Appéré François, Piardi Tullio, Memeo Ricardo, Lardière-Deguelte Sophie, Chetboun Mikael, Sommacale Daniele, Pessaux Patrick, Kianmanesh Reza
1 Robert-Debré University Hospital, University of Reims Champagne-Ardenne, Reims, France.
2 University of Strasbourg, Strasbourg, France.
Surg Innov. 2017 Oct;24(5):499-508. doi: 10.1177/1553350617723269. Epub 2017 Aug 11.
Several devices are available for liver parenchyma transection (LPT). The aim of this study was to compare the Ultracision Harmonic scalpel (UHS) with the Cavitron Ultrasonic Surgical Aspirator (CUSA) among patients who underwent hemi-right hepatectomies (RH) to homogenize transection areas.
From September 2012 to June 2015, 24 patients who underwent the UHS surgery approach were matched with 24 patients who underwent the CUSA transection procedure for RH using propensity score matching.
Total operative time (TOT) was shorter in the UHS group, 240 minutes (range 172.5-298.8) versus 330 minutes (range 270-400) in the CUSA group ( P = .0002). The occurrence of hepatopathy (odds ratio = 17; 95% confidence interval = 1.02-230) and the use of the CUSA device (odds ratio = 8; 95% confidence interval = 0.98-77) were associated with a TOT exceeding 300 minutes in multivariate analysis ( P = .05).
The UHS is a safe and effective method of LPT as compared to the use of the CUSA system. TOT is statistically decreased.
有多种设备可用于肝实质横断术(LPT)。本研究的目的是在接受右半肝切除术(RH)的患者中比较超声刀(UHS)和超声外科吸引器(CUSA),以使横断区域均匀化。
2012年9月至2015年6月,采用倾向评分匹配法,将24例行UHS手术的患者与24例行CUSA横断术的RH患者进行匹配。
UHS组的总手术时间(TOT)较短,为240分钟(范围172.5 - 298.8),而CUSA组为330分钟(范围270 - 400)(P = .0002)。在多变量分析中,肝病的发生(比值比 = 17;95%置信区间 = 1.02 - 230)和CUSA设备的使用(比值比 = 8;95%置信区间 = 0.98 - 77)与TOT超过300分钟相关(P = .05)。
与使用CUSA系统相比,UHS是一种安全有效的LPT方法。TOT在统计学上有所降低。