Comparison between staple and vessel sealing device for parynchemal transection in laparoscopic liver surgery in a swine model.
Comparison between staple and vessel sealing device for parynchemal transection in laparoscopic liver surgery in a swine model.
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DOI：
10.1080/13651820701658219
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发表时间：
2007-01-01
期刊：
影响因子：
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通讯作者：
Jacobs, Michael J
中科院分区：
文献类型：
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作者：
Saidi, Reza F;Ahad, Ahmad;Jacobs, Michael J
背景：技术的进步使腹腔镜手术扩展到高级手术，如肝切除；然而，横切法是有争议的。本研究旨在比较血管封闭器(VSD)和机械内吻合器在猪肝实质横切中的可行性和手术效果。材料和方法：两组(每组n=7)行腹腔镜左肝切除术，比较吻合器和VSD。分别于手术时和1周后观察肝脏切面出血和胆漏情况。术后1周处死动物，以确定出血和胆汁渗漏，并进行肝脏组织学评估。结果：两组患者在术前、术后1周及术后1周均未发现胆漏或出血。与LigaSure相比，吻合器组的失血量有增加的趋势(40+/-16.4cc比17+/-3.7cc，p>；0.05)。与LigaSure组相比，吻合器组的横断时间也有缩短的趋势(15+/-4.1min比21.8+/-5.3，p>；0.05)。吻合器组的器械费用显著高于吻合组(720+/-110比400+/-50；p
BACKGROUND: Advancements in technology have allowed laparoscopic surgery to expand into advanced procedures such as liver resection; however, the transection method is debatable. This study was designed to evaluate the feasibility and outcome of laparoscopic liver resection comparing the vessel sealing device (VSD) versus endomechanical stapling devices for parenchymal transection in a swine model.MATERIALS AND METHODS: Laparoscopic left hepatectomy was performed in two groups (n=7 in each group) comparing the stapler device with the VSD. The cut surfaces of the liver were evaluated for bleeding and biliary leakage at the time of the operation and 1 week later. The animals were sacrificed 1 week after the operation to determine hemorrhage and bile leakage, and to allow histological evaluation of the liver. Serum liver enzymes were checked before, after, and 1 week postoperatively.RESULTS: No evidence of biliary leakage or hemorrhage was noted at the time of the operation and 1 week later for both groups. There was a trend toward an increase in blood loss in the stapled group compared with LigaSure (40+/-16.4 cc vs 17+/-3.7 cc, p>0.05). There was also a trend toward shorter transection time in the stapled group compared with the LigaSure group (15+/-4.1 min vs 21.8+/-5.3, p>0.05). The instrument cost was significantly higher in the stapled group (720+/-110 vs 400+/-50; p