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New technique to increase resection margins during mini-invasive liver resection: a propensity score-matched study

Background: The application of radiofrequency (RF) energy in liver resection has been shown to be an effective method to minimize bleeding. However, the role of this technology in greater resection margin width and its relevance in local recurrence (LR) is still debatable at this time. This study aims to evaluate the effect of the RF energy during the resection liver surface on LR compared to conventional technologies. Methods: This is a retrospective study of patients who underwent laparoscopic radical hepatectomy for colorectal liver metastases (CRLM) between September 2006 and September 2020 was performed. After 1:1 propensity score matching (PSM), cases were divided into two groups (with or without application of RF to liver resection). Results: Once the PSM is applied, LR rate resulted to be significantly higher in the Control compared with the RF group [8 (7.84%) vs. 2 (1.9%) patients, P=0.046]. The final LR free-survival at 1, 3, and 5 years of the control and RF group patients were 86.5%, 83.9%, 80.1% and 100%, 100%, 92.3%, respectively (P=0.045). The RF energy is related to lower LR [hazards ratio (HR) =4.69; 95% confidence intervals (CI): 0.983–22.40; P=0.053]. Conclusions: Compared to conventional haemostatic technologies, liver resection with the use of RF on the resection surface can reduce local hepatic recurrence. 8