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Ultrasonically activated scalpel versus monopolar electrocautery shovel in laparoscopic total mesorectal excision for rectal cancer

引用

World Journal of Gastroenterology 2008年第25期14卷 4065-4069页

作者： Bao-Jun zhou, Wei-Qing song, Qing-Hui yan, Jian-Hui Cai, Feng-An Wang, Jin Liu, Guo-Jian Zhang, Guo-Qiang Duan, Zhan-Xue Zhang, Department of Gastrointestinal Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China Author contributions: zhou bj, song wq, yan qh, Cai JH, Wang FA, Liu J, Zhang GJ, Duan GQ and Zhang ZX contributed equally to this work zhou bj, song wq, yan qh, Cai JH and Wang FA designed the research zhou bj, Liu J and Zhang GJ performed the research Duan GQ and Zhang ZX analyzed the data and zhou bj, song wq and yan qh wrote the paper. Department of Gastrointestinal Surgery The Second Hospital of Hebei Medical University Shijiazhuang 050000 Hebei Province China. zhoubaojun67@***

AIM： To investigate the feasibility and safety of monopolar electrocautery shovel （ES） in laparoscopic total mesorectal excision （TME） with anal sphincter preservation for rectal cancer in order to reduce the cost of the laparoscopic operation, and to compare ES with the ultrasonically activated scalpel （US）. METHODS： Forty patients with rectal cancer, who underwent laparoscopic TME with anal sphincter preservation from June 2005 to June 2007, were randomly divided into ultrasonic scalpel group and monopolar ES group, prospectively. White blood cells （WBC） were measured before and after operation, operative time, blood loss, pelvic volume of drainage, time of anal exhaust, visual analogue scales （VAS） and surgery-related complications were recorded. RESULTS： All the operations were successful; no one was converted to open procedure. No significant differences were observed in terms of preoperative and postoperative d I and d 3 WBC counts （P = 0.493, P = 0.375, P = 0.559）, operation time （P = 0.235）, blood loss （P = 0.296）, anal exhaust time （P = 0.431）, pelvic drainage volume and VAS in postoperative d 1 （P = 0.431, P = 0.426） and d 3 （P = 0.844, P = 0.617） between ES group and US group. The occurrence of surgery-related complications such as anastomotic leakage and wound infection was the same in the two groups.CONCLUSION： ES is a safe and feasible tool as same as US used in laparoscopic TME with anal sphincter preservation for rectal cancer on the basis of the skillful laparoscopic technique and the complete understanding of laparoscopic pelvic anatomy. Application of ES can not only reduce the operation costs but also benefit the popularization of laparoscopic operation for rectal cancer patients.

关键词： Laparoscopy Ultrasonically activatedscalpel Monopolar electrocautery Rectal cancer Totalmesorectal excision

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