ABSTRACT
OBJECTIVE: The aim of this prospective study was to evaluate the benefits and risks when using an Ultracision Harmonic Scalpel in the surgical treatment of oral and oropharyngeal carcinomas. STUDY DESIGN: Prospective non-randomized. SETTING: Clinica Otorinolaringoiatrica, Azienda Ospedaliero-Universitaria. Trieste, Italy. SUBJECTS AND METHODS: In this study, conducted from April 2008 to August 2010, 36 consecutive patients underwent resection of oral or oropharyngeal carcinoma and lateral lymphadenectomy using the Ultracision Harmonic Scalpel. Evaluation criteria included length of the surgical procedure, intraoperative blood loss, quantity of neck drainage on the first, second and third postoperative days, postoperative complications, and a subjective assessment of postoperative pain and lymphatic oedema of the neck. Results were compared with previous surgical procedures carried out between May 2006 and March 2008 using cold knife and bipolar haemostasis (n = 36) when the Harmonic Scalpel was not available. RESULTS: In patients treated with the Harmonic Scalpel, operating time was significantly reduced, both for resection of the carcinoma and the lateral lymphadenectomy. Intraoperative blood loss and neck drainage on the first and second postoperative days were significantly less and pain scores were significantly lower than in the cold knife group. No postoperative complications were noted in the Harmonic Scalpel group. The only disadvantage noted in the Harmonic Scalpel group was the high incidence of lymphatic oedema of the neck. CONCLUSIONS: Use of the Harmonic Scalpel during resection of oral cancer and lateral lymphadenectomy is safe and confers some advantages over conventional methods.
Subject(s)
Mouth Neoplasms/surgery , Oropharyngeal Neoplasms/surgery , Ultrasonic Surgical Procedures/instrumentation , Blood Loss, Surgical , Cheek/surgery , Drainage , Glossectomy/instrumentation , Glossectomy/methods , Hemostasis, Surgical/methods , Humans , Lymphedema/etiology , Neck/pathology , Neck Dissection/instrumentation , Neck Dissection/methods , Operative Time , Pain, Postoperative/etiology , Palate, Soft/surgery , Postoperative Complications , Prospective Studies , Risk Assessment , Tonsillectomy/instrumentation , Tonsillectomy/methods , Ultrasonic Surgical Procedures/methodsABSTRACT
ObjectiveTo explore the practicability and security of the ultracision harmonic scalpel in radical gastrectomy for patients with proximal gastric cancer.Methods115 patients of stage Ⅰ ～ Ⅲ proximal gastric cancer undergone radical gastrectomy were analyzed retrospectively.65 patients were performed with ultracision harmonic scalpel,the other 50 patients were performed with conventional operation.The operative time,volume of intraoperative hemorrhage,length of incision,and postoperative complications were analyzed.ResultsThere were significant difference in operative time ( 126.9 ± 20.7 ) min and ( 150.6 ± 31.7 ) min ( P ＜ 0.05 ),volume of intraoperative hemorrhage (105.7 ±40.3)ml and (171.7 ±63.2)ml(P＜0.01) and length of incision(17.2 ±2.1)cm and (20.3 ±2.3)cm (P ＜ 0.05 ).There was no significant difference in the postoperative complications between ultracisiou harmonic scalpel group and conventional group.All patients recovered without severe complications.ConclusionRadical resection of proximal gastric cancer using ultracision harmonic scalpel could shorten operative time,decrease intraoperative hemorrhage,shorten incision length,and the technique is convenient and safe.
ABSTRACT
Objective To study the application of ultracision harmonic scalpel in laparoscopic radical gastrectomy.Methods Ten patients with gastric cancer were given laparoscopic-assisted radical gastrectomy by using ultracision harmonic scalpel.Results All operations were successfully performed with ultracision harmonic scalpel,and none of which converted into open surgery.The operation time was 300-492 min,mean(385?64) min.The blood loss was 100-500 ml,mean(401?70) ml.The number of harvested lymph nodes was 21-43,mean 31?6.The time for gastrointestinal function recovery was 3-6 d,mean(4.2?1.0) d.The time of patients' taking out-of-bed activity was 3-7 d,mean(4.5?1.3) d.The time of taking liquid food was 4-6 d,mean(5.0?0.9) d.No case had relapse or metastasis after 4-20 months(mean 12.6 months) of follow-up.Conclusions Laparoscopic radical gastrectomy by using ultracision harmonic scalpel is safe and feasible.Ultracision harmonic scalpel has the advantage of minimal invasion,less bleeding and shorter operation time,which is a very important equipment and useful for laparoscopic gastrointestinal surgery.
