Ultrasonic versus standard electric dissection in laparoscopic colorectal surgery: a prospective randomized clinical trial.

Abstract:

OBJECTIVE:To assess the safety and efficacy of the ultrasonic dissection (UC) compared with standard electrosurgery (ES) in laparoscopic colorectal surgery. BACKGROUND DATA:High-frequency ultrasound energy was introduced in laparoscopic surgery to improve dissection and coagulation. Very limited data have been published on its use in laparoscopic colorectal surgery. METHODS:Patients eligible for elective laparoscopic right or left hemicolectomy (RH and LH), sigmoidectomy (SG), or low anterior resection (LAR) were randomized to either UC or ES. The following data were collected and analyzed: preoperative data (individual patient data, indication for surgery), intraoperative data (conversion to open surgery, conversion ES to UC, operative time, blood loss, complication rate), and postoperative data (morbidity and mortality, volume of drainage, hospital stay). RESULTS:Between January 2002 and December 2003, 171 patients underwent elective laparoscopic colorectal resection. Twenty-5 patients did not satisfy the inclusion criteria and were excluded. The diagnosis of the remaining 146 patients was diverticulitis (44), colonic adenoma (31), adenocarcinoma (70), or epidermoid carcinoma (1). These patients underwent laparoscopic RH (28), LH (31), SG (47), or LAR (40). There were no differences in preoperative data. The overall conversion rate to open surgery was 11.6%, with no differences between the two groups; 20.8% undergoing ES were converted to UC, more frequently during right hemicolectomy or low anterior resection. Operative time, the primary endpoint of this study, did not differ between the two groups: UC 93 minutes versus ES 102.6 minutes (P = 0.46). Intraoperative blood loss was significantly less in UC 140.8 mL versus ES 182.6 mL (P = 0.032). No differences were observed in postoperative morbidity or other preoperative or postoperative parameters. CONCLUSIONS:UC is a useful device in laparoscopic colorectal surgery that facilitates completion of difficult cases and reduces intraoperative blood loss. Nevertheless, the majority of laparoscopic procedures can be completed with ES. Therefore, selective use of UC appears to be the most cost-effective policy.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Morino M,Rimonda R,Allaix ME,Giraudo G,Garrone C

doi

10.1097/01.sla.0000189607.38763.c5

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

897-901, discussion 901

issue

6

eissn

0003-4932

issn

1528-1140

pii

00000658-200512000-00017

journal_volume

242

pub_type

杂志文章,随机对照试验
  • Assessment of the amylase--creatinine clearance ratio in postoperative patients.

    abstract::The value of the amylase--creatinine clearance ratio (ACCR) in the diagnosis of postoperative pancreatitis was prospectively assessed. In 77 patients undergoing operations known to have a significant incidence of postoperative pancreatitis (gastric, biliary or pancreatic) i.e. "high risk" group, the ACCR was abnormall...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198008000-00011

    authors: Leckie PA,Ferreira P,Debas HT

    更新日期:1980-08-01 00:00:00

  • The spectrum of portal vein thrombosis in liver transplantation.

    abstract::Thrombosis of the portal vein with or without patency of its tributaries used to be a contraindication to orthotopic liver transplantation (OLTX) until quite recently. Rapid progress in the surgical technique of OLTX in the last few years has demonstrated that most patients with portal vein thrombosis can be safely an...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199103000-00003

    authors: Stieber AC,Zetti G,Todo S,Tzakis AG,Fung JJ,Marino I,Casavilla A,Selby RR,Starzl TE

    更新日期:1991-03-01 00:00:00

  • Technical refinements and results in full-right full-left splitting of the deceased donor liver.

    abstract:OBJECTIVE:Splitting of the liver at the line of Cantlie of otherwise healthy people is accepted worldwide as a reasonable procedure for the donors in adult living donor liver transplantation. A similar operation is still considered as experimental if performed in the deceased donor liver. The aim of this study is to ev...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000189120.62975.0d

    authors: Broering DC,Wilms C,Lenk C,Schulte am Esch J 2nd,Schönherr S,Mueller L,Kim JS,Helmke K,Burdelski M,Rogiers X

