Ramesh Rakesh S, Manjunath Suraj, Shivakumar K, Philip Roji, Selvan Sumithra
Department of Surgical Oncology, St Johns Medical College Hospital and Research Centre, Bangalore, India 5600034.
Indian J Surg Oncol. 2011 Sep;2(3):156-8. doi: 10.1007/s13193-011-0106-2. Epub 2011 Nov 29.
Patients with breast cancer and positive sentinel node biopsy usually require axillary dissection. Different instruments are used for axillary dissection like regular scalpel,monopolar cautery, bipolar cautery etc. All these instruments are having its advantages and disadvantages. Our dept did a pilot study to know the efficacy of ultrasonic shears over cautery for axillary dissection. Parameters considered were cumulative drain amount, number of days with the drain and number of lymphnodes harvested. Ultrasonic shear machine delivers precisely directed mechanical energy with an ultrasonic vibrating blade.A single device dissects, cuts, grasps, spot coagulates. This machine was used for doing axillary dissection in one group and regular cautery in the other group. Study period was from April 2011 to June 2011 at Dept of Surgical Oncology, St Johns Hospital, Bangalore. Nine people in the ultrasonic shear group and 11 people in the cautery group were included in the pilot study. No significant difference were noticed in the cumulative drain amount, number of days with the drain, and number of lymphnodes harvested in both the groups. Axillary dissection using ultrasonic shears do not show any significant difference in the cumulative drain amount, number of days with the drain, and number of lymphnodes harvested. These are the findings of the pilot study, further prospective randomized studies are required for substantiating the findings.
前哨淋巴结活检呈阳性的乳腺癌患者通常需要进行腋窝淋巴结清扫术。腋窝淋巴结清扫术会使用不同的器械，如普通手术刀、单极电刀、双极电刀等。所有这些器械都有其优缺点。我们科室进行了一项初步研究，以了解超声刀在腋窝淋巴结清扫术中相对于电刀的疗效。所考虑的参数包括累计引流量、留置引流管的天数以及获取的淋巴结数量。超声刀通过超声振动刀片传递精确导向的机械能。一台设备即可完成解剖、切割、抓取和点状凝血。该设备在一组中用于进行腋窝淋巴结清扫术，另一组则使用常规电刀。研究时间为2011年4月至2011年6月，地点在班加罗尔圣约翰医院外科肿瘤学科室。初步研究纳入了超声刀组的9人以及电刀组的11人。两组在累计引流量、留置引流管的天数以及获取的淋巴结数量方面均未发现显著差异。使用超声刀进行腋窝淋巴结清扫术在累计引流量、留置引流管的天数以及获取的淋巴结数量方面未显示出任何显著差异。这些是初步研究的结果，需要进一步的前瞻性随机研究来证实这些发现。
