Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques

Cheng, Hongbo; Hsiao, Chia‐Wen; Clymer, Jeffrey W.; Schwiers, Michael; Tibensky, Bryanna N.; Patel, Leena; Ferko, Nicole; Chekan, Edward

doi:10.1155/2015/397260

Cited by 24 publications

(32 citation statements)

References 29 publications

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“…The amount of blood lost during surgery is directly correlated with the type of gastrectomy, extent of lymph node dissection, or combined resection of other organs; however, an inappropriate surgical maneuver such as dissection of an incorrect layer or injury to adjacent organs is also an important factor. To reduce the amount of blood lost during surgery, meticulous and careful surgical maneuvers are considered critical, and use of surgical devices such as ultrasonically activated devices [12] or vessel sealing systems [13] also helps.…”

Section: Discussionmentioning

confidence: 99%

Impact of Gastric Cancer Surgery in Elderly Patients

Wakahara

Ueno²,

Maeda³

et al. 2017

Oncology

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Objectives: This study aimed to investigate the validity of gastric cancer surgery in elderly patients. Methods: A total of 544 patients who underwent elective gastrectomy for gastric cancer were divided into an elderly group (age ≥75 years, n = 171) and a control group (age <75 years, n = 373). The clinicopathological data of the patients were reviewed. Results: The overall morbidity rate (26.3 vs. 16.1%, p = 0.005) and the incidence rate of anastomotic leakage (6.4 vs. 1.6%, p = 0.003) were significantly higher in the elderly group. The proportion of patients who had severe complications (≥grade IIIa) was relatively higher in the elderly group (10.5 vs. 5.7%); however, the difference was not significant (p = 0.074). A stage-matched survival analysis revealed no significant differences between the groups (stage I: p = 0.978; stage II: p = 0.964; stage III: p = 0.199). For the pathological stages II and III, the overall survival of the patients in the elderly group who received adjuvant chemotherapy for >3 months was significantly better than that of the patients who received it for ≤3 months or did not receive it (p = 0.023). Conclusions: An aggressive treatment strategy should be adopted in selected elderly patients with gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Impact of Gastric Cancer Surgery in Elderly Patients

Wakahara

Ueno²,

Maeda³

et al. 2017

Oncology

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“…Finally the most recent study is done few year earlier by Blanchard et al, they use 25 patients during this study 11 male and 14 female were included , female and male were of equal age [14] . They found the operative time as (-18.7 min, p<0.001) [15] .…”

Section: Discussionmentioning

confidence: 98%

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

2019

JMPB

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Objective: The basic aim of this study is to find out comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy.Methodology: This randomized control trial was conducted in Surgery Department, Bahawal Victoria Hospital Bahawalpur. This study was completed in 5 months (August 2018 to January 2019) and all the patients under trial were asked for informed consent. A total number of 100% (n=62) were taken in this trial and online source Openepi.com was used for calculating sample size. Patients were selected by lottery method. Computer software SPSS version 23.2 was used for complete data entry and analysis. All the descriptive variables like onset of action and age were presented as SD and mean. Statistical test ANOVA was applied to find the significance among all groups. Chi square test was applied for analysis of continuous stats among groups. P value 0.05 was to be considered as significant.Result: A total number of 100% (n=62) patients were included, divided into two equal groups, 31 in each i.e. harmonic scalpel and conventional knot groups. The mean age of the patients, in harmonic scalpel group, was 45.29±4.56 years. There were 64.5% (n=20) males and 35.5% (n=11) females. The mean age of the patients, in conventional knot, was 44.96±2.97 years. There were 74.2% (n=23) males and 25.8% (n=8) females. No significant difference was found for age (t=0.329, p=0.743) and gender (χ 2 =0.683, p=0.409) in groups. The main outcome variables of this study were the time of procedure (minutes) and blood loss volume (ml). The mean time of procedure was 98.80±16.52minutes and 119.81±9.95 minutes for the harmonic scalpel and conventional knot groups respectively. Significant difference was found for the time of procedure in groups (t=-6.060, p-value = 0.000). Conclusion:The whole study can be ended with this conclusion that the harmonic scalpel is more effective than the conventional method of ligation or knotting in thyroidectomy. Its use offer many clinical benefits including reduction in time of surgery and blood volume as well. Introduction:The description about the thyroid gland is very prehistoric' for the first time it was name as "shield shape gland" by the Romans [1] . In the literature during 12 th or 13 th century not only the thyroid masses were mentioned but in 1170 Robert Frugard explained the complication of goiter. Thyroid surgery was begun in 12 th century by using hot iron, Setons and caustics powers (most results were fatal).At that time, the major advancement was, antisepsis, artery forceps and anesthesia to be practice [2] .The pioneers of thyroid surgery, Theodor Koches and Theodor Billroth, formulated many acceptable techniques of thyroid surgery between the year 1873 and 1883 [3] . In conventional method knot tying and ligation were important process. The very important thing of this operation is that the thyroid gland is one of the highly vascularized among all the organs having rich blood vessels and plexuses present in the parenchyma. This needs to be controlle...

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“…Likewise in pancreatic surgery, Harmonic dissection is associated with lower rates of pancreatic fistula and abdominal abscess [6,7]. In dissection during D2 lymphadenectomy following gastrectomy, Harmonic technology reduced operative time, blood loss and drainage volume [8]. Finally, Harmonic is particularly valuable in dissection near nerves, where electrosurgery has been shown to cause nerve damage, yet the use of Harmonic is no more injurious than cold scalpel [9,10].…”

Section: Discussionmentioning

confidence: 99%

Superior Dissecting Capability of A New Ultrasonic Device Improves Efficiency and Reduces Adhesion Formation

Welling¹,

Scoggins²,

Cummings³

et al. 2017

Glob Surg

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Background: Over the last two decades use of ultrasonic shears has grown in complex surgery where both precise dissection and meticulous hemostasis is required. With the introduction of HARMONIC® HD 1000i Shears (HD1000i), surgeons can now depend upon a single instrument to perform minimally-invasive dissection while securely sealing vessels up to and including 7 mm in diameter. This study was performed to compare HD1000i to the previous version of the device (HAR7) in sealing, dissecting and adhesion formation.

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Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques

Cited by 24 publications

References 29 publications

Impact of Gastric Cancer Surgery in Elderly Patients

Impact of Gastric Cancer Surgery in Elderly Patients

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

Superior Dissecting Capability of A New Ultrasonic Device Improves Efficiency and Reduces Adhesion Formation

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