Radiofrequency Assisted Partial Resection of Parenchymal Organs in Children
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The aim of the study was the analysis of radiofrequency assisted partial resection of parenchymal organs in children performed in our center.Material and methods. First operation with use of thermoresection was performed in February 2005 and since than we performed 19 such procedures. In 9 patients partial resection of spleen (hemisplenectomy), in 8 patients partial resection of liver were performed. In 2 cases we performed "in situ" reduction of liver during cadaveric multiorgan procurement (left hepatic lobe was procured).Age of the patients ranged from 19 days to 18 years, medium - 4.5 years. Indication for partial resection of splen was cyst in all cases. In 6 patients it was located in superior pole, in 3 in inferior pole of spleen. Laparoscopic procedure was performed in 5 patients, open surgery was performed in 4 children.Indication for partial resection of liver was neoplasm in 4 cases (3 hepatoblastoma, 1 undiferentiated sarcoma). In 2 patients indication for operation was giant liver hemangioma, in 1 - focal nodular hyperplasia (FNH), in 1 - ischemia of the right lobe of the liver after transplantation.Results. Postoperative period was uncomplicated in all cases except three of them. In 1 patient with acute liver failure, after transplantation ischemia of the liver revealed which was caused by compression of the costal archs. Right hemihepatectomy was performed in the 2nd day after transplantation. This patient died in the 3rd day after transplantation due to multiorgan failure. In newborn patient with giant liver hemangioma which occupied right lobe and IV segment, stricture of biliary duct occured. The most possible cause of the stricture was the result of the radiofrequency coagulation impact on the left biliary duct lying to close to the hemagioma. In 1 patient 2 months after resection of the superior spleen pole, perforation of the diaphragm and diaphragmatic hernia occured which required operation. Follow up of the patients after thermoresection is 5 to 36 months.Conclusions. Monopolar radiofrquency coagulation is very useful technique in partial resection of solid organs in children however there are limitations due to risk of the use of the coagulation too close to the vessels or biliary ducts.
1 - 3 - 2009
8 - 9 - 2009
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