{"title":"调和手术刀与传统剪刀在腹腔镜部分肾切除术中的对比:基于倾向评分的分析","authors":"Zhen Xu , Congcong Xu , Jiawen Zheng , Yichun Zheng","doi":"10.1016/j.lers.2021.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.</p></div><div><h3>Methods</h3><p>A retrospective review was conducted in patients with localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019. Eventually, 225 patients joined this retrospective study. Patients were divided into the harmonic scalpel group or scissor group based on the method used, with 71 cases and 154 cases respectively. Propensity score matching (1:1) was performed to adjust for potential baseline confounders, and each group had 57 cases. Patient characteristics, perioperative clinical results, complications, and oncological results were compared between the two groups.</p></div><div><h3>Results</h3><p>After matching, patient characteristics were not significantly different between the two groups. The scissor group was associated with a significantly shorter operative time (105 min vs. 130 min, <em>p</em> < 0.001), shorter warm ischemia time (19.35 min vs. 22.07 min, <em>p</em> = 0.005). However, the harmonic scalpel group was associated with significantly less estimated blood loss (20 mL vs. 30 mL, <em>p</em> = 0.013) and shorter length of stay (8 d vs. 10 d, <em>p</em> = 0.040). There was no significantly difference in indwelling time of drainage tube, perioperative complication, oncological outcomes or recurrence rates.</p></div><div><h3>Conclusions</h3><p>The harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy, and has benefits in intraoperative blood loss and length of stay.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lers.2021.01.002","citationCount":"0","resultStr":"{\"title\":\"Harmonic scalpel versus traditional scissors in laparoscopic partial nephrectomy: A propensity score-based analysis\",\"authors\":\"Zhen Xu , Congcong Xu , Jiawen Zheng , Yichun Zheng\",\"doi\":\"10.1016/j.lers.2021.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.</p></div><div><h3>Methods</h3><p>A retrospective review was conducted in patients with localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019. Eventually, 225 patients joined this retrospective study. Patients were divided into the harmonic scalpel group or scissor group based on the method used, with 71 cases and 154 cases respectively. Propensity score matching (1:1) was performed to adjust for potential baseline confounders, and each group had 57 cases. Patient characteristics, perioperative clinical results, complications, and oncological results were compared between the two groups.</p></div><div><h3>Results</h3><p>After matching, patient characteristics were not significantly different between the two groups. The scissor group was associated with a significantly shorter operative time (105 min vs. 130 min, <em>p</em> < 0.001), shorter warm ischemia time (19.35 min vs. 22.07 min, <em>p</em> = 0.005). However, the harmonic scalpel group was associated with significantly less estimated blood loss (20 mL vs. 30 mL, <em>p</em> = 0.013) and shorter length of stay (8 d vs. 10 d, <em>p</em> = 0.040). There was no significantly difference in indwelling time of drainage tube, perioperative complication, oncological outcomes or recurrence rates.</p></div><div><h3>Conclusions</h3><p>The harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy, and has benefits in intraoperative blood loss and length of stay.</p></div>\",\"PeriodicalId\":32893,\"journal\":{\"name\":\"Laparoscopic Endoscopic and Robotic Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.lers.2021.01.002\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laparoscopic Endoscopic and Robotic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468900921000025\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laparoscopic Endoscopic and Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468900921000025","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的比较谐波刀与传统剪刀在腹腔镜肾部分切除术中的临床疗效。方法回顾性分析2015年1月至2019年12月腹腔镜肾部分切除术的局限性肾肿瘤患者。最终，225名患者加入了这项回顾性研究。根据使用方法将患者分为谐波手术刀组71例和剪刀组154例。进行倾向评分匹配(1:1)以调整潜在的基线混杂因素，每组有57例。比较两组患者特征、围手术期临床结果、并发症及肿瘤结果。结果配对后，两组患者特征无显著差异。剪刀组的手术时间明显缩短(105分钟vs 130分钟，p <0.001)，较短的热缺血时间(19.35 min vs. 22.07 min, p = 0.005)。然而，谐波手术刀组的估计失血量显著减少(20 mL对30 mL, p = 0.013)，住院时间也较短(8天对10天，p = 0.040)。两组患者留置引流管时间、围手术期并发症、肿瘤预后及复发率均无显著差异。结论谐波刀用于腹腔镜肾部分切除术安全有效，术中出血量减少，住院时间缩短。
Harmonic scalpel versus traditional scissors in laparoscopic partial nephrectomy: A propensity score-based analysis
Objective
The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.
Methods
A retrospective review was conducted in patients with localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019. Eventually, 225 patients joined this retrospective study. Patients were divided into the harmonic scalpel group or scissor group based on the method used, with 71 cases and 154 cases respectively. Propensity score matching (1:1) was performed to adjust for potential baseline confounders, and each group had 57 cases. Patient characteristics, perioperative clinical results, complications, and oncological results were compared between the two groups.
Results
After matching, patient characteristics were not significantly different between the two groups. The scissor group was associated with a significantly shorter operative time (105 min vs. 130 min, p < 0.001), shorter warm ischemia time (19.35 min vs. 22.07 min, p = 0.005). However, the harmonic scalpel group was associated with significantly less estimated blood loss (20 mL vs. 30 mL, p = 0.013) and shorter length of stay (8 d vs. 10 d, p = 0.040). There was no significantly difference in indwelling time of drainage tube, perioperative complication, oncological outcomes or recurrence rates.
Conclusions
The harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy, and has benefits in intraoperative blood loss and length of stay.
期刊介绍：
Laparoscopic, Endoscopic and Robotic Surgery aims to provide an academic exchange platform for minimally invasive surgery at an international level. We seek out and publish the excellent original articles, reviews and editorials as well as exciting new techniques to promote the academic development.
Topics of interests include, but are not limited to:
▪ Minimally invasive clinical research mainly in General Surgery, Thoracic Surgery, Urology, Neurosurgery, Gynecology & Obstetrics, Gastroenterology, Orthopedics, Colorectal Surgery, Otolaryngology, etc.;
▪ Basic research in minimally invasive surgery;
▪ Research of techniques and equipments in minimally invasive surgery, and application of laparoscopy, endoscopy, robot and medical imaging;
▪ Development of medical education in minimally invasive surgery.
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