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腋窝淋巴结清扫术中的电热双极血管闭合系统:一项前瞻性随机临床研究。

Electrothermal bipolar vessel sealing system in axillary dissection: a prospective randomized clinical study.

机构信息

Breast Cancer Unit, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain.

出版信息

Int J Surg. 2011;9(8):636-40. doi: 10.1016/j.ijsu.2011.08.002. Epub 2011 Sep 10.

Abstract

We assessed whether axillary dissection using the electrothermal bipolar vessel sealing system (LigaSure) improved perioperative outcome when compared with conventional axillary dissection, in a prospective randomized study of 100 women with breast cancer. Those needing axillary dissection were randomized to the use of LigaSure or to conventional axillary dissection (with 50 patients in each group, all of whom had a closed suction drain in the axilla). The LigaSure patients had less intraoperative blood loss (exceeding 199 mL in 30.8% vs. 69.2%, P < 0.001), quicker axillary dissection (mean 48 vs. 63.2 min, P = 0.004), fewer days of suction drainage (4.3 vs. 5.7 days, P = 0.012), and shorter hospitalization (5.1 vs. 6.5 days, P = 0.021). No difference was found in the rate of hematomas, reoperations or infection. The use of LigaSure in axillary surgery reduced the surgical time and length of hospital stay, favoring early drain removal without increasing postoperative complications.

摘要

我们评估了在 100 例乳腺癌患者的前瞻性随机研究中,与传统腋窝清扫相比,使用电热双极血管密封系统(LigaSure)进行腋窝清扫是否能改善围手术期结果。需要腋窝清扫的患者被随机分为 LigaSure 组或传统腋窝清扫组(每组 50 例,两组患者的腋窝均放置闭式负压引流管)。LigaSure 组术中出血量较少(超过 199 毫升者占 30.8%,vs. 69.2%,P < 0.001),腋窝清扫时间更快(平均 48 分钟 vs. 63.2 分钟,P = 0.004),引流天数更少(4.3 天 vs. 5.7 天,P = 0.012),住院时间更短(5.1 天 vs. 6.5 天,P = 0.021)。两组血肿、再次手术或感染发生率无差异。LigaSure 在腋窝手术中的应用减少了手术时间和住院时间,有利于早期拔管,而不增加术后并发症。

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