Seung-Young Oh1, Boram Choi2, Kyung-Goo Lee1, Hwi-Nyeong Choe3, Hye-Joo Lee3, Yun-Suhk Suh1, Seong-Ho Kong1, Hyuk-Joon Lee1,2, Woo Ho Kim2,4, Han-Kwang Yang5,6. 1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. 2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. 3. Department of Nursing, Seoul National University Hospital, Seoul, Korea. 4. Department of Pathology, Seoul National University College of Medicine, Seoul, Korea. 5. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. hkyang@snu.ac.kr. 6. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. hkyang@snu.ac.kr.
Abstract
BACKGROUND: Previous studies regarding ultrasonically activated shears (UAS) were performed without controlled surgical procedures or consideration of potential thermal injury due to high temperature of active blade of UAS. The purpose of this study was to evaluate the efficacy and safety of UAS through a comparison with conventional monopolar electrocautery (CME) in open distal gastrectomy for gastric cancer. METHODS:From October 2011 to November 2012, 56 gastric cancer patients eligible for open distal gastrectomy were randomized into UAS or CME groups. Primary endpoints were estimated blood loss (EBL) during surgery and amount of drainage through the fifth postoperative day. Secondary endpoints were operation time, length of hospital stay, postoperative morbidity, changes in cytokine levels in serum, peritoneal irrigation saline, and peritoneal drainage, and inflammatory markers of serum. (Registration-number of ClinicalTrials.gov: NCT01971775). RESULTS:EBL was lower in the UAS group than that in the CME group (339.8 ± 201.2 vs. 428.6 ± 165.8 mL, p = 0.021). However, the amount of postoperative drainage was not significantly different between the two groups. Although the complication rate was not different between the two groups, there were three cases of intra-abdominal bleeding requiring transfusion only in the CME group. Inflammatory markers from the cytokine assays and serum laboratory tests showed no significant differences between the two groups. CONCLUSIONS:UAS reduced EBL without increasing inflammatory reactions.
RCT Entities:
BACKGROUND: Previous studies regarding ultrasonically activated shears (UAS) were performed without controlled surgical procedures or consideration of potential thermal injury due to high temperature of active blade of UAS. The purpose of this study was to evaluate the efficacy and safety of UAS through a comparison with conventional monopolar electrocautery (CME) in open distal gastrectomy for gastric cancer. METHODS: From October 2011 to November 2012, 56 gastric cancerpatients eligible for open distal gastrectomy were randomized into UAS or CME groups. Primary endpoints were estimated blood loss (EBL) during surgery and amount of drainage through the fifth postoperative day. Secondary endpoints were operation time, length of hospital stay, postoperative morbidity, changes in cytokine levels in serum, peritoneal irrigation saline, and peritoneal drainage, and inflammatory markers of serum. (Registration-number of ClinicalTrials.gov: NCT01971775). RESULTS: EBL was lower in the UAS group than that in the CME group (339.8 ± 201.2 vs. 428.6 ± 165.8 mL, p = 0.021). However, the amount of postoperative drainage was not significantly different between the two groups. Although the complication rate was not different between the two groups, there were three cases of intra-abdominal bleeding requiring transfusion only in the CME group. Inflammatory markers from the cytokine assays and serum laboratory tests showed no significant differences between the two groups. CONCLUSIONS:UAS reduced EBL without increasing inflammatory reactions.
Authors: Hang Cheng; Jeffrey W Clymer; Behnam Sadeghirad; Nicole C Ferko; Chris G Cameron; Joseph F Amaral Journal: World J Surg Oncol Date: 2018-01-04 Impact factor: 2.754