CAJ | 학술논문

目的比较超声刀与电凝在腹腔镜结直肠癌手术中的安全性与有效性.方法 2002年5月至2006年12月间,82例结直肠癌患者行腹腔镜结直肠手术,手术中分别应用超声刀(44例)和电凝(38例),比较两组的手术时间、出血量、使用止血夹数及术后肠功能恢复时间、平均住院时间和术后并发症发生率.结果超声刀组出血量明显少于电凝组(P＜0.05);超声刀组使用止血夹数(2.3枚/例)明显少于电凝组(5.1枚/例)(P＜0.05).而术后肠功能恢复时间和平均住院时间两组差异无统计学意义(P＞0.05).超声刀组并发症发生率2.3%,明显低于电凝组的10.5%,两组比较差异有统计学意义(P＜0.05).结论超声刀在腹腔镜结直肠外科应用中出血量少、使用止血夹数少、术后并发症少,是安全可靠的止血工具.
목적 비교초성도여전응재복강경결직장암수술중적안전성여유효성.방법 2002년5월지2006년12월간,82례결직장암환자행복강경결직장수술,수술중분별응용초성도(44례)화전응(38례),비교량조적수술시간、출혈량、사용지혈협수급술후장공능회복시간、평균주원시간화술후병발증발생솔.결과 초성도조출혈량명현소우전응조(P＜0.05);초성도조사용지혈협수(2.3매/례)명현소우전응조(5.1매/례)(P＜0.05).이술후장공능회복시간화평균주원시간량조차이무통계학의의(P＞0.05).초성도조병발증발생솔2.3%,명현저우전응조적10.5%,량조비교차이유통계학의의(P＜0.05).결론 초성도재복강경결직장외과응용중출혈량소、사용지혈협수소、술후병발증소,시안전가고적지혈공구.
Objective To investigate the feasibility and the efficacy of the Harmonic scalpel (HS)dissection compared with general electricoagulation(EC) in laparoscopic colorectal surgery.Methods In this nonrandomized prospective study，82 patients between May 2002 and December 2006 underwent elective laparoscopic colorectal resection.Laparoscopic right hemicolectomy(4)，left hemicolectomy(5)，sigmoidectomy(25)，or low anterior resection(48)were randomized to either electricoagulation or Harmonic scalpel dissection.The data for conversion to open surgery，operative time，blood loss，clips，complication rate，and hospital stay were compared.Results Intraoperative blood loss was significantly less in HS(180.6 ml)versus EC(229.6 ml)(P＜0.05).The number of clips was less in HS(2.3)versus EC(5.1)(P＜0.05).No differences were observed in postoperative time to recover bowl function and postoperative hospital stay.Postoperative complication rates in HS (2.3％)was significantly less as compared to EC(10.5％)(P＜0.05).Conclusion Harmonic scalpel in laparoscopic colorectal surgery can redues intraoperative blood loss，completes majority of laparoscopic procedures，and is technically easy，feasible，reliable.