Magri K, Bertrand V, Sautière J-L, Pivot X, Riethmuller D, Maillet R, Marinkovic Z
Service de Gynécologie-Obstétrique, CHU de Besançon, Hôpital Saint-Jacques, 2, place Saint-Jacques, 25030 Besançon Cedex.
J Gynecol Obstet Biol Reprod (Paris). 2006 Jun;35(4):341-7. doi: 10.1016/s0368-2315(06)76406-7.
Introduction. The techniques used for axillary node dissection are constantly evolving. The advent of the grip Ligasure Precise raise the question of its cost-effectiveness compared with surgical clips.
To compare the effectiveness of Ligasure compared with surgical clips for simple axillary node dissection or Patey procedure in terms of duration of drainage, cost of hospitalization and complications.
and method. Retrospective study extending from January 1, 2003 to December 31, 2004, concerning 187 patients who underwent simple axillary dissection (100) or Patey procedure (87), with use of surgical clips or Ligasure followed by drainage.
The use of Ligasure increased the operative cost because its price is higher than that of a clip grip with a refill. Ligasure significantly decreased the duration of drainage in the two groups but there was significantly more abundant fluid loss in the dissection group. The cost of hospitalization related to the choice of the technique of hemostasis (cost of the material + lasted of drainage X price of the day of hospitalization), was not significantly favor of Ligasure. Taking into account the choice of the hemostasis technique and the total duration of hospitalization (material cost + duration of hospitalization X price of the day of hospitalization), there is no significant difference between the two groups.
This study compares grip Ligasure Precise with surgical clips for axillary dissection. The duration of drainage was significantly shorter with Ligasure Precise but its benefit in terms of fluid loss remains to be shown. The use of Ligasure does not significantly reduce the cost of hospitalization.
引言。用于腋窝淋巴结清扫的技术不断发展。精准结扎速即纱的出现引发了与手术夹相比其成本效益的问题。
比较结扎速即纱与手术夹在单纯腋窝淋巴结清扫或帕蒂手术中引流持续时间、住院费用及并发症方面的有效性。
材料与方法。回顾性研究,时间跨度从2003年1月1日至2004年12月31日,涉及187例行单纯腋窝清扫术(100例)或帕蒂手术(87例)的患者,使用手术夹或结扎速即纱后进行引流。
使用结扎速即纱增加了手术成本,因为其价格高于带补充装的手术夹。结扎速即纱显著缩短了两组的引流持续时间,但在清扫组中液体丢失明显更多。与止血技术选择相关的住院费用(材料成本+引流持续时间×住院日价格),对结扎速即纱并无显著优势。考虑到止血技术选择和住院总时长(材料成本+住院时长×住院日价格),两组之间无显著差异。
本研究比较了精准结扎速即纱与手术夹用于腋窝清扫的情况。精准结扎速即纱的引流持续时间显著更短,但其在减少液体丢失方面的益处仍有待证明。使用结扎速即纱并未显著降低住院费用。