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三种阑尾切除术的残端压力评估:超声刀、血管闭合系统和传统技术

Evaluation of Stump Pressure in Three Types of Appendectomy: Harmonic Scalpel, LigaSure, and Conventional Technique.

作者信息

Yavuz Alper, Bulus Hakan, Taş Adnan, Aydın Altan

机构信息

1 Department of General Surgery, Kecioren Training and Research Hospital , Ankara, Turkey .

2 Department of General Surgery, Mustafa Kemal University , Hatay, Turkey .

出版信息

J Laparoendosc Adv Surg Tech A. 2016 Dec;26(12):950-953. doi: 10.1089/lap.2015.0551. Epub 2016 Apr 27.

Abstract

INTRODUCTION AND OBJECTIVE

Appendectomy is one of the most common operations carried out by general surgeons. The recent introduction of the alternative energy-based devices in surgery and their use in the laparoscopic appendectomy shortened the duration of operations, but these devices are used generally for meso dissection. These devices did not receive wide acceptance among surgeons as there is not enough evidence confirming their use in appendicular lumen operations. Our objective in this study was to test the safety of three types of appendectomy.

MATERIALS AND METHODS

Twenty-four cases with right hemicolectomy or subtotal colectomy were enrolled into this study. The patients were distributed in three groups. After the colectomy specimen was removed, in Group 1 conventional appendectomy (it was dissected with mesoappendiceal fixation and with electro cauterization) was performed in the operating room, the appendicular stump was ligated with a silk suture; in Group 2 appendectomy was performed with LigaSure™ and the stump was closed also with LigaSure; in Group 3 appendectomy was performed with Harmonic Scalpel™ and the stump was closed also with Harmonic Scalpel. Stump opening pressures were measured in all patients in the groups.

RESULTS

Three groups were compared in terms of age, gender, concomitant diseases, clinical diagnosis, previous operations, pathological findings, and applied maximum pressure levels. No statistical difference was detected among the groups.

CONCLUSION

Appendectomies carried out with LigaSure and Harmonic Scalpel are as safe as appendectomies carried out with the conventional methods.

摘要

引言与目的

阑尾切除术是普通外科医生实施的最常见手术之一。近年来手术中引入了基于替代能源的设备,且其在腹腔镜阑尾切除术中的应用缩短了手术时间,但这些设备一般用于系膜解剖。由于没有足够证据证实其在阑尾腔手术中的应用,这些设备未被外科医生广泛接受。本研究的目的是测试三种类型阑尾切除术的安全性。

材料与方法

本研究纳入了24例行右半结肠切除术或结肠次全切除术的病例。患者被分为三组。在切除结肠标本后,第1组在手术室进行传统阑尾切除术(通过阑尾系膜固定和电灼进行解剖),阑尾残端用丝线缝合结扎;第2组使用LigaSure™进行阑尾切除术,残端也用LigaSure封闭;第3组使用超声刀™进行阑尾切除术,残端也用超声刀封闭。测量了三组所有患者的残端开放压力。

结果

比较了三组患者的年龄、性别、伴随疾病、临床诊断、既往手术史、病理结果和施加的最大压力水平。各组之间未检测到统计学差异。

结论

使用LigaSure和超声刀进行的阑尾切除术与传统方法进行的阑尾切除术一样安全。

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