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Erschienen in: Surgery Today 5/2016

22.07.2015 | Original Article

A randomized phase II study of the clinical effects of ultrasonically activated coagulating shears (Harmonic scalpel) in open gastrectomy for gastric cancer

verfasst von: Ryohei Kawabata, Shuji Takiguchi, Yutaka Kimura, Hiroshi Imamura, Junya Fujita, Shigeyuki Tamura, Kazumasa Fujitani, Kentaro Kishi, Kazuyoshi Yamamoto, Shinichi Fujiwara, Yukinori Kurokawa, Masaki Mori, Yuichiro Doki

Erschienen in: Surgery Today | Ausgabe 5/2016

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Abstract

Purpose

The Harmonic Ace ultrasonic scalpel has been popular in abdominal surgery; however, only a few clinical studies have evaluated the efficacy of this device in radical open gastrectomy for gastric cancer.

Methods

The present study was designed as a multicenter, prospective, randomized, controlled trial. Patients with resectable gastric cancer were randomly assigned to gastrectomy using the Harmonic scalpel or conventional monopolar electrosurgery.

Results

A total of 248 patients were enrolled, and 123 patients were included in the Harmonic group and 114 patients were included in the conventional group. The demographics of the patients were well balanced between the groups. There was no significant difference in the length of the operation from skin incision to resection of the gastric specimen (141 ± 36 min in the Harmonic group vs. 147 ± 13 min in the conventional group; p = 0.276) nor in the amount of blood lost (365 ± 293 vs. 336 ± 272 mL; p = 0.434). There was also no significant difference in the incidence of surgical complications or the post-surgical hospital stay between the groups.

