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[腹式全子宫切除术中使用等离子动力学血管封闭术与缝合材料的比较]

[Use of plasmakinetics vessel sealing vs suture material in abdominal total hysterectomy].

作者信息

Briones Landa Carlos Humberto, Zepeda Zaragoza Jorge, Dupré Aramburu Guillermina, Cruz Islas Martha Laura

机构信息

Hospital Central Norte de Petróleos Mexicanos, Mexico.

出版信息

Ginecol Obstet Mex. 2009 Dec;77(12):556-61.

Abstract

OBJECTIVE

To compare the safety and efficacy of the use of bipolar plasmakinetic vessel sealing versus standard technique when performing total abdominal hysterectomy for benign disease.

MATERIAL AND METHODS

Controlled randomized trial involving 94 women who underwent total abdominal hysterectomy. Fourty seven procedures were performed using bipolar plasmakinetics vessel sealing and the remaining 47 with the standard suture technique. The primary outcomes were improvement in terms of blood loss, procedure time, hospital length of stay, and overall cost of the procedure. Statistical methodology considered significant p < 0.05.

RESULTS

Mean operational time was shorter with bipolar vessel sealing duration of 82 minutes (range 78-85) versus 99 minutes (range 93-104) with standard technique; (p < 0.001). Days in hospital for the bipolar vessel sealing group was 2.06 days (range 2-2.1), versus 3.2 days (range 2.9-3.4), (p < 0.001), estimated blood loss of 209 mL (range 182-235) as compared to the standard group with 330 mL(range 297-362) (p < 0.003), there was a significant difference in terms of overall cost with bipolar vessel sealing as compared to the standard technique (p < 0.001).The incidence of perioperative complications was similar.

CONCLUSIONS

Women who underwent the procedure with bipolar plasmakinetics vessel sealing showed a significant reduction in blood loss, operative time, length of stay, and also a decrease in the final cost of the procedure.

摘要

目的

比较在良性疾病全腹子宫切除术中使用双极等离子动力血管闭合术与标准技术的安全性和有效性。

材料与方法

一项对照随机试验,涉及94例行全腹子宫切除术的女性。47例手术采用双极等离子动力血管闭合术,其余47例采用标准缝合技术。主要观察指标为出血量、手术时间、住院时间和手术总成本的改善情况。统计学方法认为p<0.05具有统计学意义。

结果

双极血管闭合术的平均手术时间较短,为82分钟(范围78 - 85分钟),而标准技术为99分钟(范围93 - 104分钟);(p<0.001)。双极血管闭合术组的住院天数为2.06天(范围2 - 2.1天),而标准技术组为3.2天(范围2.9 - 3.4天),(p<0.001),估计出血量为209毫升(范围182 - 235毫升),而标准组为330毫升(范围297 - 362毫升)(p<0.003),双极血管闭合术与标准技术相比,在总成本方面存在显著差异(p<0.001)。围手术期并发症的发生率相似。

结论

接受双极等离子动力血管闭合术的女性在出血量、手术时间、住院时间方面均有显著减少,手术最终成本也有所降低。

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