A comparative study of argon plasma coagulation and electrosurgical knife on postoperative complications after curative resection for hepatocellular carcinoma.

[PURPOSE] This study aimed to compare the impact of argon plasma coagulation (APC) and electrosurgical knife (EK) in sealing the hepatic transection surface of patients undergoing curative resection for hepatocellular carcinoma (HCC).

[METHODS] This single-center retrospective study was performed in the department of hepatobiliary and pancreatic surgery of 900th Hospital at the Joint Logistics Support Force of the Chinese People's Liberation Army between January 2013 and January 2018. 319 patients who underwent surgery for hepatocellular carcinoma were analysed ; and categorized into the two groups according to usage of argon plasma coagulation and the electrosurgical monopolar knife as secondary hemostatic surgical instruments. After 1:1 propensity score matching analysis, differences between two groups were assessed in terms of postoperative clinical outcomes. Multivariate logistic regression analysis was performed to identify independent factors associated with postoperative complications.

[RESULTS] After propensity score matching analysis, the group in which argon plasma coagulation was used for secondary hemostasis had a significantly lower postoperative complication rate compared to the group that used electrosurgical monopolar knife (p:0.033).A lower rate of complications graded according to Clavien-Dindo classification (grade III-V) was also seen in APC group (p:0.030). Moreover, the APC group had significantly less seen complications of bile leakage (p:0.015), ascites (p:0.011), and intra-abdominal infection (p:0.030). Multivariate analysis revealed the use of APC as an independent factor effective on postoperative complications (OR: 0.42, 95% CI: 0.21-0.84).

[CONCLUSION] The use of APC during curative resection of HCC decreased the incidence of postoperative complications in comparison with EK.