Velotti N, Manigrasso M, Di Lauro K, Vitiello A, Berardi G, Manzolillo D, Anoldo P, Bocchetti A, Milone F, Milone M, De Palma G D, Musella M
Department of Advanced Biomedical Sciences, "Federico II" University, Via Pansini 5, 80131 Naples, Italy.
J Obes. 2019 Jan 3;2019:3402137. doi: 10.1155/2019/3402137. eCollection 2019.
New laparoscopic devices, such as electrothermal bipolar-activated devices (LigaSure™ (LS)) or ultrasonic systems (Harmonic® scalpel (HS)), have been applied recently to bariatric surgery allowing to reduce blood loss and surgical risks. The aim of this study was to retrospectively compare intraoperative performance of HS and LS, postoperative results, and clinical outcomes in a large cohort of patients undergoing LSG.
Data from 422 morbidly obese patients undergoing LSG in our Bariatric Unit at the Advanced Biomedical Sciences Department of the "Federico II" University of Naples (Italy) between January 2009 and December 2017 were retrospectively analyzed. Subjects were divided into two groups (HS and LS), and operative time, intraoperative complications, and postoperative (within 30 days from surgery) complications were compared. Bleeding from the omentum or from the staple line, use of hemostatic clips, and absorbable hemostat were recorded as intraoperative complications; hemorrhages, abscess formation, gastric leaks, fever, and mortality were considered as postoperative complications.
Statistical analysis showed no difference in terms of baseline demographics between the two cohorts. Operative time (48 ± 9 vs 49 ± 6 min, =0.646) and the rates of intraoperative and postoperative complications did not significantly differ between groups.
Harmonic® and LigaSure™ are both useful tools in bariatric surgery, and these two advanced power devices are user-friendly and can facilitate surgeon work; from this point of view, the choice of the energy device should be based on the preference of the surgeon and on the hospital costs policy and availability.
新型腹腔镜设备，如电热双极激活设备（LigaSure™（LS））或超声系统（Harmonic® 超声刀（HS）），最近已应用于减肥手术，可减少失血和手术风险。本研究的目的是回顾性比较HS和LS在大量接受腹腔镜袖状胃切除术（LSG）患者中的术中表现、术后结果和临床结局。
回顾性分析2009年1月至2017年12月在意大利那不勒斯“费德里科二世”大学高级生物医学科学系减肥科接受LSG的422例病态肥胖患者的数据。将受试者分为两组（HS和LS），比较手术时间、术中并发症和术后（术后30天内）并发症。记录网膜或吻合钉线出血、止血夹的使用和可吸收止血剂作为术中并发症；出血、脓肿形成、胃漏、发热和死亡率被视为术后并发症。
统计分析显示两组之间的基线人口统计学无差异。手术时间（48±9 vs 49±6分钟，=0.646）以及术中及术后并发症发生率在两组之间无显著差异。
Harmonic®和LigaSure™都是减肥手术中的有用工具，这两种先进的能量设备使用方便，可方便外科医生操作；从这个角度来看，能量设备的选择应基于外科医生的偏好以及医院的成本政策和可用性。
