The Evaluation of the 1318 nm Diode Laser in Open Liver Surgery
(1) Background: Numerous dissection instruments are available for liver resection. So far, there has been no evidence in favor of a specific dissection device effecting a reduction in postoperative mortality and morbidity or a reduction in intraoperative blood loss. The aim of the study was to evalu...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/5/1191 |
| _version_ | 1797475469323403264 |
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| author | Patrick Pfitzmaier Matthias Schwarzbach Ulrich Ronellenfitsch |
| author_facet | Patrick Pfitzmaier Matthias Schwarzbach Ulrich Ronellenfitsch |
| author_sort | Patrick Pfitzmaier |
| collection | DOAJ |
| description | (1) Background: Numerous dissection instruments are available for liver resection. So far, there has been no evidence in favor of a specific dissection device effecting a reduction in postoperative mortality and morbidity or a reduction in intraoperative blood loss. The aim of the study was to evaluate the safety of liver resection with the 1318 nm surgical laser. (2) Methods: 151 consecutive patients who underwent liver resection using the 1318 nm surgical laser (<i>n</i> = 119) or conventional dissection methods (<i>n</i> = 32) were evaluated retrospectively. As primary outcome, postoperative complications were assessed using the Clavien–Dindo classification. Secondary outcomes were postoperative mortality, reoperations and reinterventions, intraoperative blood loss, the need for vascular control using the Pringle maneuver and oncological safety assessed through histopathological evaluation of resection margins. (3) Results: For liver resections using the 1318 nm surgical laser, the postoperative morbidity (41.2% vs. 59.4%, <i>p</i> = 0.066), mortality (1.7% vs. 3.1%, <i>p</i> = 0.513) and the reoperation rate (2.5% vs. 3.1%, <i>p</i> = 1.000) were not significantly different from conventional liver resections. In the laser group, a lower reintervention rate (9.2% vs. 21.9%, <i>p</i> = 0.050) was observed. The oncological safety demonstrated by a tumor-free resection margin was similar after laser and conventional resection (93.2% vs. 89.3%, <i>p</i> = 0.256). The median intraoperative blood loss was significantly lower in the laser group (300 mL vs. 500 mL, <i>p</i> = 0.005) and there was a significantly lower need for a Pringle maneuver (3.4% vs. 15.6%, <i>p</i> = 0.021). (4) Conclusions: Liver resections using the 1318 nm surgical laser can be routinely performed with a favorable risk profile. Compared to alternative resection methods, they are associated with low blood loss, appear adequate from an oncological point of view, and are not associated with increased mortality and morbidity. |
| first_indexed | 2024-03-09T20:45:32Z |
| format | Article |
| id | doaj.art-47a39448332e413ca725ff7db0303595 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T20:45:32Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-47a39448332e413ca725ff7db03035952023-11-23T22:47:14ZengMDPI AGCancers2072-66942022-02-01145119110.3390/cancers14051191The Evaluation of the 1318 nm Diode Laser in Open Liver SurgeryPatrick Pfitzmaier0Matthias Schwarzbach1Ulrich Ronellenfitsch2Department of General, Visceral, Vascular and Thoracic Surgery, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt, GermanyDepartment of General, Visceral, Vascular and Thoracic Surgery, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt, GermanyDepartment of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany(1) Background: Numerous dissection instruments are available for liver resection. So far, there has been no evidence in favor of a specific dissection device effecting a reduction in postoperative mortality and morbidity or a reduction in intraoperative blood loss. The aim of the study was to evaluate the safety of liver resection with the 1318 nm surgical laser. (2) Methods: 151 consecutive patients who underwent liver resection using the 1318 nm surgical laser (<i>n</i> = 119) or conventional dissection methods (<i>n</i> = 32) were evaluated retrospectively. As primary outcome, postoperative complications were assessed using the Clavien–Dindo classification. Secondary outcomes were postoperative mortality, reoperations and reinterventions, intraoperative blood loss, the need for vascular control using the Pringle maneuver and oncological safety assessed through histopathological evaluation of resection margins. (3) Results: For liver resections using the 1318 nm surgical laser, the postoperative morbidity (41.2% vs. 59.4%, <i>p</i> = 0.066), mortality (1.7% vs. 3.1%, <i>p</i> = 0.513) and the reoperation rate (2.5% vs. 3.1%, <i>p</i> = 1.000) were not significantly different from conventional liver resections. In the laser group, a lower reintervention rate (9.2% vs. 21.9%, <i>p</i> = 0.050) was observed. The oncological safety demonstrated by a tumor-free resection margin was similar after laser and conventional resection (93.2% vs. 89.3%, <i>p</i> = 0.256). The median intraoperative blood loss was significantly lower in the laser group (300 mL vs. 500 mL, <i>p</i> = 0.005) and there was a significantly lower need for a Pringle maneuver (3.4% vs. 15.6%, <i>p</i> = 0.021). (4) Conclusions: Liver resections using the 1318 nm surgical laser can be routinely performed with a favorable risk profile. Compared to alternative resection methods, they are associated with low blood loss, appear adequate from an oncological point of view, and are not associated with increased mortality and morbidity.https://www.mdpi.com/2072-6694/14/5/1191hepatectomyhepatic resectionlasermorbiditycomplicationsmortality |
| spellingShingle | Patrick Pfitzmaier Matthias Schwarzbach Ulrich Ronellenfitsch The Evaluation of the 1318 nm Diode Laser in Open Liver Surgery Cancers hepatectomy hepatic resection laser morbidity complications mortality |
| title | The Evaluation of the 1318 nm Diode Laser in Open Liver Surgery |
| title_full | The Evaluation of the 1318 nm Diode Laser in Open Liver Surgery |
| title_fullStr | The Evaluation of the 1318 nm Diode Laser in Open Liver Surgery |
| title_full_unstemmed | The Evaluation of the 1318 nm Diode Laser in Open Liver Surgery |
| title_short | The Evaluation of the 1318 nm Diode Laser in Open Liver Surgery |
| title_sort | evaluation of the 1318 nm diode laser in open liver surgery |
| topic | hepatectomy hepatic resection laser morbidity complications mortality |
| url | https://www.mdpi.com/2072-6694/14/5/1191 |
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