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. 超声刀在妇科恶性肿瘤根治术46例中的应用分析[J].南通大学学报:医学版, 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, 彭国兰. 超声刀在妇科腹腔镜手术中的应用价值研究[J].中国医疗前沿, 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.	郑以秀, 曾月翠, 刘惠芬. 超声刀在治疗子宫内膜异位症中的效果评价[J].中国肿瘤外科杂志, 2013, 5(4):242-244.
6.	张弋, 左绪磊, 童晓文. 超声刀在42例妇科腹腔镜手术中应用分析[J].同济大学学报:医学版, 2004, 25(1):51-53.
7.	梁志清, 徐惠成, 常青, 等. 腹腔镜超声刀在妇科恶性肿瘤淋巴结切除术中的应用[J].第三军医大学学报, 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, Parlakgümüş 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, 刘延, 沈立翡, 等. 超声止血刀在81例妇科腹腔镜手术中的应用[J].中国实用妇科与产科杂志, 2000, 16(11):679-680.
14.	沈怡, 闵洁, 熊宙芳, 等. 超声刀在腹腔镜全子宫切除术中的应用[J].中国内镜杂志, 2009, 15(10):1059-1061.
15.	苏颖然, 张科静. 腹腔镜下行子宫颈癌根治术5例[J].河北联合大学学报:医学版, 2012, 14(3):365.

1. 高思蓉. 超声刀在妇科恶性肿瘤根治术46例中的应用分析[J].南通大学学报:医学版, 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, 彭国兰. 超声刀在妇科腹腔镜手术中的应用价值研究[J].中国医疗前沿, 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. 郑以秀, 曾月翠, 刘惠芬. 超声刀在治疗子宫内膜异位症中的效果评价[J].中国肿瘤外科杂志, 2013, 5(4):242-244.
6. 张弋, 左绪磊, 童晓文. 超声刀在42例妇科腹腔镜手术中应用分析[J].同济大学学报:医学版, 2004, 25(1):51-53.
7. 梁志清, 徐惠成, 常青, 等. 腹腔镜超声刀在妇科恶性肿瘤淋巴结切除术中的应用[J].第三军医大学学报, 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, Parlakgümüş 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, 刘延, 沈立翡, 等. 超声止血刀在81例妇科腹腔镜手术中的应用[J].中国实用妇科与产科杂志, 2000, 16(11):679-680.
14. 沈怡, 闵洁, 熊宙芳, 等. 超声刀在腹腔镜全子宫切除术中的应用[J].中国内镜杂志, 2009, 15(10):1059-1061.
15. 苏颖然, 张科静. 腹腔镜下行子宫颈癌根治术5例[J].河北联合大学学报:医学版, 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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