Department of Surgery, University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Japan.
Surg Laparosc Endosc Percutan Tech. 2021 Mar 12;31(4):497-501. doi: 10.1097/SLE.0000000000000923.
The aim of this study was to investigate advantages of the left-handed ultrasonic shears technique in robotic gastrectomy for gastric cancer.
We retrospectively analyzed 67 consecutive gastric cancer patients who underwent robotic gastrectomy. Fifty-six patients underwent gastrectomy with the left-handed ultrasonic shears technique (the left hand group), and 11 patients underwent surgery with the conventional approach (the conventional group). Intraoperative and postoperative outcomes were compared between the 2 groups.
Operative blood loss, morbidity, and mortality were similar between the 2 groups. We observed a trend toward a shorter operation time and higher number of retrieved lymph nodes in the left hand group compared with the conventional group. Console time (docking-gastrectomy) in the left hand group was significantly shorter than in the conventional group (192.20 vs. 218.36 min, P<0.05). In robotic distal gastrectomy, both operation time and console time in the left hand group were significantly shorter than in the conventional group (276.10 vs. 354.80 min, 176.43 vs. 209.20 min, P<0.05 for both). The postoperative intra-abdominal infectious complication (Clavien Dindo≥1) rate in the left hand group was significantly lower than that in the conventional group (0% vs. 20%, P<0.05).
Use of the left-handed ultrasonic shears technique is safe and provides a technically superior operative environment with satisfactory postoperative results.
本研究旨在探讨左手超声刀技术在胃癌机器人胃切除术中的优势。
我们回顾性分析了 67 例连续接受机器人胃切除术的胃癌患者。56 例患者接受了左手超声刀技术的胃切除术（左手组），11 例患者接受了常规手术（常规组）。比较两组患者的术中及术后结果。
两组患者的手术出血量、发病率和死亡率相似。与常规组相比，左手组的手术时间更短，淋巴结检出数更多，但差异无统计学意义。左手组控制台时间（对接-胃切除术）明显短于常规组（192.20 比 218.36 分钟，P<0.05）。在机器人远端胃切除术中，左手组的手术时间和控制台时间均明显短于常规组（276.10 比 354.80 分钟，176.43 比 209.20 分钟，均 P<0.05）。左手组术后腹腔内感染并发症（Clavien Dindo≥1）发生率明显低于常规组（0%比 20%，P<0.05）。
左手超声刀技术安全可靠，可为术者提供更优越的手术操作环境，并获得满意的术后效果。
