Yamada Nobuya, Amano Ryosuke, Kimura Kenjiro, Murata Akihiro, Yashiro Masakazu, Tanaka Sayaka, Wakasa Kenichi, Hirakawa Kosei
Hepatogastroenterology. 2015 Mar-Apr;62(138):389-92.
BACKGROUND/AIMS: A soft-coagulation system (SCS) was introduced as an effective device to reduce blood loss in hepatectomy. Here we evaluated the efficacy of a two-surgeon technique using precoagulation by an SCS and the Cavitron Ultrasonic Surgical Aspirator (CUSA) for liver transection.
The 163 patients with liver tumors were divided into two groups (conventional group and two-surgeon group). Liver transection was conducted using saline-coupled bipolar electrocautery and CUSA in 102 patients (conventional group). In 61 patients (the two-surgeon group), a two-surgeon technique using precoagulation by an SCS and CUSA for liver resection was performed.
The median blood loss was significantly less in the two-surgeon group compared to the conventional group (354.8 mL vs. 557.8 mL, respec tively: p = 0.0011). The postoperative hospital stay was significantly shorter in the two-surgeon group compared to the conventional group (12.7 days vs. 15.5 days, p = 0.0035).
The two-surgeon technique using precoagulation by an SCS and CUSA was significantly reduced blood loss during liver transection, and associated with low morbidity and mortality. This technique may be useful for many hepatobiliary surgeons.
背景/目的：引入一种软凝固系统（SCS）作为减少肝切除术失血的有效设备。在此，我们评估了一种双术者技术的疗效，该技术使用SCS预凝固和超声外科吸引器（CUSA）进行肝实质离断。
163例肝肿瘤患者分为两组（传统组和双术者组）。102例患者（传统组）使用生理盐水耦合双极电凝和CUSA进行肝实质离断。61例患者（双术者组）采用双术者技术，使用SCS预凝固和CUSA进行肝切除。
双术者组的术中失血量中位数显著低于传统组（分别为354.8 mL和557.8 mL：p = 0.0011）。双术者组的术后住院时间显著短于传统组（12.7天对15.5天，p = 0.0035）。
使用SCS预凝固和CUSA的双术者技术在肝实质离断期间显著减少了失血量，且发病率和死亡率较低。该技术可能对许多肝胆外科医生有用。
