The Advantages and Drawbacks of Harmonic Scalpel in the Surgery for Carcinoma of Uterine Cervix_West China Medical Journal

Authors：

 ChenMeng ,  WangXiaoli , WangJing

Department of Gynecology and Obstetrics, the Second People's Hospital of Chengdu, Chengdu, Sichuan 610017, P. R. China;

Corresponding?author：

WangXiaoli, Email: wangxiaoli.07@163.com

Keywords：

Carcinoma of uterine cervix; Harmonic scalpel; Conventional electro-scalpel

DOI：

10.7507/1002-0179.201600501

Video：

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Objective To compare the advantages and drawbacks of harmonic scalpel (HS) versus conventional electro-scalpel (ES) in the surgery for carcinoma of uterine cervix. Methods A total of 126 patients with stage Ⅰ uterine cervix carcinoma who underwent surgery between January 2011 and November 2015 were randomly and averagely divided into HS group and ES group with 63 patients in each. The operation time, intra-operative bleeding volume, the number of lymph nodes detected and operation cost were compared between the two groups of patients. Results All the patients underwent surgery successfully. There were significant differences between the HS and ES groups in terms of operation time[(202.06±11.67) minutes vs.(223.48±18.01) minutes, P<0.001], intra-operative bleeding[(373.97±27.95) mL vs.(458.16±33.18) mL, P<0.001], operation cost[(4 171.43±276.46) yuan vs.(3 101.54±258.59) yuan, P<0.001]. There was no significant difference between the two groups in terms of the number of lymph nodes detected (10.38±2.43 vs.9.76±2.61, P=0.172). Conclusion The use of harmonic scalpel can reduce operation time and intra-operative bleeding volume effectively, but it cannot increase the number of lymph nodes detected. Moreover, it significantly increases the operation cost and economic burden for the patients.

Citation： ChenMeng, WangXiaoli, WangJing. The Advantages and Drawbacks of Harmonic Scalpel in the Surgery for Carcinoma of Uterine Cervix. West China Medical Journal, 2016, 31(11): 1826-1828. doi: 10.7507/1002-0179.201600501 Copy

1.	高思蓉. 超聲刀在婦科惡性腫瘤根治術46例中的應用分析[J].南通大學學報:醫學版, 2014, 34(6):557-558.
2.	Gizzo S, Andrisani A, Ancona E, et al. Could Harmonic Scalpel (Ultracision^?) be considered the best device in surgicaltreatment of vulvar cancer of patients with implanted pace-maker? Proposal and rationale[J].Int J Clin Exp Med, 2015, 8(6):9805-9809.
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4.	Gizzo S, Saccardi C, Patrelli TS, et al. Magnetic resonance-guided focused ultrasound myomectomy:safety, efficacy, subsequent fertility and quality-of-life improvements, a systematic review[J].Reprod Sci, 2014, 21(4):465-476.
5.	鄭以秀, 曾月翠, 劉惠芬. 超聲刀在治療子宮內膜異位癥中的效果評價[J].中國腫瘤外科雜志, 2013, 5(4):242-244.
6.	張弋, 左緒磊, 童曉文. 超聲刀在42例婦科腹腔鏡手術中應用分析[J].同濟大學學報:醫學版, 2004, 25(1):51-53.
7.	梁志清, 徐惠成, 常青, 等. 腹腔鏡超聲刀在婦科惡性腫瘤淋巴結切除術中的應用[J].第三軍醫大學學報, 2001, 23(12):1466-1468.
8.	Gizzo S, Noventa M. Electrosurgical bipolar vessel sealing for vaginal hysterectomies:criticism of evidences from a meta-analysis[J].Arch Gynecol Obstet, 2014, 290(6):1045-1046.
9.	Litta P, Fantinato S, Calonaci F, et al. A randomized controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy[J].Fertil Steril, 2010, 94(5):1882-1886.
10.	Litta P, Saccardi C, Gizzo S, et al. Inflammatory cytokine expression following the use of bipolar electrocoagulation, ultracision harmonic scalpel and cold knife biopsy[J].Mol Med Rep, 2015, 12(2):2985-2990.
11.	Tirelli G, Del Piero GC, Perrino F. Ultracision Harmonic Scalpel in oral and oropharyngeal cancer resection[J].J Craniomaxillofac Surg, 2014, 42(5):544-547.
12.	Alkan M, Parlakgümü? C, Iskit SH, et al. Renal sparing surgery using focus ultracision harmonic scalpelin patients with bilateral wilms' tumor:case report[J].Balkan Med J, 2013, 30(3):318-320.
13.	喇端端, 劉延, 沈立翡, 等. 超聲止血刀在81例婦科腹腔鏡手術中的應用[J].中國實用婦科與產科雜志, 2000, 16(11):679-680.
14.	沈怡, 閔潔, 熊宙芳, 等. 超聲刀在腹腔鏡全子宮切除術中的應用[J].中國內鏡雜志, 2009, 15(10):1059-1061.
15.	蘇穎然, 張科靜. 腹腔鏡下行子宮頸癌根治術5例[J].河北聯合大學學報:醫學版, 2012, 14(3):365.

