应用超声刀（CUSA）与高频电刀行肝切除术的回顾性队列研究。
Liver resection using cavitron ultrasonic surgical aspirator (CUSA) versus harmonic scalpel: a retrospective cohort study.
机构信息
University of California Los Angeles, Division of Transplantation, Los Angeles, CA, USA.
Thomas Jefferson University, Division of Biostatistics, Philadelphia, PA 19107, USA.
出版信息
Int J Surg. 2014;12(5):500-3. doi: 10.1016/j.ijsu.2014.02.007. Epub 2014 Feb 18.
BACKGROUND
The aim of this study was to evaluate the safety and efficacy of two device combinations used in parenchymal division during hepatic resections in non-cirrhotic patients and without inflow vascular occlusion.
METHODS
We retrospectively analyzed 47 patients who underwent liver resection at our Institution from 2004 to 2010 using the TissueLink with either the Cavitron Ultrasonic Surgical Aspirator (CUSA) or the Harmonic Scalpel. The TissueLink was used with the CUSA in 27 patients and with the Harmonic Scalpel in 20 patients.
RESULTS
Median estimated blood loss (EBL) in the Harmonic Scalpel and CUSA groups was 250 and 1035 mL respectively (p < 0.05). Three patients were transfused banked blood perioperatively in the Harmonic Scalpel group and 11 in the CUSA group (p < 0.05). Median operative time in the Harmonic Scalpel and CUSA groups was 185 and 290 min respectively. Length of stay (LOS) was shorter in the Harmonic Scalpel group at 6 days compared to 7 days in the CUSA group (p < 0.05). Perioperative complications were documented in 20% and 26% in the Harmonic Scalpel and CUSA groups, respectively.
CONCLUSIONS
Our results show the Harmonic Scalpel with TissueLink to be a safe, effective method of parenchymal division with significantly less EBL and LOS when compared to CUSA with TissueLink.
背景
本研究旨在评估两种设备组合在非肝硬化患者和无入流血管闭塞的情况下用于肝切除实质分割的安全性和有效性。
方法
我们回顾性分析了 2004 年至 2010 年间在我院接受肝切除术的 47 例患者，分别使用 TissueLink 与 Cavitron Ultrasonic Surgical Aspirator（CUSA）或 Harmonic Scalpel 联合使用。在 27 例患者中使用 TissueLink 与 CUSA，在 20 例患者中使用 TissueLink 与 Harmonic Scalpel。
结果
Harmonic Scalpel 组和 CUSA 组的中位估计出血量（EBL）分别为 250 和 1035 mL（p < 0.05）。Harmonic Scalpel 组有 3 例患者在围手术期输注库存血，CUSA 组有 11 例患者（p < 0.05）。Harmonic Scalpel 组和 CUSA 组的中位手术时间分别为 185 和 290 min。Harmonic Scalpel 组的住院时间（LOS）为 6 天，明显短于 CUSA 组的 7 天（p < 0.05）。Harmonic Scalpel 组和 CUSA 组分别有 20%和 26%的患者发生围手术期并发症。
结论
与 TissueLink 与 CUSA 相比，我们的结果表明，Harmonic Scalpel 与 TissueLink 联合使用是一种安全、有效的实质分割方法，可显著减少 EBL 和 LOS。
Zotero 插件