Comparison of perioperative outcomes between bipolar sealing, ultrasonic shears and a hybrid device during laparoscopic gastrectomy for early gastric cancer: a prospective, multicenter, randomized study
- Authors
- Park, Ji-Hyeon; Kong, Seong-Ho; Berlth, Felix; Choi, Jong-Ho; Kim, Sara; Kim, Sa-Hong; Kang, So Hyun; Lee, Sangjun; Yoo, Jaeun; Goo, Eunhee; Jeong, Kyoungyun; Kim, Hyun Myong; Park, Young Suk; Ahn, Sang-Hoon; Suh, Yun-Suhk; Park, Do Joong; Lee, Hyuk-Joon; Kim, Hyung-Ho; Yang, Han-Kwang
- Issue Date
- May-2023
- Publisher
- SPRINGER
- Keywords
- Early gastric cancer; Energy devices; Laparoscopy gastrectomy; Bipolar; Ultrasonic
- Citation
- GASTRIC CANCER, v.26, no.3, pp 438 - 450
- Pages
- 13
- Journal Title
- GASTRIC CANCER
- Volume
- 26
- Number
- 3
- Start Page
- 438
- End Page
- 450
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74986
- DOI
- 10.1007/s10120-023-01365-6
- ISSN
- 1436-3291
1436-3305
- Abstract
- BackgroundAlthough EBDs are essential for minimally invasive surgery, well-established prospective randomized studies comparing EBDs are scarce. This study aimed to compare the intraoperative inflammatory response and short-term surgical outcomes among different energy-based devices (EBDs) in laparoscopic distal gastrectomy (LDG).MethodsPatients with clinical stage I gastric cancer scheduled for LDG at two different medical centers were prospectively randomized into three groups: ultrasonic shears (US), advanced bipolar (BP) and ultrasonic-bipolar hybrid (HB). The C-reactive protein (CRP) level, operation time, intraoperative blood loss (IBL), laboratory tests, cytokines (interleukin (IL)-6 and IL-10), hospital stay, and complication rate were analyzed. A novel semiquantitative measurement method using indocyanine green (ICG) and a near-infrared camera measured the amount of lymphatic leakage.ResultsThe primary endpoint, the CRP level, was significantly lower in the BP (n = 60) group than in the US (n = 57) or HB (n = 57) group [9.03 +/- 5.55 vs. 11.12 +/- 5.02 vs. 12.67 +/- 6.14, p = 0.001, on postoperative day (POD) 2 and 7.48 vs. 9.62 vs. 9.48, p = 0.026, on POD 4]. IBL was significantly lower in BP than in US or HB (26.3 +/- 25.3 vs. 43.7 +/- 42.0 vs. 34.9 +/- 37.0, p = 0.032). Jackson-Pratt drainage triglycerides were significantly lower in BP than in US (53.6 +/- 33.7 vs. 84.2 +/- 59.0, p = 0.11; HB: 71.3 +/- 51.4). ICG fluorescence intensity, operation time, laboratory results, cytokines, hospital stay, and complication rate were not significantly different among the 3 groups.ConclusionBP showed a lower postoperative CRP level and less IBL than US and HB, suggesting less collateral thermal damage and better sealing function. Surgeons may consider this when selecting EBDs for laparoscopic surgery.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - ETC > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74986)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.