    更新日期:2005-12-01 00:00:00

  • Functional and Cognitive Decline Among Older Adults After High-Risk Surgery.

    abstract:OBJECTIVE:The aim of this study was to determine whether older adults are at higher risk of lasting functional and cognitive decline after surgery, and the impact of decline on survival and healthcare use. SUMMARY BACKGROUND DATA:Patient-centered outcomes after surgery are poorly characterized. METHODS:Using data fro...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003950

    authors: Suwanabol PA,Li Y,Abrahamse P,De Roo AC,Vu JV,Silveira MJ,Mody L,Dimick JB

    更新日期:2020-05-11 00:00:00

  • Defining "the elderly" undergoing major gastrointestinal resections: receiver operating characteristic analysis of a large ACS-NSQIP cohort.

    abstract:OBJECTIVE:"The elderly" is an often used but poorly defined descriptor of surgical patients. Investigators have used varying subjectively determined age cutoffs to report outcomes in the elderly. We set out to use objective outcomes data to determine the "at-risk" elderly population. METHODS: PATIENTS:129,331 patient...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182a196d8

    authors: Kurian AA,Wang L,Grunkemeier G,Bhayani NH,Swanström LL

    更新日期:2013-09-01 00:00:00

  • Quality of life after Brooke ileostomy and ileal pouch-anal anastomosis. Comparison of performance status.

    abstract::Although the clinical results of Brooke ileostomy are good, patients are permanently incontinent of stool and gas. Alternative operations designed to restore enteric continence, such as ileal pouch-anal anastomosis, must not only be as safe and effective as Brooke ileostomy, but should provide an improved quality of l...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198905000-00015

    authors: Pemberton JH,Phillips SF,Ready RR,Zinsmeister AR,Beahrs OH

    更新日期:1989-05-01 00:00:00

  • Pancreatectomy in multiple endocrine neoplasia type 1-related gastrinomas and pancreatic endocrine neoplasias.

    abstract:OBJECTIVE:The aim of this study was to evaluate the results of pancreatic resection in pancreatic endocrine neoplasias (PENs) in patients affected by multiple endocrine neoplasia type 1 (MEN1) syndrome. BACKGROUND:Since these tumors often show an indolent course, the role of diagnostic procedures and type of surgical ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000218073.77254.62

    authors: Tonelli F,Fratini G,Nesi G,Tommasi MS,Batignani G,Falchetti A,Brandi ML

    更新日期:2006-07-01 00:00:00

  • Use of transcutaneous oxygen sensors to titrate PEEP.

    abstract::The relationship of transcutaneous oxygen tension (PtcO2) to arterial oxygen tension (PaO2), pulmonary shunt (Qsp/Qt), mixed venous oxygen tension (PVO2), and O2 delivery was determined in patients with respiratory failure in order to explore the possible usefulness of PtcO2 to titrate the level of positive end expira...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198102000-00014

    authors: Tremper KK,Waxman K,Shoemaker WC

    更新日期:1981-02-01 00:00:00

  • Usefulness of selective arterial secretin injection test for localization of gastrinoma in the Zollinger-Ellison syndrome.

    abstract::Secretin was injected into a feeding or nonfeeding artery of a gastrinoma and blood samples were taken from the hepatic vein (HV) or a peripheral artery (PA) to measure the changes of serum immunoreactive gastrin concentration (IRG). The IRG in the HV rose within 40 seconds and in the PA rose within 60 seconds after t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198703000-00003

    authors: Imamura M,Takahashi K,Adachi H,Minematsu S,Shimada Y,Naito M,Suzuki T,Tobe T,Azuma T

    更新日期:1987-03-01 00:00:00

  • Gastrointestinal myoelectric and clinical patterns of recovery after laparotomy.

