Evaluation of therapeutical effect:Hepatectomy using Tissue-Link & Cusa without vascular occlusion

Objective To compare the clinical results between hepatectomy with vascular occlusion and using Tissue-Link Cusa without vascular occlusion in the treatment of hepatocellular carcinoma(HCC). Methods From January 2003 to September 2006, 105 patients of HCC underwent hepatectomy with vascular occlusion (control group,n =50) and using TissueLing Cusa without vascular occlusion (non-occlusion group,n=55)were analyzed rerto-spectively. Results Compared with control group, the incisional margin were significantly wider in non-occlusion group [(1.1±0.3) cm vs. (0.7 ±0.5)cm, P 0.05], both the edge positive rate and local recurrence rate were significantly lower than that non-occlusion group (0% vs. 4%, P0.05; 0% vs. 6%, P0.05), but no significant difference were seen in the out of incional margin recurrence rate (13% vs. 14%, P= 0.112). The duration of hepatectomy was significantly longer in non-occlusion group than in control group. However,in the amount of operative bleeding were significantly lower in non-occlusion group. Serum total bilirubin levels on 7th day after operation, and the supplement of albumin were significantly lower in non-occlusion group than in control group. Whereas, there were no significant differences in 1-, 2-, and 3-year tumor-free survival rates (90.9% 、87.3% and 80.0% vs. 90.0% 、 74.0% and 66.0% respectively,between the two groups (P=0.134). Conclusion Heppatectomy with Tissue-Link and cusa non occlusion technigue is superior to the hilar occlusion method in the curative effects for the treatment of hepato-cellular carcinoma. It has a clear operative field, less operative bleeding, few damage of liver funetion and a lower cancer residual rate of incisional margin and recurrence rate.