超声手术与电外科系统（USES）联合传统超声刀（CUS）在胃癌根治术中的应用：一项回顾性队列研究。
Ultrasonic surgical and electrosurgical system (USES) with conventional ultrasonic scalpel (CUS) in gastrectomy: a retrospective cohort study.
作者信息
Jing Changqing, Chen Yuezhi, Shang Liang, Wang Jinshen, Lian Guodong, Tian Feng, Shao Yixue, Zhao Yingnan, Xuan Jianwei, Li Leping
机构信息
Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
出版信息
Cost Eff Resour Alloc. 2022 May 7;20(1):21. doi: 10.1186/s12962-022-00344-5.
BACKGROUND
Harmonic ACE +7 Shears with Advanced Hemostasis is an upgraded ultrasonic device, an ultrasonic surgical and electrosurgical system (USES). The study aimed to evaluate the economic and clinical effectiveness of the USES compared with the conventional ultrasonic scalpel (CUS) in gastrectomy.
METHODS
We conducted a single-center, retrospective cohort study using the electronic medical records in China. We collected intraoperative and postoperative data from gastric cancer patients who underwent the endoscope-assisted distal gastrectomy from 2018 to June 30, 2019. Procedure-related costs were estimated. We used linear regression by controlling a set of covariates to assess the effect of USES on outcomes.
RESULT
Out of 87 eligible patients, the USES group (40 patients) and CUS group (47 patients) were comparable in terms of age, medical history and stages of cancer. Compared with the CUS, the USES saved 4.27 hemoclips per person (95% CI 0.57-7.97, p < 0.05) and 34.18 ml intraoperative blood per person (95% CI 8.74-59.62 ml, p < 0.05), respectively. Postoperative length of stay (LOS) was shorter in the USES group (7.90 ± 1.95 vs. 9.26 ± 2.81 days) but the difference was not statistically significant (p = 0.05).
CONCLUSIONS
The USES group was associated with fewer hemoclips use and intraoperative blood loss in patients undergoing laparoscopic gastrectomy at comparable costs.
背景
具备先进止血功能的谐波ACE +7剪是一种升级的超声设备，即超声外科和电外科系统（USES）。本研究旨在评估USES与传统超声刀（CUS）在胃癌切除术中的经济和临床效果。
方法
我们利用中国的电子病历进行了一项单中心回顾性队列研究。我们收集了2018年至2019年6月30日接受内镜辅助远端胃癌切除术的胃癌患者的术中和术后数据。估算了与手术相关的费用。我们通过控制一组协变量使用线性回归来评估USES对结局的影响。
结果
在87例符合条件的患者中，USES组（40例患者）和CUS组（47例患者）在年龄、病史和癌症分期方面具有可比性。与CUS相比，USES每人节省4.27个血管夹（95%置信区间0.57 - 7.97，p < 0.05），每人术中出血量减少34.18毫升（95%置信区间8.74 - 59.62毫升，p < 0.05）。USES组术后住院时间较短（7.90 ± 1.95天对9.26 ± 2.81天），但差异无统计学意义（p = 0.05）。
结论
在成本相当的情况下，USES组在接受腹腔镜胃癌切除术的患者中使用血管夹较少，术中失血也较少。
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