Randomized controlled trial of the LigaSure vessel sealing system versus conventional open gastrectomy for gastric cancer

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• 作者：Junya Fujita (1)
  Shuji Takiguchi (2)
  Kazuhiro Nishikawa (3)
  Yutaka Kimura (4)
  Hiroshi Imamura (5)
  Shigeyuki Tamura (6)
  Chikara Ebisui (7)
  Kentaro Kishi (8)
  Kazumasa Fujitani (9)
  Yukinori Kurokawa (2)
  Masaki Mori (2)
  Yuichiro Doki (2)
  
• 关键词：LigaSure ; Gastrectomy ; Randomized controlled trial ; Gastric cancer
• 刊名：Surgery Today
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：44
• 期：9
• 页码：1723-1729
• 全文大小：199 KB
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  6. Sandonato L, Cipolla C, Graceffa G, Fricano S, Li Petri S, Prinzi G, et al. Bipolar electrothermic coagulation (ligasure bipolar vessel sealing system) in thyroid surgery. Chir Ital. 2003;55:411- (article in Italian).
  7. Elhao M, Abdallah K, Serag I, El-Laithy M, Agur W. Efficacy of using electrosurgical bipolar vessel sealing during vaginal hysterectomy in patients with different degrees of operative difficulty: a randomised controlled trial. Eur J Obstet Gynecol Reprod Biol. 2009;147:86-0. CrossRef
  8. Yao HS, Wang WJ, Wang Q, Gao WC, Xiang HG, Hu ZQ, et al. Randomized clinical trial of vessel sealing system (LigaSure) in esophagogastric devascularization and splenectomy in patients with portal hypertension. Am J Surg. 2011;202:82-0. CrossRef
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  15. Imamura H, Kurokawa Y, Kawada J, Tsujinaka T, Takiguchi S, Fujiwara Y, et al. Influence of bursectomy on operative morbidity and mortality after radical gastrectomy for gastric cancer: results of a randomized controlled trial. World J Surg. 2011;35:625-0. CrossRef
  16. Takiguchi S, Yamamoto K, Hirao M, Imamura H, Fujita J, Yano M, et al. A comparison of postoperative quality of life and dysfunction after Billroth I and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer: results from a multi-institutional RCT. Gastric Cancer. 2012;15:198-05. CrossRef
  17. Tan EK, Cornish J, Darzi AW, Papagrigoriadis S, Tekkis PP. Meta-analysis of short-term outcomes of randomized controlled trials of LigaSure vs conventional hemorrhoidectomy. Arch Surg. 2007;142:1209-8. CrossRef
  18. Silva-Filho AL, Rodrigues AM, Vale de Castro Monteiro M, da Rosa DG, Pereira e Silva YM, Werneck RA, et al. Randomized study of bipolar vessel sealing system versus conventional suture ligature for vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2009;146:200-. CrossRef
  19. Elhao M, Abdallah K, Serag I, El-Laithy M, Agur W. Efficacy of using electrosurgical bipolar vessel sealing during vaginal hysterectomy in patients with different degrees of operative difficulty: a randomised controlled trial. Eur J Obstet Gynecol Reprod Biol. 2009;147:86-0. CrossRef
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• 作者单位：Junya Fujita (1)
  Shuji Takiguchi (2)
  Kazuhiro Nishikawa (3)
  Yutaka Kimura (4)
  Hiroshi Imamura (5)
  Shigeyuki Tamura (6)
  Chikara Ebisui (7)
  Kentaro Kishi (8)
  Kazumasa Fujitani (9)
  Yukinori Kurokawa (2)
  Masaki Mori (2)
  Yuichiro Doki (2)
  
  1. Department of Surgery, NTT West Osaka Hospital Osaka, Osaka, Japan
  2. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
  3. Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan
  4. Department of Surgery, Sakai Municipal Hospital, Sakai, Japan
  5. Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan
  6. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan
  7. Department of Surgery, Suita Municipal Hospital, Suita, Japan
  8. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  9. Department of Surgery, Osaka General Medical Center, Osaka, Japan
  
• ISSN：1436-2813

文摘

Purpose LigaSure, a bipolar electronic vessel sealing system, has become popular in abdominal surgery but few clinical studies have been conducted to evaluate its effectiveness in radical gastrectomy for gastric cancer. Methods In this multicenter, prospective, randomized controlled trial, patients with curative gastric cancer were randomly assigned to undergo gastrectomy either with LigaSure or a conventional technique. Results Of the 160 patients enrolled, 80 were randomized to the LigaSure group and 78 to the conventional group. Patient characteristics were well balanced in the two groups. There were no significant differences between the LigaSure and conventional groups in blood loss (288 vs. 260?ml, respectively; P?=?0.748) or operative time (223 and 225?min, respectively; P?=?0.368); nor in the incidence of surgical complications or duration of postoperative hospital stay. In a subgroup analysis of patients who underwent gastrectomy that preserved the distal part of the greater omentum, the use of LigaSure significantly reduced blood loss (179 vs. 245?ml; P?=?0.033), and the duration of the operation (195 vs. 221?min; P?=?0.039). Conclusions LigaSure did not contribute to reducing intraoperative blood loss, operative time, or other adverse surgical outcomes. The usefulness of the device may be limited to a specific part of the surgical procedure in open gastrectomy.