LigaSure和超声刀在Miccoli手术中的应用研究

目的 比较LigaSure血管闭合系统与超声刀在Miccoli手术中应用的手术时间和并发症.方法 回顾性分析上海交通大学附属第六人民医院普外科2007年1月至2011年12月期间684例行Miccoli术式患者的临床资料,其中应用LigaSure血管闭合系统者335例,应用超声刀完成手术者349例.对其平均手术时间及术后常见并发症(切口内血肿、一过性声音嘶哑、永久性喉返神经麻痹及低钙血症)进行对比.结果 所有684例患者中,有263例行甲状腺全切除术,421例行甲状腺腺叶切除术.使用超声刀者手术时间略短于使用LigaSure血管闭合系统,但二者比较差异无统计学意义(P＞0.05)；二者的术后常见并发症比较差异亦无统计学意义(P＞0.05).结论 LigaSure血管闭合系统和超声刀设备应用于甲状腺手术均是安全、可靠的,术者可根据手术习惯及医院配备选择应用手术器械.

Application of LigaSure Versus Harmonic Scalpel in Miccoli Thyroidectomy

Objective To compare the mean operative time and complications between the LigaSure device and Harmonic Scalpel during video-assisted endoscopic approaches thyroidectomy.Methods The clinical data of 684 cases performed Miccoli thyroidectomy by the same operation team from January 2007 to December 2011 in the department of general surgery,Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University were analyzed.Three hundred and forty-nine patients were used Harmonic Scalpel,335 patients were used LigaSure device.The mean operative time and complications(such as hematoma,transient hoarseness,permanent recurrent laryngeal nerve injury,and hypocalcemia) were compared between two groups.Results A total of 684 patients were included in the study,of whom 263 underwent total thyroidectomy and 421 underwent lobectomy.There were not significant differences of the operative time and the complications in both thyroidectomy and lobectomy between the LigaSure device and Harmonic Scalpel(P>0.05).Conclusions The uses of the LigaSure device and Harmonic Scalpel in thyroid surgery are safe and reliable,surgeons may choose surgical instruments by habits and medical equipments.