Department of Gynecology, West China Second Hospital of Sichuan University, The People of South Road 20, Chengdu, Sichuan 610041, China.
Arch Gynecol Obstet. 2012 Aug;286(2):457-63. doi: 10.1007/s00404-012-2275-9. Epub 2012 Mar 29.
To evaluate the efficacy and security of ERBE BiClamp(®) forceps in radical abdominal hysterectomy for managing those cervical cancers, extending to other gynecologic cancers such as endometrial cancer and ovarian cancer as well.
A retrospective cohort study was made in 391 cases from 450 FIGO IA2-IIB cervical cancers between November 2005 and September 2010. After baseline character analysis, the conventional group (n = 195) was compared with the BiClamp group (n = 196) on the basis of surgical outcome and complications. Data analysis was based on intention to treat with statistics software SPSS17.0.
Comparison between conventional suture ligation and BiClamp(®) forceps is as follows: the operation time was 247.7 ± 47.7 min for the conventional suture ligation versus 224.1 ± 36.2 min (P < 0.001) for BiClamp(®) forceps, estimated blood loss was 769.2 ± 310.4 ml versus 534.8 ± 232.5 ml (P < 0.001), gauze consumption was 35.3 ± 10.6 sheets versus 28.2 ± 7.4 sheets (P < 0.001), intra-operative blood transfusion rate was 75.9 versus 28.1% (P < 0.001), hemoglobin decline was 29.2 ± 10.1 g/L versus 26.5 ± 9.2 g/L (P = 0.085), postoperative blood transfusion rate was 17.0 versus 15.6% (P = 0.818), closed suction drainage was 268.8 ± 162.0 ml versus 208.3 ± 141.7 ml (P < 0.001), hospital stay was 8.8 ± 2.5 days versus 7.1 ± 2.2 days (P < 0.001), postoperative complications was 23.6 versus 14.8% (P = 0.027).
With obvious decrease of operation time, blood loss, postoperative complications, hospital stay and particularly, intra-operative blood transfusion rate, BiClamp(®) forceps has been proved more efficient and controllable in radical abdominal hysterectomies of cervical cancers than conventional suture ligations, extending to endometrial cancers and ovarian cancers, hence deserves to be popularized.
评估 ERBE BiClamp（®）在根治性腹部子宫切除术治疗宫颈癌中的疗效和安全性，以及子宫内膜癌和卵巢癌等其他妇科癌症。
对 2005 年 11 月至 2010 年 9 月期间 450 例 FIGOIA2-IIB 宫颈癌患者中的 391 例进行回顾性队列研究。在基线特征分析后，根据手术结果和并发症将常规组（n=195）与 BiClamp 组（n=196）进行比较。数据分析采用 SPSS17.0 统计软件进行意向治疗。
常规缝合结扎与 BiClamp（®）钳夹的比较如下：常规缝合结扎的手术时间为 247.7±47.7 分钟，而 BiClamp（®）钳夹的手术时间为 224.1±36.2 分钟（P＜0.001），估计出血量为 769.2±310.4ml，而 BiClamp（®）钳夹的出血量为 534.8±232.5ml（P＜0.001），纱布使用量为 35.3±10.6 张，而 BiClamp（®）钳夹的纱布使用量为 28.2±7.4 张（P＜0.001），术中输血率为 75.9%，而 BiClamp（®）钳夹的术中输血率为 28.1%（P＜0.001），血红蛋白下降量为 29.2±10.1g/L，而 BiClamp（®）钳夹的血红蛋白下降量为 26.5±9.2g/L（P=0.085），术后输血率为 17.0%，而 BiClamp（®）钳夹的术后输血率为 15.6%（P=0.818），闭式引流量为 268.8±162.0ml，而 BiClamp（®）钳夹的闭式引流量为 208.3±141.7ml（P＜0.001），住院时间为 8.8±2.5 天，而 BiClamp（®）钳夹的住院时间为 7.1±2.2 天（P＜0.001），术后并发症发生率为 23.6%，而 BiClamp（®）钳夹的术后并发症发生率为 14.8%（P=0.027）。
BiClamp（®）在根治性腹部子宫切除术治疗宫颈癌中比常规缝合结扎更有效、更可控，可明显缩短手术时间、出血量、术后并发症发生率、住院时间，尤其是术中输血率，同时也适用于子宫内膜癌和卵巢癌，值得推广。
