title: Randomized clinical trial of vessel sealing system (LigaSure) in esophagogastric devascularization and splenectomy in patients with portal hypertension.
abstract: BACKGROUND
  The LigaSure vessel sealing system (Valleylab, Boulder, CO) has been tested, with excellent results, in different fields of surgery. However, no study has evaluated the efficiency of the LigaSure in open esophagogastric decongestion and splenectomy in a randomized trial to date.
  
  
  METHODS
  Patients scheduled to undergo esophagogastric decongestion and splenectomy were assigned to the use of either the LigaSure or a conventional clamp-and-tie technique. Primary outcome measures were operating time and intraoperative blood loss. Secondary outcome measures were postoperative drainage volume, complications such as spleen fever, bleeding, portal vein thrombosis, length of incision, pain, and time to discharge.
  
  
  RESULTS
  Sixty patients were randomized to the LigaSure (n = 30) and clamp-and-tie (n = 30) groups. The groups were well matched with respect to liver function, associated illnesses, and grading of esophageal varices. Postoperative outcomes in drainage and major complications did not differ between the groups, while operative time and the volume of blood loss were significantly decreased in the LigaSure group compared with the clamp-and-tie group (P < .001).
  
  
  CONCLUSIONS
  The use of the LigaSure is safe and effective in vessel division and homeostasis in the esophagogastric decongestion and splenectomy, with statistically significant decreases in operative time and intraoperative blood loss and without significantly modifying postoperative results.
authors: Department of General Surgery, Shanghai Chang Zheng Hospital, Second Military Medical University, China.
authors: Hou Shan
authors: HS
authors: Yao
authors: Wei Jun
authors: WJ
authors: Wang
authors: Qiang
authors: Q
authors: Wang
authors: Wen Chao
authors: WC
authors: Gao
authors: Hong Gang
authors: HG
authors: Xiang
authors: Zhi Qian
authors: ZQ
authors: Hu
authors: Jia Dong
authors: JD
authors: Gao
authors: Xue Yun
authors: XY
authors: Chen
authors: Wei Min
authors: WM
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D004311:Double-Blind Method; D004564:Electrocoagulation / Q000295:instrumentation*; D004932:Esophageal and Gastric Varices / Q000601:surgery; D004947:Esophagus / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D013156:Splenectomy; D013270:Stomach / Q000098:blood supply / Q000601:surgery*; D013997:Time Factors