Yokoo Hideki, Kamiyama Toshiya, Nakanishi Kazuaki, Tahara Munenori, Fukumori Daisuke, Kamachi Hirofumi, Matsushita Michiaki, Todo Satoru
Department of General Surgery, Hokkaido University Graduate School of Medinice, Sapporo, Japan.
Hepatogastroenterology. 2012 May;59(115):831-5. doi: 10.5754/hge10337.
BACKGROUND/AIMS: Many kinds of transection devices have been developed but there are very few reports on the effectiveness of using ultrasonically activated scalpel with a hook blade in combination with a thermo-coagulating device for hepatectomy.
We studied 533 consecutive patients who underwent hepatectomy for primary disease and for living- related liver transplantation (LRLT) donors preformed using ultrasonically activated scalpel with a hook blade along with a saline-linked radiofrequency dissecting sealer (TL group, n=215) or bipolar cautery with a saline-irrigation system (IB group, n=318). Intraoperative blood loss, operative time, postoperative laboratory data collected over a week and the incidence of postoperative complications were analyzed in accordance with the pre-existing liver conditions.
The median operative time required to perform partial hepatectomy and hemihepatectomy in liver tumor cases was found to be significantly shorter in the TL group than in the IB group. There was no significant difference in the amount of blood loss between the 2 groups. Postoperative laboratory data was favorable and the overall complication rate after hepatectomy was 9.01%.
Ultrasonically activated scalpel with a hook blade used in combination with a thermo-coagulation device yielded favorable intra and postoperative outcomes.
背景/目的:已研发出多种切割器械,但关于使用带钩刃超声刀联合热凝装置进行肝切除术有效性的报道却很少。
我们研究了533例连续接受肝切除术的患者,这些患者因原发性疾病接受肝切除术,以及作为活体肝移植(LRLT)供体接受手术,手术中使用带钩刃超声刀联合盐水连接射频解剖密封器(TL组,n = 215)或带盐水冲洗系统的双极电凝器(IB组,n = 318)。根据术前肝脏状况分析术中失血量、手术时间、术后一周内收集的实验室数据以及术后并发症的发生率。
在肝肿瘤病例中,TL组进行部分肝切除术和半肝切除术所需的中位手术时间明显短于IB组。两组之间的失血量没有显著差异。术后实验室数据良好,肝切除术后的总体并发症发生率为9.01%。
带钩刃超声刀联合热凝装置使用,在术中和术后均取得了良好的效果。