Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
Gastric Cancer. 2014;17(3):556-61. doi: 10.1007/s10120-013-0301-7. Epub 2013 Sep 19.
Use of ultrasonically activated shears (UAS) is gaining popularity in open surgery but without concrete evidence. We conducted a prospectively randomized study to assess the efficacy of ultrasonic dissection in open gastrectomy for gastric cancer.
Patients with gastric cancer who were to undergo gastrectomy with D2 lymph node dissection were enrolled and assigned to either the conventional surgery group (n = 125) or the UAS group (n = 128).
The mean operating time was significantly reduced in the UAS group (89.3 ± 15.6 min) when compared to the conventional group (97.8 ± 17.2 min; p < 0.001). However, we did not find any significant difference in operative blood loss, the amount of postoperative abdominal drainage, or the rate of postoperative complications between the groups. A multivariate analysis for operating time revealed that the use of UAS, female gender and BMI less than 25 were significantly associated with reduced operating time. The operating time was significantly longer in the conventional group than in the UAS group (B 7.786; 95 % CI 4.103-11.468; p < 0.001). In the subgroup analysis, the use of UAS significantly reduced the operating time, especially in male patients, regardless of the BMI status.
The use of UAS in gastrectomy for gastric cancer was a safe and efficient method, especially in terms of reducing operating time for male patients.
超声刀（UAS）在开放手术中越来越受欢迎，但缺乏具体证据。我们进行了一项前瞻性随机研究，以评估超声切割在胃癌开放性胃切除术中的疗效。
将接受胃癌根治术和 D2 淋巴结清扫术的胃癌患者纳入并随机分为常规手术组（n=125）和 UAS 组（n=128）。
与常规组（97.8±17.2min）相比，UAS 组的平均手术时间明显缩短（89.3±15.6min；p<0.001）。然而，两组间手术出血量、术后腹腔引流量和术后并发症发生率无显著差异。多因素分析显示，UAS 的使用、女性和 BMI<25 与手术时间缩短显著相关。常规组的手术时间明显长于 UAS 组（B 7.786；95%CI 4.103-11.468；p<0.001）。亚组分析显示，UAS 的使用显著缩短了手术时间，尤其是在男性患者中，无论 BMI 状态如何。
UAS 在胃癌根治术中是一种安全有效的方法，尤其是可以缩短男性患者的手术时间。