Conclusion

The Harmonic scalpel procedure was not superior to the conventional monopolar electrosurgery with regard to reducing the length of the operation, blood loss, postoperative complications, or postoperative hospital stay in radical open gastrectomy.
Literatur
1.
Zurück zum Zitat Long N, Moore MA, Chen W, Gao CM, Lai MS, Mizoue T, et al. Cancer epidemiology and control in north-East Asia-past, present and future. Asian Pac J Cancer Prev. 2010;11:107–48.PubMed Long N, Moore MA, Chen W, Gao CM, Lai MS, Mizoue T, et al. Cancer epidemiology and control in north-East Asia-past, present and future. Asian Pac J Cancer Prev. 2010;11:107–48.PubMed
2.
Zurück zum Zitat Maruyama K, Okabayashi K, Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg. 1987;11:418–25.CrossRefPubMed Maruyama K, Okabayashi K, Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg. 1987;11:418–25.CrossRefPubMed
3.
Zurück zum Zitat Amaral JF. Ultrasonic dissection. Surg Allied Tech. 1994;2:181–5. Amaral JF. Ultrasonic dissection. Surg Allied Tech. 1994;2:181–5.
4.
Zurück zum Zitat Foschi D, Cellerino P, Corsi F, Taidelli T, Morandi E, Rizzi A, et al. The mechanisms of blood vessel closure in humans by the application of ultrasonic energy. Surg Endosc. 2002;16:814–9.CrossRefPubMed Foschi D, Cellerino P, Corsi F, Taidelli T, Morandi E, Rizzi A, et al. The mechanisms of blood vessel closure in humans by the application of ultrasonic energy. Surg Endosc. 2002;16:814–9.CrossRefPubMed
5.
Zurück zum Zitat Holub Z, Jabor A, Kliment L, Lukac J, Voracek J. Laparoscopic lymph node dissection using ultrasonically activated shears: comparison with electrosurgery. J Laparoendosc Adv Surg Tech A. 2002;12:175–80.CrossRefPubMed Holub Z, Jabor A, Kliment L, Lukac J, Voracek J. Laparoscopic lymph node dissection using ultrasonically activated shears: comparison with electrosurgery. J Laparoendosc Adv Surg Tech A. 2002;12:175–80.CrossRefPubMed
6.
Zurück zum Zitat Voutilainen PE, Haapiainen RK, Haglund CH. Ultrasonically activated shears in thyroid surgery. Am J Surg. 1998;175:491–3.CrossRefPubMed Voutilainen PE, Haapiainen RK, Haglund CH. Ultrasonically activated shears in thyroid surgery. Am J Surg. 1998;175:491–3.CrossRefPubMed
7.
Zurück zum Zitat Fitz-Gerald AL, Tan J, Chan KW, Polyakov A, Edwards GN, Najjar H, et al. Comparison of ultrasonic shears and traditional suture ligature for vaginal hysterectomy: randomized controlled trial. J Minim Invasive Gynecol. 2013;20:853–7.CrossRefPubMed Fitz-Gerald AL, Tan J, Chan KW, Polyakov A, Edwards GN, Najjar H, et al. Comparison of ultrasonic shears and traditional suture ligature for vaginal hysterectomy: randomized controlled trial. J Minim Invasive Gynecol. 2013;20:853–7.CrossRefPubMed
8.
Zurück zum Zitat Iovino F, Auriemma PP, Ferraraccio F, Antoniol G, Barbarisi A. Preventing seroma formation after axillary dissection for breast cancer: a randomized clinical trial. Am J Surg. 2012;203:708–14.CrossRefPubMed Iovino F, Auriemma PP, Ferraraccio F, Antoniol G, Barbarisi A. Preventing seroma formation after axillary dissection for breast cancer: a randomized clinical trial. Am J Surg. 2012;203:708–14.CrossRefPubMed
9.
Zurück zum Zitat Khan S, Khan S, Chawla T, Murtaza G. Harmonic scalpel versus electrocautery dissection in modified radical mastectomy: a randomized controlled trial. Ann Surg Oncol. 2014;21:808–14.CrossRefPubMed Khan S, Khan S, Chawla T, Murtaza G. Harmonic scalpel versus electrocautery dissection in modified radical mastectomy: a randomized controlled trial. Ann Surg Oncol. 2014;21:808–14.CrossRefPubMed
11.
Zurück zum Zitat Association Japanese Gastric Cancer. Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRef Association Japanese Gastric Cancer. Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRef
12.
Zurück zum Zitat Japanese Gastric Cancer Society. Guidelines for Diagnosis and treatment of carcinoma of the stomach April. 2004th ed. Tokyo: Kanehara; 2004. Japanese Gastric Cancer Society. Guidelines for Diagnosis and treatment of carcinoma of the stomach April. 2004th ed. Tokyo: Kanehara; 2004.
13.
Zurück zum Zitat Sano T, Sasako M, Yamamoto S, Nashimoto A, Kurita A, Hiratsuka M, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy—Japan Clinical Oncology Group study 9501. J Clin Oncol. 2004;22:2767–73.CrossRefPubMed Sano T, Sasako M, Yamamoto S, Nashimoto A, Kurita A, Hiratsuka M, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy—Japan Clinical Oncology Group study 9501. J Clin Oncol. 2004;22:2767–73.CrossRefPubMed
14.
Zurück zum Zitat Fujita J, Takiguchi S, Nishikawa K, Kimura Y, Imamura H, Tamura S, et al. Randomized controlled trial of the LigaSure vessel sealing system versus conventional open gastrectomy for gastric cancer. Surg Today. 2014;44:1723–9.CrossRefPubMed Fujita J, Takiguchi S, Nishikawa K, Kimura Y, Imamura H, Tamura S, et al. Randomized controlled trial of the LigaSure vessel sealing system versus conventional open gastrectomy for gastric cancer. Surg Today. 2014;44:1723–9.CrossRefPubMed
15.
Zurück zum Zitat Takiguchi N, Nagata M, Soda H, Nomura Y, Takayama W, Yasutomi J, et al. Multicenter randomized comparison of LigaSure versus conventional surgery for gastrointestinal carcinoma. Surg Today. 2010;40:1050–4.CrossRefPubMed Takiguchi N, Nagata M, Soda H, Nomura Y, Takayama W, Yasutomi J, et al. Multicenter randomized comparison of LigaSure versus conventional surgery for gastrointestinal carcinoma. Surg Today. 2010;40:1050–4.CrossRefPubMed
16.
Zurück zum Zitat Tsimoyiannis EC, Jabarin M, Tsimoyiannis JC, Betzios JP, Tsilikatis C, Glantzounis G. Ultrasonically activated shears in extended lymphadenectomy for gastric cancer. World J Surg. 2002;26:158–61.CrossRefPubMed Tsimoyiannis EC, Jabarin M, Tsimoyiannis JC, Betzios JP, Tsilikatis C, Glantzounis G. Ultrasonically activated shears in extended lymphadenectomy for gastric cancer. World J Surg. 2002;26:158–61.CrossRefPubMed
17.
Zurück zum Zitat Inoue K, Nakane Y, Michiura T, Yamada M, Mukaide H, Fukui J, et al. Ultrasonic scalpel for gastric cancer surgery: a prospective randomized study. J Gastrointest Surg. 2012;16:1840–6.CrossRefPubMed Inoue K, Nakane Y, Michiura T, Yamada M, Mukaide H, Fukui J, et al. Ultrasonic scalpel for gastric cancer surgery: a prospective randomized study. J Gastrointest Surg. 2012;16:1840–6.CrossRefPubMed
18.
Zurück zum Zitat Dechartres A, Boutron I, Trinquart L, Charles P, Ravaud P. Single-center trials show larger treatment effects than multicenter trials: evidence from a meta-epidemiologic study. Ann Intern Med. 2011;155:39–51.CrossRefPubMed Dechartres A, Boutron I, Trinquart L, Charles P, Ravaud P. Single-center trials show larger treatment effects than multicenter trials: evidence from a meta-epidemiologic study. Ann Intern Med. 2011;155:39–51.CrossRefPubMed
19.
Zurück zum Zitat MacDonald JD, Bowers CA, Chin SS, Burns G. Comparison of the effects of surgical dissection devices on the rabbit liver. Surg Today. 2014;44:1116–22.CrossRefPubMed MacDonald JD, Bowers CA, Chin SS, Burns G. Comparison of the effects of surgical dissection devices on the rabbit liver. Surg Today. 2014;44:1116–22.CrossRefPubMed
Metadaten
Titel
A randomized phase II study of the clinical effects of ultrasonically activated coagulating shears (Harmonic scalpel) in open gastrectomy for gastric cancer
verfasst von
Ryohei Kawabata
Shuji Takiguchi
Yutaka Kimura
Hiroshi Imamura
Junya Fujita
Shigeyuki Tamura
Kazumasa Fujitani
Kentaro Kishi
Kazuyoshi Yamamoto
Shinichi Fujiwara
Yukinori Kurokawa
Masaki Mori
Yuichiro Doki
Publikationsdatum
22.07.2015
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 5/2016
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1213-4

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