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腹腔镜子宫颈上子宫切除术(LSH)中使用单极SupraLoop™电极与单极针进行子宫颈分离:一项介入性比较队列研究

Cervical Detachment Using Monopolar SupraLoop™ Electrode versus Monopolar Needle in Laparoscopic Supracervical Hysterectomy (LSH): An Interventional, Comparative Cohort Study.

作者信息

Brucker S, Rothmund R, Krämer B, Neis F, Schönfisch B, Zubke W, Taran F A, Wallwiener M

机构信息

Women's Clinic, University Tübingen, Tübingen.

Women's Clinic Heidelberg, University Heidelberg, Heidelberg.

出版信息

Geburtshilfe Frauenheilkd. 2013 Nov;73(11):1121-1127. doi: 10.1055/s-0033-1350975.

Abstract

Currently available monopolar loop electrodes are difficult to handle in laparoscopic supracervical hysterectomy (LSH) and are entirely disposable devices, generating additional operating costs. The aim of this interventional study was the comparison of the efficiency and safety of cervical detachment with a newly developed monopolar loop electrode (SupraLoop™) with a conventional method of cervical detachment in LSH. Our study sample included 1598 patients; 1070 patients that underwent LSH with cervical detachment using the monopolar SupraLoop™ (study group) and 528 patients that underwent LSH with cervical detachment using the monopolar needle (control group). We also assessed cervical detachment time and total device application and cutting time in a subgroup of 49 patients (23 patients from the study group and 26 patients from the control group). Total operation time for LSH was significantly shorter among SupraLoop™ patients (93 ± 41 minutes) when compared to patients in whom cervical detachment was performed with the needle (105 ± 44 minutes) (p < 0.001). Cervical detachment time and total device application including cutting time was significantly shorter for the SupraLoop™ group (SupraLoop vs. needle; 0.12 ± 0.21 min vs. 5.1 ± 4.4 min [p < 0.001]; 2.3 ± 1.8 min vs. 5.4 ± 2.4 min [p < 0.001]). There were no major or minor complications directly related to the use of the SupraLoop™ device, whereas two intraoperative complications were directly related to the application of the monopolar needle. The newly developed monopolar loop electrode (SupraLoop™) is both an effective and safe instrument for cervical detachment in laparoscopic supracervical hysterectomy, and performed better than the needle, offering a significantly shorter operating time and less complications for the hysterectomy compared to the conventional method.

摘要

目前可用的单极环形电极在腹腔镜子宫颈上子宫切除术(LSH)中难以操作,并且是完全一次性使用的设备,会产生额外的手术成本。这项干预性研究的目的是比较一种新开发的单极环形电极(SupraLoop™)与LSH中传统的子宫颈分离方法在子宫颈分离方面的效率和安全性。我们的研究样本包括1598名患者;1070名使用单极SupraLoop™进行子宫颈分离的LSH患者(研究组)和528名使用单极针进行子宫颈分离的LSH患者(对照组)。我们还在49名患者的亚组中评估了子宫颈分离时间以及总的设备应用和切割时间(研究组23名患者,对照组26名患者)。与使用针进行子宫颈分离的患者相比,SupraLoop™患者的LSH总手术时间显著更短(93±41分钟对105±44分钟)(p<0.001)。SupraLoop™组的子宫颈分离时间以及包括切割时间在内的总的设备应用时间显著更短(SupraLoop与针;0.12±0.21分钟对5.1±4.4分钟[p<0.001];2.3±1.8分钟对5.4±2.4分钟[p<0.001])。没有与SupraLoop™设备使用直接相关的重大或轻微并发症,而有两例术中并发症与单极针的应用直接相关。新开发的单极环形电极(SupraLoop™)是腹腔镜子宫颈上子宫切除术中子宫颈分离的一种有效且安全的器械,并且比针表现更好,与传统方法相比,子宫切除术的手术时间显著更短且并发症更少。

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