: A systematic review of the literature was performed to identify randomised controlled trials reporting on the method of vascular occlusion, parenchymal transection, and management of the cut surface during liver resection...
November 2015: International Journal of Surgery
Jiang-ming Chen, Wei Geng, Fu-bao Liu, Hong-chuan Zhao, Sheng-xue Xie, Hui Hou, Yi-jun Zhao, Guo-bin Wang, Xiao-ping Geng
BACKGROUND: Blood loss and the requirement of blood transfusions during liver transection have been shown to correlate well with higher morbidity and mortality rates and a worse prognosis. Various devices for liver parenchymal transection have been developed to reduce intraoperative blood loss. The goal of this study is to evaluate the safety and effectiveness of BiClamp® forcep transection compared to a clamp crushing technique in patients undergoing liver resection. METHODS/DESIGN: This study will include patients 18 years and older scheduled for hepatectomy with hepatic vascular exclusion who give informed consent...
April 30, 2015: Trials
Rui Guo, Xiaobin Feng, Senlin Xiao, Jun Yan, Feng Xia, Kuansheng Ma, Xiaowu Li
The objective of this study was to compare the short- and long-term outcomes of radiofrequency-assisted liver resection (RFLR) and conventional clamp-crushing liver resection (CCLR) and to evaluate the safety and efficiency of RFLR. Between January 2008 and December 2012, a total of 597 patients with hepatocellular carcinoma (HCC) who underwent curative hepatectomy were identified. A total of 272 patients underwent RFLR, and 325 patients received CCLR. The short- and long-term outcomes were compared. The patients in the RFLR and CCLR groups showed similar baseline characteristics...
February 2015: Bioscience Trends
L Kaman, E Yhoshu, D Dahia
No abstract text is available yet for this article.
September 2011: Journal of Clinical and Experimental Hepatology
Roderich E Schwarz
BACKGROUND: Parenchyma transection techniques during liver resection (LR) are linked to intraoperative blood loss and postoperative morbidity, with a recent increased use of energy devices over traditional clamp-crush hepatotomy (CCH). METHODS: Prospectively collected data from 191 consecutive patients undergoing LR with exclusive CCH by a single surgeon were examined. RESULTS: There were 94 men and 97 women, with 25% primary and 59% secondary malignancies or other conditions (16%)...
March 2015: American Journal of Surgery
Sun Hanyong, Lau Wanyee, Fu Siyuan, Liu Hui, Yang Yuan, Lin Chuan, Zhou Weiping, Wu Mengchao
BACKGROUND: Hemorrhage and liver failure are the two major complications in partial hepatectomy. The finger fracture or clamp crushing technique has been a standard technique used for transection of liver parenchyma. Hepatic vascular Inflow occlusion (Pringle maneuver, PM) is often used to minimize blood loss, but hepatic ischemia-reperfusion may result with an increased risk of post-operative liver failure. The Harmonic scalpel (HS) has been shown to be effective in reducing blood loss during liver parenchymal transection without any hepatic vascular inflow occlusion...
February 2015: European Journal of Surgical Oncology
H Bruns, M W Büchler, P Schemmer
Liver resection has developed into the current standard procedure due to modern resection techniques, profound knowledge of the liver anatomy and optimized surgical and anesthesiological strategies to allow extended resections with both low morbidity and mortality. Initially major blood loss was the biggest concern with liver resection and a Pringle's manoeuvre was necessary. Nowadays, biliary leakage is the major problem after liver surgery. Besides the classical conventional clamp crushing technique for parenchymal transection, various devices including ultrasound, microwaves and staplers have been introduced...
June 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Jian-Yang Guo, De-Wei Li, Rui Liao, Ping Huang, Xian-Bing Kong, Ji-Ming Wang, Hong-Lin Wang, Shi-Qiao Luo, Xiong Yan, Cheng-You Du
AIM: To evaluate the application of bipolar coagulation (BIP) in hepatectomy by comparing the efficacy of BIP alone, cavitron ultrasonic surgical aspirator (CUSA) + BIP and conventional clamp crushing (CLAMP). METHODS: Based on our database of patient records, a total of 380 consecutive patients who underwent hepatectomy at our hospital were retrospectively studied for the efficacy of BIP alone, CUSA + BIP and CLAMP. Of all the patients, 75 received saline-coupled BIP (Group A), 53 received CUSA + BIP (Group B), and 252 received CLAMP (Group C)...
