Ultrasonically activated shears versus electrocautery in open gastrectomy for gastric cancer: a randomized controlled trial.
BACKGROUND
Use of ultrasonically activated shears (UAS) is gaining popularity in open surgery but without concrete evidence. We conducted a prospectively randomized study to assess the efficacy of ultrasonic dissection in open gastrectomy for gastric cancer.


METHODS
Patients with gastric cancer who were to undergo gastrectomy with D2 lymph node dissection were enrolled and assigned to either the conventional surgery group (n = 125) or the UAS group (n = 128).


RESULTS
The mean operating time was significantly reduced in the UAS group (89.3 ± 15.6 min) when compared to the conventional group (97.8 ± 17.2 min; p < 0.001). However, we did not find any significant difference in operative blood loss, the amount of postoperative abdominal drainage, or the rate of postoperative complications between the groups. A multivariate analysis for operating time revealed that the use of UAS, female gender and BMI less than 25 were significantly associated with reduced operating time. The operating time was significantly longer in the conventional group than in the UAS group (B 7.786; 95 % CI 4.103-11.468; p < 0.001). In the subgroup analysis, the use of UAS significantly reduced the operating time, especially in male patients, regardless of the BMI status.


CONCLUSIONS
The use of UAS in gastrectomy for gastric cancer was a safe and efficient method, especially in terms of reducing operating time for male patients.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
Min-Gew
MG
Choi
Seung Jong
SJ
Oh
Jae Hyung
JH
Noh
Tae Sung
TS
Sohn
Sung
S
Kim
Jae Moon
JM
Bae
D000328:Adult; D016063:Blood Loss, Surgical; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects / Q000379:methods*