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Safety and efficacy of new integrated bipolar and ultrasonic scissors compared to conventional laparoscopic 5-mm sealing and cutting instruments.新型集成双极和超声剪刀与传统腹腔镜 5mm 密封切割器械的安全性和有效性比较。
Surg Endosc. 2012 Sep;26(9):2541-9. doi: 10.1007/s00464-012-2229-0. Epub 2012 Mar 24.
2
Dissection versus diathermy for tonsillectomy.扁桃体切除术的剥离法与透热法
Cochrane Database Syst Rev. 2011 Mar 16;2011(3):CD002211. doi: 10.1002/14651858.CD002211.pub2.
3
A randomized controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy.一项比较腹腔镜子宫肌瘤剔除术中超声刀与电外科手术的随机对照研究。
Fertil Steril. 2010 Oct;94(5):1882-6. doi: 10.1016/j.fertnstert.2009.08.049. Epub 2009 Oct 12.
4
[Harmonic scalpel tonsillectomy--personal experience and review of literature].[谐波手术刀扁桃体切除术——个人经验及文献综述]
Otolaryngol Pol. 2008;62(5):561-6. doi: 10.1016/S0030-6657(08)70315-9.
5
Clipless laparoscopic cholecystectomy by ultrasonic dissection.超声刀辅助无钛夹法腹腔镜胆囊切除术
J Laparoendosc Adv Surg Tech A. 2008 Aug;18(4):593-8. doi: 10.1089/lap.2007.0227.
6
Harmonic Scalpel hemorrhoidectomy: a painless procedure?谐波手术刀痔切除术:一种无痛手术?
Med Pregl. 2007 Sep-Oct;60(9-10):421-6. doi: 10.2298/mpns0710421i.
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Harmonic scalpel tonsillectomy using the curved shears instrument versus cold dissection tonsillectomy: a retrospective study.使用弯剪器械的谐波手术刀扁桃体切除术与冷剥离扁桃体切除术的回顾性研究
Ann Otol Rhinol Laryngol. 2008 Jan;117(1):46-50. doi: 10.1177/000348940811700110.
8
Coblation versus other surgical techniques for tonsillectomy.用于扁桃体切除术的低温等离子消融术与其他手术技术的比较
Cochrane Database Syst Rev. 2007 Jul 18(3):CD004619. doi: 10.1002/14651858.CD004619.pub2.
9
Key messages from the National Prospective Tonsillectomy Audit.国家前瞻性扁桃体切除术审计的关键信息。
Laryngoscope. 2007 Apr;117(4):717-24. doi: 10.1097/mlg.0b013e318031f0b0.
10
Postoperative pain following coblation tonsillectomy: randomized clinical trial.低温等离子体扁桃体切除术后的疼痛:随机临床试验
ANZ J Surg. 2006 Apr;76(4):226-9. doi: 10.1111/j.1445-2197.2006.03700.x.

谐波手术刀与低温等离子体扁桃体切除术的对比研究

Harmonic Scalpel Versus Coblation Tonsillectomy A Comparative Study.

作者信息

Basu Soumik, Sengupta Anindita, Dubey Arya Brata, Sengupta Arunabha

机构信息

Department of Ent Head Neck Surgery, Institute of Postgraduate Medical Education Research, 244 AJC Bose Road, Kolkata, 700020 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Dec;71(4):498-503. doi: 10.1007/s12070-019-01679-x. Epub 2019 Jun 18.

DOI:10.1007/s12070-019-01679-x
PMID:31750110
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6838272/
Abstract

Tonsillectomy is an age old procedure in ENT practice. Though traditional dissection method is gold standard, we surgeons are trying different techniques like electrocautery, coblation, harmonic scalpel (HS) mainly to improve surgical convenience, to decrease operative time, post operative pain, intra and post operative bleeding and fast return to normal life. In this particular study we are comparing coblation and HS as surgical tool in tonsillectomy. It is a prospective double-blind randomized controlled trial where information was compared between two groups of coblation and HS tonsillectomy. A total number of 128 patients were compared over operation time, intra-operative blood loss, postoperative pain, time needed to regain the normal diet and activity and postoperative haemorrhage. We found statistically significant differences in operation time ( < 0.001) and intra operative blood loss ( < 0.001). Secondary haemorrhage rate was far better in HS (1.5%) group compared to coblation (7.8%). Whereas postoperative pain, time needed to go back to the normal diet and activity were better in HS group but the difference is not significant. This study revealed a significantly less operative time and intra-operative and post operative blood loss in harmonic scalpel tonsillectomy in comparison with coblation method. These findings addressed HS tonsillectomy as an advanced method.

摘要

扁桃体切除术是耳鼻喉科临床中一项由来已久的手术。尽管传统的剥离法是金标准,但我们外科医生正在尝试不同的技术,如电灼、低温等离子消融、超声刀(HS),主要是为了提高手术便利性、缩短手术时间、减轻术后疼痛、减少术中及术后出血,并能更快恢复正常生活。在这项具体研究中,我们比较了低温等离子消融和超声刀作为扁桃体切除术中的手术工具。这是一项前瞻性双盲随机对照试验,比较了低温等离子消融扁桃体切除术和超声刀扁桃体切除术两组之间的信息。总共128例患者在手术时间、术中失血、术后疼痛、恢复正常饮食和活动所需时间以及术后出血等方面进行了比较。我们发现手术时间(<0.001)和术中失血(<0.001)存在统计学上的显著差异。超声刀组(1.5%)的继发性出血率远低于低温等离子消融组(7.8%)。虽然超声刀组术后疼痛、恢复正常饮食和活动所需时间更好,但差异不显著。这项研究表明,与低温等离子消融法相比,超声刀扁桃体切除术的手术时间、术中及术后失血明显更少。这些发现表明超声刀扁桃体切除术是一种先进的方法。