July 14, 2014: World Journal of Gastroenterology: WJG
Sundeep Jain, Bharat Sharma, Mitesh Kaushik, Lokendra Jain
Introduction and Objective. Bleeding is an important complication in liver transections. To determine the safety and efficacy of Debakey forceps for liver parenchymal transection and its ergonomic advantages over clamp crushing method we analysed our data. Methods. We used Debakey crushing technique in 100 liver resections and analysed data for transection time, transfusion rate, morbidity, mortality, hospital stay, influence of different types of liver conditions, and ergonomi features of Debakey forceps. Results...
2014: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
Gaya Spolverato, Timothy M Pawlik
When feasible, surgical resection is typically the preferred therapeutic option in patients with both primary and secondary hepatic malignancies. Improved patient selection, preoperative management, and advances in perioperative care have had a considerable effect on short-term and long-term outcomes following hepatic resection. Parenchymal transection of the liver can be performed using many different techniques such as digitoclasia, clamp crushing, vessel sealing system, harmonic scalpel, water-jet, Cavitron Ultrasonic Surgical Aspirator, or radiofrequency dissecting sealer...
2014: American Society of Clinical Oncology Educational Book
Constantinos Simillis, Tianjing Li, Jessica Vaughan, Lorne A Becker, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Liver resection is a major surgery with significant mortality and morbidity. Various methods have been attempted to decrease blood loss and morbidity during elective liver resection. These methods include different methods of vascular occlusion, parenchymal transection, and management of the cut surface of the liver. A surgeon typically uses only one of the methods from each of these three categories. Together, one can consider this combination as a treatment strategy. The optimal treatment strategy for liver resection is unknown...
April 2, 2014: Cochrane Database of Systematic Reviews
O Strobel, M W Büchler
No abstract text is available yet for this article.
April 2014: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Guido Torzilli, Fabio Procopio, Matteo Cimino, Matteo Donadon, Daniele Del Fabbro, Guido Costa, Andrea Gatti, Carlos A Garcia-Etienne
BACKGROUND: In patients with hepatocellular carcinoma (HCC) in a diseased liver, surgery should be offered in a parenchyma-sparing fashion. This approach seems unfeasible for large and deeply located lesions. Ultrasound study of the tumor-vessel relationship and hepatic inflow and outflow opens new technical solutions: herein is described a new operation based on this approach.1 (-) 3 METHODS: A 69-year-old man with a large centrally located HCC (Barcelona Clinic Liver Cancer stage C) underwent surgery...
June 2014: Annals of Surgical Oncology
Andrea Muratore, Alfredo Mellano, Giuseppe Tarantino, Patrizia Marsanic, Michele De Simone, Fabrizio Di Benedetto
BACKGROUND: Liver transection is considered a critical factor influencing intra-operative blood loss. A increase in the number of complex liver resections has determined a growing interest in new devices able to 'optimize' the liver transection. The aim of this randomized controlled study was to compare a radiofrequency vessel-sealing system with the 'gold-standard' clamp-crushing technique. METHODS: From January to December 2012, 100 consecutive patients undergoing a liver resection were randomized to the radiofrequency vessel-sealing system (LF1212 group; N = 50) or to the clamp-crushing technique (Kelly group, N = 50)...
August 2014: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
N N Rahbari, H Elbers, M Koch, P Vogler, F Striebel, T Bruckner, A Mehrabi, P Schemmer, M W Büchler, J Weitz
BACKGROUND: Various devices have been developed to facilitate liver transection and reduce blood loss in liver resections. None of these has proven superiority compared with the classical clamp-crushing technique. This randomized clinical trial compared the effectiveness and safety of stapler transection with that of clamp-crushing during open liver resection. METHODS: Patients admitted for elective open liver resection between January 2010 and October 2011 were assigned randomly to stapler transection or the clamp-crushing technique...
February 2014: British Journal of Surgery
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