    abstract::The objective of this study was to define the patterns of myoelectric activity that occur throughout the gastrointestinal tract during normal recovery from laparotomy. Electrodes were placed on the stomach, jejunum, and transverse colon of 44 patients undergoing laparotomy. Basal electric rhythms in all areas showed n...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199006000-00018

    authors: Waldhausen JH,Shaffrey ME,Skenderis BS 2nd,Jones RS,Schirmer BD

    更新日期:1990-06-01 00:00:00

  • Cost-efficacy of cultured epidermal autografts in massive pediatric burns.

    abstract:OBJECTIVE:To assess the efficacy of cultured epidermal autografts (CEA) for closure of burn wounds in pediatric burn patients with full-thickness burns of more than 90% total body surface area. SUMMARY BACKGROUND DATA:Paucity of donor sites in massive burns makes the use of expanded skin of paramount importance. CEA t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200006000-00011

    authors: Barret JP,Wolf SE,Desai MH,Herndon DN

    更新日期:2000-06-01 00:00:00

  • Popliteal artery trauma. Systemic anticoagulation and intraoperative thrombolysis improves limb salvage.

    abstract:OBJECTIVE:This study was conducted to evaluate those factors associated with popliteal artery injury that influence amputation, with emphasis placed on those that the surgeon can control. SUMMARY BACKGROUND DATA:Generally accepted factors impacting amputation after popliteal artery injury include blunt trauma, prolong...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199705000-00009

    authors: Melton SM,Croce MA,Patton JH Jr,Pritchard FE,Minard G,Kudsk KA,Fabian TC

    更新日期:1997-05-01 00:00:00

  • Rational use of elemental and nonelemental diets in hospitalized patients.

    abstract::Study A included 30 patients who received immediate postoperative enteral feeding with a nonelemental diet. The nonelemental diet was well tolerated. Study patients rapidly achieved nitrogen equilibrium and had a cumulative nitrogen balance of -11.1 g verus -46.7 g for the control group. In part B, 16 patients with va...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198011000-00003

    authors: Fairfull-Smith R,Abunassar R,Freeman JB,Maroun JA

    更新日期:1980-11-01 00:00:00

  • The core competencies of James Marion Sims, MD.

    abstract::The concept of core competencies in graduate medical education was introduced by the Accreditation Council for Graduate Medical Education of the American Medical Association to semiquantitatively assess the professional performance of students, residents, practitioners, and faculty. Many aspects of the career of J. Ma...

    journal_title:Annals of surgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1097/SLA.0b013e318249ce3b

    authors: Straughn JM Jr,Gandy RE,Rodning CB

    更新日期:2012-07-01 00:00:00

  • Alterations in gut hormones after laparoscopic sleeve gastrectomy: a prospective clinical and laboratory investigational study.

    abstract:OBJECTIVE:To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on fasting and meal-stimulated release of the gut hormones ghrelin, pancreatic polypeptide (PP), peptide-YY (PYY), glucagon-like peptide-1 (GLP-1), and amylin and of the adipocytokine leptin. BACKGROUND:Mounting evidence suggests that the mechan...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31826e1846

    authors: Dimitriadis E,Daskalakis M,Kampa M,Peppe A,Papadakis JA,Melissas J

    更新日期:2013-04-01 00:00:00

  • A systematic proactive risk assessment of hazards in surgical wards: a quantitative study.

    abstract:OBJECTIVE:To identify and prioritize hazards in surgical wards and recommend interventions. BACKGROUND:Retrospective and prospective studies report the frequency and severity of surgical adverse events, but not in sufficient detail to allow interventions to be recommended in surgical wards. METHODS:Seventy hours of o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31824f5f36

    authors: Anderson O,Brodie A,Vincent CA,Hanna GB

    更新日期:2012-06-01 00:00:00

  • Long-term results with resection of radiation-induced soft tissue sarcomas.

