Tsolakidis Dimitrios, Chatzistamatiou Kimon, Markopoulou Efthalia, Zouzoulas Dimitrios, Theodoulidis Vasilis, Tzitzis Panagiotis, Sofianou Iliana, Kissoudi Kalliopi, Topalidou Maria, Timotheadou Eleni, Grimbizis Grigorios
1st Department of Obstetrics and Gynaecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece.
Department of Radiation Oncology, Papageorgiou General Hospital, 56403 Thessaloniki, Greece.
J Clin Med. 2025 Sep 5;14(17):6293. doi: 10.3390/jcm14176293.
: Cytoreductive surgery for women with advanced ovarian cancer is a demanding process with high morbidity. The present analysis aims to identify whether using the Ligasure Maryland jaw open sealer/divider (LMJsd) with a nanocoating (Covidien, Medtronic, 710 Medtronic Parkway, Minneapolis, MN, USA), could lead to better outcomes during cytoreduction surgery by reducing intraoperative bleeding and other hospitalization-related parameters. : Patients with ovarian cancer (FIGO III/IV) who were subjected to primary or interval cytoreductive surgery at the Gynecologic-Oncology Unit, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Thessaloniki, Greece, were included in the analysis. Patients were retrospectively allocated into two groups: women operated on with or without using the LMJsd. Differences between the two groups (intraoperative blood loss and blood transfusion, duration of surgery, postoperative blood transfusion, admission to intensive care unit (ICU), and overall hospital length of stay) were investigated. : From 2012 to 2020, 284 women with ovarian cancer were surgically treated; 208 were stage III/IV. In the LMJsd group of women (n = 34), the duration of surgery and blood loss during surgery were significantly decreased ( < 0.0005) compared to the non-LMJsd group (n = 174). The intraoperative blood transfusion rate and the number of packed red blood cell units transfused were significantly decreased in the first group ( = 0.0025); the postoperative blood transfusion rate was not different ( = 0.065). Moreover, ICU admission and overall hospital length of stay were significantly decreased in the LMJsd group ( < 0.0005 and = 0.015). : Using the LMJsd is associated with decreased intraoperative bleeding and transfusion rates, duration of surgery, admission to ICU, and overall hospital length of stay in women treated with surgical cytoreduction for advanced ovarian cancer. Some limitations of this study are as follows: its limited impact because it is an observational retrospective analysis and bias because the cumulative experience of the surgeons may have an impact on the surgical outcomes.
对于晚期卵巢癌女性患者而言,减瘤手术是一个要求严苛且并发症发生率高的过程。本分析旨在确定使用带有纳米涂层的马里兰颚式开放闭合器/分离器(LMJsd,美国美敦力公司,地址:美国明尼苏达州明尼阿波利斯市美敦力大道710号),是否能通过减少术中出血及其他与住院相关的参数,在减瘤手术中带来更好的结果。
纳入分析的患者为在希腊塞萨洛尼基帕帕佐格鲁综合医院第一妇产科妇科肿瘤科接受初次或间隔减瘤手术的卵巢癌(国际妇产科联盟(FIGO)III/IV期)患者。患者被回顾性地分为两组:使用或未使用LMJsd进行手术的女性。研究了两组之间的差异(术中失血量和输血情况、手术时长、术后输血情况、入住重症监护病房(ICU)情况以及总体住院时长)。
2012年至2020年期间,284例卵巢癌女性接受了手术治疗;其中208例为III/IV期。与未使用LMJsd的组(n = 174)相比,使用LMJsd的女性组(n = 34)手术时长和术中失血量显著减少(P < 0.0005)。第一组术中输血率和输注的红细胞悬液单位数量显著减少(P = 0.0025);术后输血率无差异(P = 0.065)。此外,使用LMJsd的组入住ICU情况和总体住院时长显著减少(P < 0.0005和P = 0.015)。
对于接受晚期卵巢癌手术减瘤治疗的女性,使用LMJsd与术中出血和输血率降低、手术时长缩短、入住ICU情况减少以及总体住院时长缩短相关。本研究存在一些局限性:由于是观察性回顾分析,其影响力有限;且由于外科医生的累积经验可能会对手术结果产生影响,存在偏差。