Impact of monopolar radiofrequency coagulation on intraoperative blood loss during liver resection: a prospective randomised controlled trial

Abstract

Purpose: To evaluate the impact of using monopolar thermal coagulation based on radiofrequency (RF) currents on intraoperative blood loss during liver resection. Materials and methods: A prospective randomized controlled trial was planned. Patients undergoing hepatectomy were randomized into two groups. In the Control group (n=10), hemostasis was obtained with a combination of stitches, vessel-sealing bipolar RF systems, sutures or clips. In the monopolar radiofrequency coagulation (MRFC) group (n=18), hemostasis was mainly obtained using an internally cooled monopolar RF electrode. Results: No differences in demographic or clinical characteristics were found between groups. Mean blood loss during liver resection in the Control group was more than twice that of the MRFC group (556±471 ml vs. 225±313 ml, p=0.02). The adjusted mean bleeding/transection area was also significantly higher in the Control group (7.0±3.3 ml/cm2 vs. 2.8±4.0 ml/cm2 , p=0.006). No significant differences were observed in the rate of complications between the groups. Conclusions: The findings suggest that the monopolar electrocoagulation created with an internally-cooled RF electrode considerably reduces intraoperative blood loss during liver resection.