    abstract:INTRODUCTION:Radiation therapy is increasingly used as adjuvant treatment of many childhood and adult malignancies. Radiation-induced sarcoma is a well recognized if uncommon event. The objective of this study is to determine the prevalence and long-term outcome for patients who develop radiation-induced sarcomas. MET...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000128686.51815.8b

    authors: Cha C,Antonescu CR,Quan ML,Maru S,Brennan MF

    更新日期:2004-06-01 00:00:00

  • Clinical experience with the use of a valve-bearing conduit to construct a second left ventricular outflow tract in cases of unresectable intra-ventricular obstruction.

    abstract::Two patients, ages 7 and 17, with unresectable obstructions within the left ventricular cavity, have been managed by interposing a conduit bearing a porcine aortic valve between the apex of the left ventricle and the infra-renal abdominal aorta. The younger child had idiopathic hypertrophic subaortic stenosis (IHSS) r...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197609000-00009

    authors: Dembitsky WP,Weldon CS

    更新日期:1976-09-01 00:00:00

  • Defining lower limb lymphedema after inguinal or ilio-inguinal dissection in patients with melanoma using classification and regression tree analysis.

    abstract:OBJECTIVE:This study aims to objectively define the criteria for assessing the presence of lymphedema and to report the prevalence of lymphedema after inguinal and ilio-inguinal (inguinal and pelvic) lymph node dissection for metastatic melanoma. SUMMARY BACKGROUND DATA:Lymphedema of the lower limb is a common problem...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31817ed7c3

    authors: Spillane AJ,Saw RP,Tucker M,Byth K,Thompson JF

    更新日期:2008-08-01 00:00:00

  • Subclassification of Microscopic Vascular Invasion in Hepatocellular Carcinoma.

    abstract:OBJECTIVE:To investigate whether subclassification of microscopic vascular invasion (MiVI) affects the long-term outcome after curative surgical resection or liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). SUMMARY OF BACKGROUND DATA:The most important factor for TNM staging in HCC is MiVI, ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003781

    authors: Kang I,Jang M,Lee JG,Han DH,Joo DJ,Kim KS,Kim MS,Choi JS,Kim SI,Park YN,Choi GH

    更新日期:2020-01-14 00:00:00

  • Infected aortic aneurysms. A changing entity.

    abstract::Infected (mycotic) aortic aneurysms are infrequent and, without surgical intervention, usually lead to uncontrolled sepsis or catastrophic hemorrhage. Symptoms are frequently absent or non-specific during the early stages, and a high index of suspicion is essential to make the diagnosis. Surgery performed after ruptur...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199205000-00005

    authors: Gomes MN,Choyke PL,Wallace RB

    更新日期:1992-05-01 00:00:00

  • Brochial stump closure techniques following pneumonectomy: A serial comparative study.

    abstract::Three methods of closing bronchial stumps were evaluated in 90 dogs undergoing left pneumonectomy:interrupted 3-0 silk sutures, interrupted 3-0 nylon sutures, and stapling with an automatic device. The dogs were sacrificed at 24 hours, 3, 5, 7, 10, and 14 days after pneumonectomy. Brochial stump leakage pressures and ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197608000-00012

    authors: Scott RN,Faraci RP,Hough A,Chretien PB

    更新日期:1976-08-01 00:00:00

  • Laparoscopic sphincter-preserving total mesorectal excision with colonic J-pouch reconstruction: five-year results.

    abstract:OBJECTIVE:To prospectively evaluate the oncologic and functional outcomes of laparoscopic total mesorectal excision (TME) with colonic J-pouch reconstruction. BACKGROUND:TME is considered the established gold standard in rectal cancer surgery. However, data on laparoscopic sphincter-preserving TME are limited. METHOD...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000202180.16723.03

    authors: Tsang WW,Chung CC,Kwok SY,Li MK

    更新日期:2006-03-01 00:00:00

  • Multivisceral transplantation for diffuse portomesenteric thrombosis.

