A comparative study of laparoscopic extraperitoneal laparoscopy with the use of ultrasonically activated shears

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• 作者：Arash Rafii ; Alex ; ra Camicas ; Gwenael Ferron ; Eliane Mery ; Laurence Gladieff ; Martine Delannes ; Denis Querleu
• 关键词：harmonic scalpel ; lymphocele ; paraaortic lymphadenectomy
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2009
• 出版时间：October 2009
• 年：2009
• 卷：201
• 期：4
• 页码：370.e1-370.e5
• 全文大小：197 K

文摘

Objective

We evaluated the use of the harmonic scalpel in reducing the occurrence of symptomatic lymphoceles and its related complications in paraaortic laparoscopic lymphadenectomies (PALLs).

Study Design

All PALL that were performed at the Institut Claudius Regaud between January 2003 and June 2007 were included. Since January 2006, the harmonic scalpel has been used systematically for all lymphostasis. Lymphoceles that required treatment were recorded as a complication.

Results

Ninety-eight patients were enrolled, 62 PALLs were performed with the standard technique (control group), and 36 PALLs were performed with the harmonic scalpel (study group). There were no differences regarding operating time, blood loss, median nodal yield, and duration of hospital stay. Seven patients of the control group vs none of the study group (P = .03) experienced a symptomatic lymphocele that required medical treatment; 4 patients had radiologic drainage, and 1 patient had surgical drainage.

Conclusion

We demonstrate the efficacy of harmonic scalpel in reducing the occurrence of symptomatic lymphoceles in paraaortic extraperitoneal lymphadenectomy.