title: Ultrasonic scalpel for gastric cancer surgery: a prospective randomized study.
abstract: BACKGROUND
  The aim of the study was to evaluate the potential advantages of the ultrasonic scalpel compared with the conventional technique in gastric cancer surgery.
  
  
  METHODS
  Patients with resectable adenocarcinoma of the stomach were randomly assigned to ultrasonic scalpel or conventional technique. We used the HARMONIC FOCUS (Ethicon Endo-Surgery, Inc.) as ultrasonic scalpel.
  
  
  RESULTS
  Between February 2010 and December 2010, 60 patients with resectable gastric cancer were enrolled into the study. Operative time was significantly shorter with the ultrasonic arm than with the conventional arm (median 238.5 vs. 300.5 min; P = 0.0004). Blood loss was also significantly lower in the ultrasonic arm than in the conventional arm (median 351.0 vs. 569.5 ml; P = 0.016). Clavien-Dindo grades of postoperative complications were similar in the two groups. From a questionnaire survey of operators, the ultrasonic scalpel significantly reduced the stress of lymph node dissection (3.67 vs. 2.87; P = 0.0006). However, in assisting surgeons, the contributions to surgery, study, and technical improvement of the ultrasonic group were lower than in the conventional group.
  
  
  CONCLUSIONS
  This study shows that the ultrasonic scalpel is a reliable and safe tool for open gastric cancer surgery.
authors: Department of Surgery, Kansai Medical University, Shinmachi 2-3-1, Hirakata City, Osaka, 573-1191, Japan. inoueke@hirakata.kmu.ac.jp
authors: Kentaro
authors: K
authors: Inoue
authors: Yasushi
authors: Y
authors: Nakane
authors: Taku
authors: T
authors: Michiura
authors: Masanori
authors: M
authors: Yamada
authors: Hiromi
authors: H
authors: Mukaide
authors: Junichi
authors: J
authors: Fukui
authors: Hirokazu
authors: H
authors: Miki
authors: Yosuke
authors: Y
authors: Ueyama
authors: Richi
authors: R
authors: Nakatake
authors: Katsuji
authors: K
authors: Tokuhara
authors: Shigeyoshi
authors: S
authors: Iwamoto
authors: Hiroaki
authors: H
authors: Yanagimoto
authors: Hideyoshi
authors: H
authors: Toyokawa
authors: Sohei
authors: S
authors: Satoi
authors: A-Hon
authors: AH
authors: Kwon
mesh_terms: D000230:Adenocarcinoma / Q000191:economics / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D004210:Dissection / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D006488:Hemostasis, Surgical / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D057194:Intention to Treat Analysis; D007564:Japan; D008197:Lymph Node Excision / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000191:economics / Q000601:surgery*; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000191:economics / Q000295:instrumentation* / Q000379:methods