Tumori, 90: 32-35, 2004 Introduction Surgical resection remains the only potentially cu- rative procedure for hepatic tumors. Even though liv- er resection can be performed with a low mortality rate, it remains a formidable surgical procedure re- quiring experienced surgeons to perform it safely. In- traoperative blood loss has become a major parame- ter in evaluating results of liver resection, since it af- fects postoperative morbidity, mortality and long- term survival in malignant disease 1-3 . Operative blood loss can occur during dissection, parenchymal transection and revascularization. To re- duce blood loss during the transection phase, differ- ent techniques have been developed over the years 4-7 . Surgeons can utilize low central venous pressure anesthesia, continuous or intermittent hepatic pedicle clamping, or total vascular exclusion. Parenchymal division can be performed with the scalpel, by crush- ing with fingers or clamps, using ultrasonic dissec- tors and hydrodissectors, or stapling devices. In the present paper the authors report the early re- sults obtained with a new technique for liver resec- tion using radiofrequency (RF) energy to obtain co- agulative desiccation of the resection margins that can subsequently be divided with a surgical scalpel. The technique was initially used only in cases of small segmental resections, but it has subsequently permitted major liver resection. Patients and methods Between January 2001 and July 2002, 42 patients underwent RF-guided liver resection for hepatic tu- mors at the Hammersmith Hospital, London, UK (Table 1). All patients underwent careful preoperative assessment of their disease including spiral comput- erized tomography (CT) scan of chest and abdomen and/or magnetic resonance imaging (MRI) to exclude evidence of unresectable extrahepatic disease. The indications for surgery were discussed at the Multi Disciplinary Treatment and Pathway Meetings. A written consent was obtained from patients be- fore surgery. Under general anesthesia, a modified right subcostal incision was performed. The peri- toneal cavity was examined for evidence of extrahep- atic disease, and an intraoperative ultrasonography Correspondence to: Prof Giuseppe Navarra, H Consultant, Department of GI Surgery, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK. Tel +44-20-8383-8574; fax +44-20-8383-3212; e-mail gnavarra@unime.it Received December 24, 2002; accepted August 28, 2003. EARLYRESULTS AFTER RADIOFREQUENCY-ASSISTED LIVER RESECTION Giuseppe Navarra, Cesare Lorenzini, Giuseppe Currò, Ernesto Basaglia, and Nagy H Habib Department of Surgical Oncology and Technology, Imperial College School of Medicine, Hammersmith Hospital Campus, London W12 0NN, UK Key words: liver resection, liver tumors, radiofrequency ablation. Aims and background: Intraoperative blood loss during liver re- section remains a major concern due to its association with higher postoperative complications and shorter long-term survival. The aim of this study was to assess the feasibility and safety of a novel concept for liver resection using a ra- diofrequency energy-assisted technique. Methods: From January 2001 to July 2002, 42 patients were oper- ated on using radiofrequency energy-assisted liver resection. Radiofrequency energy was applied along the resection edge to create a ‘zone of desiccation’ prior to resection with a scalpel. Results: Median resection time was 50 mins (range, 30-110). The median blood loss during resection was 30 mL (range, 15- 992). Mean preoperative and postoperative hemoglobin values were 13.7 g/dL (SD ± 1.6) and 11.8 g/dL (SD ± 1.4), respective- ly. No blood transfusion was registered, nor was any mortality observed. There were 3 postoperative complications, one sub- phrenic abscess, one chest infection and one biliary leak from a hepatico-jejunostomy. Median postoperative stay was 8 days (range, 5-86). Conclusions: Liver resection assisted by radiofrequency energy is feasible, easy and safe. This novel technique offers a new method for ‘transfusion-free’ resection without the need for sutures, ties, staples, tissue glue or admission to an intensive care unit. Table 1 - Patient characteristics: age, sex and diagnosis Age 57.5 (25-79) Sex Male 26 Female 16 Primary Colorectal 20 Carcinoid 4 HCC 3 Gallbladder 3 Others 12