title: Ultrasonic dissection versus conventional electrocautery during gastrectomy for gastric cancer: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Use of ultrasonic surgical instrument is gaining popularity for dissection and coagulation in open surgery. However, there is still no consensus on the efficacy and safety of its use compared with conventional surgical technique in open gastrectomy for gastric cancer. The aim of this meta-analysis was to evaluate the role and surgical outcomes of ultrasonic dissection (UD) compared with conventional electrocautery (EC).
  
  
  METHODS
  A systematic literature search was performed to identify all studies comparing UD and EC in gastric cancer surgery. Intraoperative and postoperative outcomes were compared using weighted mean differences (WMDs) and odds ratios (ORs).
  
  
  RESULTS
  Five studies were included in this meta-analysis, comprising 489 patients. Meta-analysis results showed that compared with EC, UD was associated with significantly shorter operation time (P = 0.03), less intraoperative blood loss (P = 0.002), lower morbidity (P = 0.02), and reduced postoperative hospital stay (P = 0.03). However, there was no significant difference between the two surgical techniques with regards to postoperative abdominal drainage (P = 0.17), and total cost in hospital (P = 0.59).
  
  
  CONCLUSIONS
  Compared to EC, the use of UD during open gastrectomy can provide several improved outcomes for operation time, intraoperative blood loss, overall morbidity, and postoperative hospital stay. It appears that UD can be used instead of conventional EC in open gastric cancer surgery, although more larger trials with long follow-up should be performed.
authors.affiliation: Department of General Surgery, Weifang People's Hospital, Weifang 261041, Shandong, China.
authors.forename: Z C
authors.initials: ZC
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Weifang People's Hospital, Weifang 261041, Shandong, China.
authors.forename: W G
authors.initials: WG
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Weifang People's Hospital, Weifang 261041, Shandong, China. Electronic address: xxming0602@163.com.
authors.forename: X M
authors.initials: XM
authors.lastname: Xiao
authors.affiliation: Epidemiology and Statistics Teaching and Research Section, School of Public Health, Tianjin Medical University, Tianjin 300070, China.
authors.forename: W H
authors.initials: WH
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Weifang People's Hospital, Weifang 261041, Shandong, China.
authors.forename: D M
authors.initials: DM
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Weifang People's Hospital, Weifang 261041, Shandong, China.
authors.forename: H M
authors.initials: HM
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Weifang People's Hospital, Weifang 261041, Shandong, China.
authors.forename: H L
authors.initials: HL
authors.lastname: Gao
authors.affiliation: Department of Cardiovascular Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: R X
authors.initials: RX
authors.lastname: Wang
mesh_terms: D016063:Blood Loss, Surgical; D004210:Dissection / Q000009:adverse effects / Q000379:methods*; D004564:Electrocoagulation / Q000009:adverse effects; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D061646:Operative Time; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000601:surgery*; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects
keywords: Electrocautery; Gastrectomy; Gastric cancer; Lymphadenectomy; Meta-analysis; Ultrasonic dissection