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在普通外科手术中使用能量设备:对围手术期结果的影响。

Use of energy device in general surgical operations: impact on peri-operative outcomes.

机构信息

Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria.

Department of Anaesthesia, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

出版信息

BMC Surg. 2022 Mar 9;22(1):90. doi: 10.1186/s12893-022-01540-z.

Abstract

BACKGROUND

The introduction of energy devices has significantly expanded the scope of surgical expedition. The LigaSure™ vessel sealing system is a bipolar electrosurgical device, recently introduced to our practice. Its impact on peri-operative outcomes in a variety of major operations was evaluated in this study.

METHODS

A retrospective review of operations performed following the adoption of the LigaSure™ vessel sealing device was carried out. Five categories of operations were evaluated (Thyroidectomies, Gastrectomies, Colectomies, Pancreaticoduodenectomies, and Anterior/Abdomino-perineal resection [A/APR of the rectum). Peri-operative outcomes (duration of operation, intra-operative blood loss, blood transfusion rates) were compared with a cohort of similar operations performed using conventional techniques. Data analysis and comparisons were done on a subgroup basis.

RESULTS

A total of 117 operations were performed using the LigaSure™ device with thyroidectomies being the most common (66/117-56.4%). Compared to cases done using conventional techniques of suture and knot with electrocautery (120 cases), the use of LigaSure™ was associated with a significant reduction in operation time in all categories of operations. Intraoperative blood loss was also lower in all categories of cases, but this was only statistically significant following A/APR and Thyroidectomies. Generally, there was a trend towards a reduction in blood transfusion rates.

CONCLUSIONS

The use of energy devices for surgical operations is feasible in a resource-limited setting. It has the potential of improving outcomes.

摘要

背景

能量设备的引入极大地扩展了手术范围。LigaSure™血管密封系统是一种双极电外科设备,最近引入我们的实践中。本研究评估了它在各种主要手术中对围手术期结果的影响。

方法

对采用 LigaSure™血管密封装置后的手术进行回顾性研究。评估了五类手术(甲状腺切除术、胃切除术、结肠切除术、胰十二指肠切除术和直肠前/腹会阴切除术[A/APR])。将围手术期结果(手术时间、术中失血量、输血率)与使用传统技术进行的类似手术队列进行比较。对亚组进行数据分析和比较。

结果

共有 117 例手术使用 LigaSure™装置进行,其中甲状腺切除术最为常见(66/117-56.4%)。与使用传统的缝合和结与电烙术(120 例)的病例相比,LigaSure™的使用在所有手术类别中均显著缩短了手术时间。所有类别的病例术中失血量也较低,但仅在 A/APR 和甲状腺切除术后具有统计学意义。通常,输血率呈下降趋势。

结论

在资源有限的情况下,能量设备用于手术操作是可行的。它有可能改善结果。

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