    abstract:OBJECTIVE:To evaluate the clinical outcomes of multivisceral transplantation (MVT) in the setting of diffuse thrombosis of the portomesenteric venous system. BACKGROUND:Liver transplantation (LT) in the face of cirrhosis and diffuse portomesenteric thrombosis (PMT) is controversial and contraindicated in many transpla...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31825429c0

    authors: Vianna RM,Mangus RS,Kubal C,Fridell JA,Beduschi T,Tector AJ

    更新日期:2012-06-01 00:00:00

  • Longitudinal pancreaticojejunostomy in chronic relapsing pancreatitis with onset in childhood.

    abstract::Despite the rarity of chronic relapsing pancreatitis in children, in the last 15 years at Vanderbilt University Medical Center and its Children's Hospital we have used longitudinal pancreaticojejunostomy in treatment of eight patients whose symptoms began in childhood. Duration of symptoms ranged from 2 to 36 years. S...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198405000-00017

    authors: Scott HW Jr,Neblett WW,O'Neill JA Jr,Sawyers JL,Avant GS,Starnes VA

    更新日期:1984-05-01 00:00:00

  • Should adenocarcinoma of the esophagogastric junction be classified as esophageal cancer? A comparative analysis according to the seventh AJCC TNM classification.

    abstract:OBJECTIVE:The aim of this study was to evaluate the adequacy of esophageal classification for adenocarcinoma of the esophagogastric junction (AEJ) of the seventh American Joint Committee on Cancer (AJCC) TNM classification. BACKGROUND:The seventh AJCC TNM classification proposed the new classification for AEJ as a par...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31824beb95

    authors: Suh YS,Han DS,Kong SH,Lee HJ,Kim YT,Kim WH,Lee KU,Yang HK

    更新日期:2012-05-01 00:00:00

  • Growth-inhibitory effects of epidermal growth factor on human breast cancer and carcinoma of the esophagus transplanted into nude mice.

    abstract::The present work was performed to clarify the effects of epidermal growth factor (EGF) on the growth of human breast cancer and carcinoma of the esophagus. Human breast cancer MX-1, UM-1, and esophageal cancer ES-4 were transplanted to the subcutaneous tissue of nude mice. Human EGF (2 micrograms) was injected locally...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:

    authors: Murayama Y

    更新日期:1990-03-01 00:00:00

  • Long-term results of brachial thrombectomy following cardiac catheterization.

    abstract::The late results of brachial thrombectomy following cardiac catheterization were evaluated in 20 patients. All patients had a radial pulse present and no symptoms or signs of ischemia of the hand at the time of discharge from the hospital. Late evaluation of these 20 patients revealed 8 in whom the long-term results w...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197604000-00019

    authors: Nicholas GG,DeMuth WE Jr

    更新日期:1976-04-01 00:00:00

  • Reconstruction of the pharynx after resection for cancer. A comparison of methods.

    abstract::Repair of the pharynx after extirpation of malignancy may require the introduction of independently vascularized tissue either at the time of resection (primary reconstruction) or later for undesirable sequelae, such as fistula or stenosis. A ten-year retrospective study compares two methods of pharyngeal reconstructi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198905000-00007

    authors: Coleman JJ 3rd

    更新日期:1989-05-01 00:00:00

  • Impact of neoadjuvant chemoradiation on lymph node status in esophageal cancer: post hoc analysis of a randomized controlled trial.

    abstract:OBJECTIVE:The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. BACKGROUND:Pathological LN status is a major disease prognostic factor and marker...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000000991

    authors: Robb WB,Dahan L,Mornex F,Maillard E,Thomas PA,Meunier B,Boige V,Pezet D,Le Brun-Ly V,Bosset JF,Mabrut JY,Triboulet JP,Bedenne L,Seitz JF,Mariette C,Fédération Française de Cancérologie Digestive, Société Française de Radiot

    更新日期:2015-05-01 00:00:00