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腹腔镜结肠切除术中电热双极血管闭合器与超声刀的对比研究

Comparative study of electrothermal bipolar vessel sealer and ultrasonic coagulating shears in laparoscopic colectomy.

作者信息

Takada M, Ichihara T, Kuroda Y

机构信息

Department of Gastroenterological Surgery, Graduate School of Medicine, Kobe University, Kobe, 650-0017, Japan.

出版信息

Surg Endosc. 2005 Feb;19(2):226-8. doi: 10.1007/s00464-004-9072-x. Epub 2004 Dec 2.

Abstract

BACKGROUND

As an alternative to suture ligatures of the vessels, an electrothermal bipolar vessel sealer (EBVS) was recently developed. Meanwhile, ultrasonic coagulating shears (UCS) have been widely used clinically to provide hemostatic cutting in laparoscopic procedures. We conducted a comparative study to investigate the relative advantages of these two instruments.

METHODS

The study included 30 patients with colon cancer who underwent laparoscopic colectomy using either the EBVS or the UCS. We performed a comparative analysis of the instruments by viewing videotapes showing their application in laparoscopic transverse colectomy and sigmoidectomy.

RESULTS

Average patient age was 71.6 +/- 1.4 years. Average hospital stay was 14.2 +/- 1.0 days. There were no statistical differences between the groups in age and hospital stay. The incidence of rebleeding was significantly lower in the EBVS group than in the UCS group for both surgical procedures (0.3 vs 1.2 in transverse colectomy, 0.3 vs 2.0 in sigmoidectomy, respectively). In addition, the required time for mesocolon dissection was also significantly shorter when the EBVS was used in both laparoscopic transverse colectomy and sigmoidectomy (7.9 vs 18.4, 15.0 vs 27.6, respectively).

CONCLUSION

The use of the EBVS will enable surgeons to reduce the total operating time for laparoscopic colectomy.

摘要

背景

作为血管缝合结扎的替代方法,一种电热双极血管闭合器(EBVS)最近被研发出来。同时,超声刀(UCS)已在临床广泛应用于腹腔镜手术中的止血切割。我们进行了一项对比研究以探究这两种器械的相对优势。

方法

该研究纳入了30例接受腹腔镜结肠切除术的结肠癌患者,他们分别使用了EBVS或UCS。我们通过观看展示这两种器械在腹腔镜横结肠切除术和乙状结肠切除术中应用的录像带,对它们进行了对比分析。

结果

患者平均年龄为71.6±1.4岁。平均住院时间为14.2±1.0天。两组在年龄和住院时间方面无统计学差异。在两种手术中,EBVS组的再出血发生率均显著低于UCS组(横结肠切除术中分别为0.3比1.2,乙状结肠切除术中分别为0.3比2.0)。此外,在腹腔镜横结肠切除术和乙状结肠切除术中使用EBVS时,肠系膜分离所需时间也显著缩短(分别为7.9比18.4,15.0比27.6)。

结论

使用EBVS能够使外科医生缩短腹腔镜结肠切除术的总手术时间。

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