超声刀在经腹近端胃癌根治术中的应用

Application of ultrasonic harmonic scalpel in open radical gastrectomy of proximal gastric cancer

目的探讨超声刀在经腹近端胃癌根治术中的实用性和安全性。方法回顾性分析115例I～Ⅲ期近端胃癌行经腹近端胃癌根治术患者资料，其中65例术中使用超声刀，另50例采用传统方法，比较两组手术时间、手术中出血量、手术切口长度、术后并发症及住院时间。结果超声刀组与传统手术组手术时间分别为（126．9±20．7）min与（150．6±31．7）min（P〈0．05），术中出血量分别为（105．7±40．3）m1与（171．7±63．2）ml（P〈0．01），手术切口长度分别为（17．2±2．1）cm与（20．3±2．3）cm（P〈0．05）。两组术后并发症发生率差异无统计学意义，均顺利出院。结论经腹近端胃癌根治术中使用超声刀，可以节约手术时间，减少术中出血量，缩短手术切口，使用安全，具有一定的临床应用价值。

Objective To explore the practicability and security of the ultracision harmonic scalpel in radical gastrectomy for patients with proximal gastric cancer. Methods 115 patients of stage I - III proximal gastric cancer undergone radical gastrectomy were analyzed retrospectively. 65 patients were performed with ultracision harmonic scalpel, the other 50 patients were performed with conventional operation. The operative time, volume of intraoperative hemorrhage, length of incision, and postoperative complications were analyzed. Results There were significant difference in operative time（ 126.9 ± 20.7 ） min and （ 150.6 ± 31.7 ） min（ P 〈 0.05 ）, volume of intraoperative hemorrhage （105.7 ±40.3）ml and （171.7 ±63.2）ml（P 〈0.01） and length of incision（17.2 ±2.1）cm and （20.3 ±2.3）cm （P 〈 0.05）. There was no significant difference in the postoperative complications between ultracision harmonic scalpel group and conventional group. All patients recovered without severe complications. Conclusion Radical resection of proximal gastric cancer using ultracision harmonic scalpel could shorten operative time, decrease intraoperative hemorrhage, shorten incision length, and the technique is convenient and safe.