Safety comparison of cavitron ultrasonic surgical aspirator combined with high-frequency electrotome versus harmonic scalpel in hepatectomy

doi:10.3877/cma.j.issn.2095-3232.2015.04.007

Abstract

Abstract:

Objective

To compare the safety of cavitron ultrasonic surgical aspirator (CUSA) combined with high-frequency electrotome versus harmonic scalpel in hepatectomy.

Methods

Clinical data of 102 patients undergoing hepatectomy using CUSA combined with high-frequency electrotome or harmonic scalpel in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2011 and January 2014 were retrospectively studied. The patients were divided into the hepatectomy using CUSA combined with high-frequency electrotome group (the CUSA group, n=53) and the hepatectomy using harmonic scalpel group (the harmonic scalpel group, n=49). In the CUSA group, 32 were males and 21 were females with the average age of (48±11) years old. In the harmonic scalpel group, 31 were males and 18 were females with the average age of (49±13) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. Porta hepatis was occluded by selective porta hepatis exclusion during hepatectomy. The interval of selective portal hepatis exclusion, intraoperative blood loss and postoperative complications of the two groups were observed. The observation indexes of the two groups were compared using t test or Chi-square test.

Results

The interval of selective portal hepatis exclusion of the CUSA group was (13±2) min, which was significantly shorter than (23±3) min of the harmonic scalpel group (t=-19.946, P<0.05). The intraoperative blood loss of the CUSA group was (293±53) ml, which was significantly less than (468±54) ml of harmonic scalpel group (t=-16.510, P<0.05). The incidence of biliary leakage of the CUSA group was 4% (2/53), which was significantly lower than 16% (8/49) of the harmonic scalpel group (χ²=4.537, P<0.05).

Conclusions

Compared with harmonic scalpel, CUSA combined high-frequency electrotome in hepatectomy has the advantages of less intraoperative blood loss, shorter interval of selective portal hepatis exclusion and lower incidence of biliary leakage. Thus, the safety of hepatectomy is enhanced significantly.

Key words: Hepatectomy, Cavitron ultrasonic surgical aspirator, Harmonic scalpel, Electric knife

Yang Wang, Huayao Zhang, Jianping Liu, Shanglin Yang, Zheng Su, Jinxing Wei. Safety comparison of cavitron ultrasonic surgical aspirator combined with high-frequency electrotome versus harmonic scalpel in hepatectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2015, 04(04): 218-221.

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References 19

[1]	Bodzin AS, Leiby BE, Ramirez CG, et al. Liver resection using cavitron ultrasonic surgical aspirator (CUSA) versus harmonic scalpel: a retrospective cohort study[J]. Int J Surg, 2014，12(5): 500-503.
[2]	Yeh TS, Ho YP, Jan YY, et al. Efficacy of color sonography and harmonic scalpel in laparoscopic management of multiple/lobulated liver cysts and abscesses[J]. Hepatogastroenterology, 2007, 54(74): 485-488.
[3]	S Hammond J, Muirhead W, Zaitoun AM, et al. Comparison of liver parenchymal ablation and tissue necrosis in a cadaveric bovine model using the Harmonic Scalpel, the LigaSure, the Cavitron Ultrasonic Surgical Aspirator and the Aquamantys devices[J]. HPB, 2012, 14(12): 828-832.
[4]	刘海鹰，余南荣，杨国华，等．Habib 4X射频止血切割器在肝恶性肿瘤患者肝切除术中的应用[J/CD]．中华肝脏外科手术学电子杂志，2014, 3(2): 84-87.
[5]	Kaibori M, Matsui K, Ishizaki M, et al. A prospective randomized controlled trial of hemostasis with a bipolar sealer during hepatic transection for liver resection[J]. Surgery, 2013, 154(5):1046-1052.
[6]	Ho CM, Wakabayashi G, Nitta H, et al. Total laparoscopic limited anatomical resection for centrally located hepatocellular carcinoma in cirrhotic liver[J]. Surg Endosc, 2013, 27(5): 1820-1825.
[7]	王东，朱继业．精准肝脏分离技术在复杂肝脏切除术中的应用研究[J/CD]．中华肝脏外科手术学电子杂志，2012, 1(1):14-18.
[8]	喻智勇，蔡强，邬明，等．Kelly钳精细钳夹法切肝技术的临床应用[J/CD]．中华肝脏外科手术学电子杂志，2013, 2(4):43-46.
[9]	仇毓东，周建新，冯伟，等．精准肝蒂离断技术在肝细胞肝癌解剖性肝段切除患者中的应用[J/CD]．中华肝脏外科手术学电子杂志，2013,2(4):14-18.
[10]	Wu Z, Chen Z, Peng L. Evaluation of the harmonic scalpel in open surgery for abdominal aortic aneurysm[J]. Front Med, 2012, 6(1): 85-88.
[11]	Tirelli G, Del Piero GC, Perrino F. Ultracision Harmonic Scalpel in oral and oropharyngeal cancer resection[J]. J Craniomaxillofac Surg, 2014, 42(5): 544-547.
[12]	Olmez A, Karabulut K, Aydin C, et al. Comparison of harmonic scalpel versus conventional knot tying for transection of short hepatic veins at liver transplantation: prospective randomized study[J]. Transplant Proc, 2012, 44(6): 1717-1719.
[13]	El Moghazy WM, Hedaya MS, Kaido T, et al. Two different methods for donor hepatic transection: cavitron ultrasonic surgical aspirator with bipolar cautery versus cavitron ultrasonic surgical aspirator with radiofrequency coagulator: a randomized controlled trial[J]. Liver Transpl, 2009, 15(1): 102-105.
[14]	刘文斌，许戈良，荚卫东，等．超声吸引刀结合单极电凝在肝切除术中的应用价值——附251例报告[J]．新医学，2010, 41(6): 382-385.
[15]	尹震宇，王付强，彭友缘，等．超声乳化吸引刀联合超声刀在腹腔镜肝肿瘤切除术中的应用[J]．中华肝胆外科杂志，2011, 17(12):1013-1014.
[16]	陈焕伟，甄作均，苏树英，等．术中超声和超吸刀在解剖性肝切除中的应用[J]．中华肝胆外科杂志，2010, 16(7):545-546.
[17]	Forterre F, Dickomeit M, Senn D, et al. Microfenestration using the CUSA Excel ultrasonic aspiration system in chondrodystrophic dogs with thoracolumbar disk extrusion: a descriptive cadaveric and clinical study[J]. Vet Surg, 2011, 40(1): 34-39.
[18]	陈滨，彭民浩，彭涛，等．超声吸引刀结合血流阻断技术在解剖性半肝切除中的应用[J]．微创医学，2010, 5(5):441-443.
[19]	Itoh S, Fukuzawa K, Shitomi Y, et al. Impact of the VIO system in hepatic resection for patients with hepatocellular carcinoma[J]. Surg Today, 2012, 42(12):1176-1182.

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