Efficacy of microwave tissue coagulator in hepatocellular carcinoma resection

Background : Liver surgery using a microwave tissue coagulator (MTC) greatly diminishes the risk of hemorrhage during operation. But higher incidences of septic complications have also been reported. We investigated the operative efficacy and complications related to the use of MTC in hepatocellular carcinoma resection.Material and Methods : One hundred sixteen consecutive patients undergoing liver resection for hepatocellular carcinoma between 1976 and 1995 were included in this study (60 patients with MTC surgery, 56 without MTC). Postoperative clinical courses were evaluated retrospectively with special references to patients' characteristics and surgically-related complications.Results : Although patients with MTC surgery showed limited liver function with significant decreases in platelet counts (p = 0.004) and prothrombin time activity (p = 0.008) and significant increase in ICG15 (p = 0.048), incidences of postoperative bile leakage (5.4 % vs. 3.3 %), abscess formation (10.7 % vs. 6.7 %) and the average amount of blood loss were not different with or without MTC. Persistent fever lasting more than 1 week is encountered more in patients with MTC surgery, but with no statistical significance. No complications attributable to MTC were noted.Conclusions : These results led us to conclude that MTC can be utilized safely and effectively in liver resection for hepatocellular carcinoma, especially in patients with cirrhosis.