Randomized controlled trial of the LigaSure vessel sealing system versus conventional open gastrectomy for gastric cancer.
OBJECTIVE
LigaSure, a bipolar electronic vessel sealing system, has become popular in abdominal surgery but few clinical studies have been conducted to evaluate its effectiveness in radical gastrectomy for gastric cancer.


METHODS
In this multicenter, prospective, randomized controlled trial, patients with curative gastric cancer were randomly assigned to undergo gastrectomy either with LigaSure or a conventional technique.


RESULTS
Of the 160 patients enrolled, 80 were randomized to the LigaSure group and 78 to the conventional group. Patient characteristics were well balanced in the two groups. There were no significant differences between the LigaSure and conventional groups in blood loss (288 vs. 260 ml, respectively; P = 0.748) or operative time (223 and 225 min, respectively; P = 0.368); nor in the incidence of surgical complications or duration of postoperative hospital stay. In a subgroup analysis of patients who underwent gastrectomy that preserved the distal part of the greater omentum, the use of LigaSure significantly reduced blood loss (179 vs. 245 ml; P = 0.033), and the duration of the operation (195 vs. 221 min; P = 0.039).


CONCLUSIONS
LigaSure did not contribute to reducing intraoperative blood loss, operative time, or other adverse surgical outcomes. The usefulness of the device may be limited to a specific part of the surgical procedure in open gastrectomy.
Department of Surgery, NTT West Osaka Hospital Osaka, Osaka, Japan.
Junya
J
Fujita
Shuji
S
Takiguchi
Kazuhiro
K
Nishikawa
Yutaka
Y
Kimura
Hiroshi
H
Imamura
Shigeyuki
S
Tamura
Chikara
C
Ebisui
Kentaro
K
Kishi
Kazumasa
K
Fujitani
Yukinori
Y
Kurokawa
Masaki
M
Mori
Yuichiro
Y
Doki
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D055815:Young Adult