Department of Surgery, Kansai Medical University, Shinmachi 2-3-1, Hirakata City, Osaka, 573-1191, Japan.
J Gastrointest Surg. 2012 Oct;16(10):1840-6. doi: 10.1007/s11605-012-1970-y. Epub 2012 Jul 26.
The aim of the study was to evaluate the potential advantages of the ultrasonic scalpel compared with the conventional technique in gastric cancer surgery.
Patients with resectable adenocarcinoma of the stomach were randomly assigned to ultrasonic scalpel or conventional technique. We used the HARMONIC FOCUS (Ethicon Endo-Surgery, Inc.) as ultrasonic scalpel.
Between February 2010 and December 2010, 60 patients with resectable gastric cancer were enrolled into the study. Operative time was significantly shorter with the ultrasonic arm than with the conventional arm (median 238.5 vs. 300.5 min; P = 0.0004). Blood loss was also significantly lower in the ultrasonic arm than in the conventional arm (median 351.0 vs. 569.5 ml; P = 0.016). Clavien-Dindo grades of postoperative complications were similar in the two groups. From a questionnaire survey of operators, the ultrasonic scalpel significantly reduced the stress of lymph node dissection (3.67 vs. 2.87; P = 0.0006). However, in assisting surgeons, the contributions to surgery, study, and technical improvement of the ultrasonic group were lower than in the conventional group.
This study shows that the ultrasonic scalpel is a reliable and safe tool for open gastric cancer surgery.
本研究旨在评估超声刀相较于传统技术在胃癌手术中的潜在优势。
将可切除的胃腺癌患者随机分为超声刀组或传统技术组。我们使用 HARMONIC FOCUS（Ethicon Endo-Surgery，Inc.）作为超声刀。
2010 年 2 月至 2010 年 12 月，共纳入 60 例可切除胃癌患者。超声刀组的手术时间明显短于传统技术组（中位数 238.5 分钟 vs. 300.5 分钟；P=0.0004）。超声刀组的出血量也明显少于传统技术组（中位数 351.0 毫升 vs. 569.5 毫升；P=0.016）。两组术后并发症的 Clavien-Dindo 分级相似。从手术医生的问卷调查来看，超声刀显著减轻了淋巴结清扫的压力（3.67 分 vs. 2.87 分；P=0.0006）。然而，在协助外科医生方面，超声组对手术、研究和技术改进的贡献低于传统组。
本研究表明，超声刀是一种可靠且安全的开腹胃癌手术工具。