1. 高思蓉. 超聲刀在婦科惡性腫瘤根治術46例中的應用分析[J].南通大學學報:醫學版, 2014, 34(6):557-558.
2. Gizzo S, Andrisani A, Ancona E, et al. Could Harmonic Scalpel (Ultracision^?) be considered the best device in surgicaltreatment of vulvar cancer of patients with implanted pace-maker? Proposal and rationale[J].Int J Clin Exp Med, 2015, 8(6):9805-9809.
3. 李小梅, 彭國蘭. 超聲刀在婦科腹腔鏡手術中的應用價值研究[J].中國醫療前沿, 2013, 8(16):37, 103.
4. Gizzo S, Saccardi C, Patrelli TS, et al. Magnetic resonance-guided focused ultrasound myomectomy:safety, efficacy, subsequent fertility and quality-of-life improvements, a systematic review[J].Reprod Sci, 2014, 21(4):465-476.
5. 鄭以秀, 曾月翠, 劉惠芬. 超聲刀在治療子宮內膜異位癥中的效果評價[J].中國腫瘤外科雜志, 2013, 5(4):242-244.
6. 張弋, 左緒磊, 童曉文. 超聲刀在42例婦科腹腔鏡手術中應用分析[J].同濟大學學報:醫學版, 2004, 25(1):51-53.
7. 梁志清, 徐惠成, 常青, 等. 腹腔鏡超聲刀在婦科惡性腫瘤淋巴結切除術中的應用[J].第三軍醫大學學報, 2001, 23(12):1466-1468.
8. Gizzo S, Noventa M. Electrosurgical bipolar vessel sealing for vaginal hysterectomies:criticism of evidences from a meta-analysis[J].Arch Gynecol Obstet, 2014, 290(6):1045-1046.
9. Litta P, Fantinato S, Calonaci F, et al. A randomized controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy[J].Fertil Steril, 2010, 94(5):1882-1886.
10. Litta P, Saccardi C, Gizzo S, et al. Inflammatory cytokine expression following the use of bipolar electrocoagulation, ultracision harmonic scalpel and cold knife biopsy[J].Mol Med Rep, 2015, 12(2):2985-2990.
11. Tirelli G, Del Piero GC, Perrino F. Ultracision Harmonic Scalpel in oral and oropharyngeal cancer resection[J].J Craniomaxillofac Surg, 2014, 42(5):544-547.
12. Alkan M, Parlakgümü? C, Iskit SH, et al. Renal sparing surgery using focus ultracision harmonic scalpelin patients with bilateral wilms' tumor:case report[J].Balkan Med J, 2013, 30(3):318-320.
13. 喇端端, 劉延, 沈立翡, 等. 超聲止血刀在81例婦科腹腔鏡手術中的應用[J].中國實用婦科與產科雜志, 2000, 16(11):679-680.
14. 沈怡, 閔潔, 熊宙芳, 等. 超聲刀在腹腔鏡全子宮切除術中的應用[J].中國內鏡雜志, 2009, 15(10):1059-1061.
15. 蘇穎然, 張科靜. 腹腔鏡下行子宮頸癌根治術5例[J].河北聯合大學學報:醫學版, 2012, 14(3):365.

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West China Medical Journal

The Advantages and Drawbacks of Harmonic Scalpel in the Surgery for Carcinoma of Uterine Cervix

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