Skip to Main content Skip to Navigation
Journal articles

Disposable bipolar irrigated sealer (Aquamantys ®) for liver resection: use with caution

Abstract : The disposable bipolar irrigated sealer has been demonstrated to reduce perioperative bleeding, but its role in preventing postoperative cut-surface complications has not been evaluated to date. A prospective observational study was performed between January and September 2013 to evaluate a disposable bipolar irrigated sealed (Aquamantys(A (R))) on a continuous series of 51 first liver resections without biliary reconstruction. Primary end-point was the occurrence of cut-surface complications during the postoperative period. Secondary endpoints were postoperative complications and the 1-year overall survival rate. The results were compared to a propensity score matched group of 153 liver resections performed with conventional monopolar cautery. A cut-surface complication occurred in 13/51 (25.5 %) resected patients. Bleeding, bile leakage and subphrenic abscess occurred in 7.8, 11.8 and 11.8 % patients, respectively. Compared to the matched group, the resected group had a higher rate of cut-surface complications (25.5 vs. 14.7 %, p < 0.01) and a higher rate of Clavien-Dindo type a parts per thousand yen3 postoperative complications (29.5 vs. 17.2 %, p < 0.01). In the multivariate analysis, preoperative chemotherapy (p = 0.03, 95 % CI 1.09-5.9, OR 2.53), blood transfusion (p = 0.02, 95 % CI 1.78-6.55, OR 2.78) and Aquamantys(A (R)) use (p = 0.02, 95 % CI 1.21-6.7, OR 2.85) were independent of cut-surface complications within the first 90 postoperative days. The overall 1-year survival rates were not different between the two groups (p = 0.078). Aquamantys(A (R)) use is associated with an increased rate of postoperative complications compared to classical monopolar cautery, and we recommend that it should be used with caution in this type of surgery.
Complete list of metadatas

https://hal-univ-rennes1.archives-ouvertes.fr/hal-01363196
Contributor : Laurent Jonchère <>
Submitted on : Friday, September 9, 2016 - 2:32:45 PM
Last modification on : Saturday, October 24, 2020 - 3:45:26 AM

Identifiers

Citation

Andrea Patrizi, Caroline Jezequel, Laurent Sulpice, Bernard Meunier, Michel Rayar, et al.. Disposable bipolar irrigated sealer (Aquamantys ®) for liver resection: use with caution. Updates In Surgery, 2016, 68 (2), pp.171--177. ⟨10.1007/s13304-016-0367-y⟩. ⟨hal-01363196⟩

Share

Metrics

Record views

210