Rimonda Roberto, Arezzo Alberto, Garrone Corrado, Allaix Marco Ettore, Giraudo Giuseppe, Morino Mario
Department of Surgery, University of Torino, Torino, Italy.
Dis Colon Rectum. 2009 Apr;52(4):657-61. doi: 10.1007/DCR.0b013e3181a0a70a.
This study was designed to compare the efficacy and safety of laparoscopic colorectal surgery performed with the aid of LigaSure vessel-sealing system or Ultracision.
Patients eligible for elective laparoscopic right or left hemicolectomy or anterior resection of rectum were randomly assigned to either the use of Ligasure or Ultracision. The primary end point was intraoperative reduction of blood loss. Secondary end points were intraoperative and postoperative morbidity and operative time.
Between April 2005 and December 2006, 140 consecutive patients were included in the study (70 Ligasure and 70 Ultracision. We performed 31 right hemicolectomies, 69 left hemicolectomies, and 40 anterior resections of rectum. Blood loss was 109.6 ml (Ultracision 107.9 ml vs. Ligasure 111.2 ml, P value = 0.72). Intraoperative complication rate was 2.8 percent (Ultracision 1.4 percent vs. Ligasure 4.2 percent, P value < 0.01). Postoperative mortality was 0.7 percent. The overall conversion rate was 7.8 percent, 6 in the Ligasure group and 5 in the Ultracision group (P value = 0.09). Operative time, considered from pneumoperitoneum to minilaparotomy, was 115.7 minutes (Ultracision 114.8 minutes vs. Ligasure 116.3 minutes, P value = 0.89).
Results showed that Ligasure and Ultracision are both useful instruments for laparoscopic colorectal surgery with no significant difference in terms of intraoperative/postoperative morbidity and operative time. Choice of which technique to perform should be according to the surgeon's preference.
本研究旨在比较使用LigaSure血管闭合系统或超声刀进行腹腔镜结直肠手术的疗效和安全性。
符合择期腹腔镜右半结肠或左半结肠切除术或直肠前切除术的患者被随机分配使用LigaSure或超声刀。主要终点是术中减少失血。次要终点是术中和术后的发病率及手术时间。
在2005年4月至2006年12月期间，140例连续患者纳入研究（70例使用LigaSure，70例使用超声刀）。我们进行了31例右半结肠切除术、69例左半结肠切除术和40例直肠前切除术。失血量为109.6毫升（超声刀组107.9毫升，LigaSure组111.2毫升，P值=0.72）。术中并发症发生率为2.8%（超声刀组1.4%，LigaSure组4.2%，P值<0.01）。术后死亡率为0.7%。总体中转率为7.8%，LigaSure组6例，超声刀组5例（P值=0.09）。从气腹到小切口剖腹手术的手术时间为115.7分钟（超声刀组114.8分钟，LigaSure组116.3分钟，P值=0.89）。
结果表明，LigaSure和超声刀都是腹腔镜结直肠手术的有用器械，在术中和术后发病率及手术时间方面无显著差异。选择哪种技术应根据外科医生的偏好。
