To investigate the efficacy and feasibility of microwave coagulation in reducing the intraoperative bleeding during laparoscopic hepatectomy for hepatocellular carcinoma (HCC).

Clinical data of 35 patients undergoing laparoscopic hepatectomy for HCC in the First Affiliated Hospital of Sun Yat-sen University from June 2013 to June 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to whether the microwave coagulation was used during the operation, the patients were divided into microwave coagulation-assisted laparoscopic liver resection group (microwave group) and laparoscopic liver resection group (laparoscopic group). In the microwave group (n=12), 8 patients were male and 4 were female, aged (57±7) years on average. In the laparoscopic group (n=23), 18 cases were male and 5 were female, aged (51±12) years on average. The perioperative blood loss between two groups was statistically compared by Wilcoxon rank-sum test. The ratio comparison was performed by Chi-square test or Fisher's exact probability test. Survival analysis was performed by Kaplan-Meier survival curve and Log-rank test.

The intraoperative blood loss in microwave group was 90(50, 200) ml, significantly less than 200(100, 500) ml in laparoscopic group (Z=-2.520, P<0.05). The incidence of postoperative complications was respectively 8.3% and 8.7% in microwave and laparoscopic group, where no significant difference was observed (P=1.000). The 2-year tumor-free survival rate was respectively 66.7% and 69.6% in microwave and laparoscopic group, and the 2-year overall survival rate was respectively 70.1% and 87.7%, where no significant difference was observed (χ²=0.075, 0.082; P>0.05).

Microwave coagulation can effectively reduce the intraoperative bleeding during laparoscopic hepatectomy for HCC and improve the safety of operation, which is an effective assisting technique for liver resection.