PDF(Pubmed)
Abstract：
BACKGROUND: Breast cancer is one of the most common malignancies in women. Hence, its treatment has become our utmost priority in developing countries like India. Modified radical mastectomy (MRM) has traditionally been used as the standard of care for early-stage invasive breast carcinoma and still is the most commonly used surgical treatment for carcinoma breast.
OBJECTIVE: The study compared the incidence of intraoperative and postoperative outcomes with skin flaps raised using a harmonic scalpel versus those raised using electrocautery.
METHODS: Sixty women with biopsy-proven breast cancer who had to undergo MRM were randomly assigned to undergo skin flap raising during mastectomy by using electrocautery or harmonic scalpel. Thirty patients had surgery with electrocautery (Group 1) and 30 with a harmonic scalpel (Group 2) by the same surgical team.
RESULTS: The mean operative time was significantly longer with harmonic scalpel when compared to that with electrocautery (140.67 ± 28.55 vs. 122.00 ± 19.16 mins, P =0.004). The amount of intraoperative blood loss (178.33 ± 21.06 vs 138.50 ± 28.53 mL P = 0.001) was less in the group operated with the harmonic scalpel, which was statistically significant. There was no significant difference between the groups regarding total drainage content (310.83 ± 88.93 vs 298.20 ± 127.87 mL, P = 0.659), drain duration (6.83 ± 0.75 vs 7.43 ± 2.27 days, p=0.174), seroma (3.3% vs. 0%) wound infection (3.3% vs 0%), flap necrosis (16.7% vs. 3.3%, P = 0.195), duration of hospital stays (8.57 ± 0.77 vs 8.43 ± 1.61 days, p=0.684).
CONCLUSIONS: Harmonic scalpels have a few advantages over electrocautery, but are not cost-effective.
OBJECTIVE: The study compared the incidence of intraoperative and postoperative outcomes with skin flaps raised using a harmonic scalpel versus those raised using electrocautery.
METHODS: Sixty women with biopsy-proven breast cancer who had to undergo MRM were randomly assigned to undergo skin flap raising during mastectomy by using electrocautery or harmonic scalpel. Thirty patients had surgery with electrocautery (Group 1) and 30 with a harmonic scalpel (Group 2) by the same surgical team.
RESULTS: The mean operative time was significantly longer with harmonic scalpel when compared to that with electrocautery (140.67 ± 28.55 vs. 122.00 ± 19.16 mins, P =0.004). The amount of intraoperative blood loss (178.33 ± 21.06 vs 138.50 ± 28.53 mL P = 0.001) was less in the group operated with the harmonic scalpel, which was statistically significant. There was no significant difference between the groups regarding total drainage content (310.83 ± 88.93 vs 298.20 ± 127.87 mL, P = 0.659), drain duration (6.83 ± 0.75 vs 7.43 ± 2.27 days, p=0.174), seroma (3.3% vs. 0%) wound infection (3.3% vs 0%), flap necrosis (16.7% vs. 3.3%, P = 0.195), duration of hospital stays (8.57 ± 0.77 vs 8.43 ± 1.61 days, p=0.684).
CONCLUSIONS: Harmonic scalpels have a few advantages over electrocautery, but are not cost-effective.
摘要：
背景：乳腺癌是女性最常见的恶性肿瘤之一。因此，在像印度这样的发展中国家，它的治疗已经成为我们的首要任务。传统上，改良根治术（MRM）已被用作早期浸润性乳腺癌的护理标准，并且仍然是乳腺癌最常用的手术治疗方法。
目的：该研究比较了使用谐波手术刀抬高皮瓣与使用电灼术抬高皮瓣的术中和术后结局的发生率。
方法：60例经活检证实的乳腺癌患者必须接受MRM，在乳房切除术期间随机分配使用电灼术或谐波手术刀进行皮瓣抬高。30例患者接受了电灼术（第1组）和30例谐波手术刀（第2组）的手术。
结果：与电刀相比，使用谐波手术刀的平均手术时间明显更长（140.67±28.55vs.122.00±19.16分钟，P=0.004)。使用谐波手术刀组的术中失血量（178.33±21.06vs138.50±28.53mLP=0.001）较少，具有统计学意义。两组之间的总排水量没有显着差异（310.83±88.93vs298.20±127.87mL，P=0.659),排水持续时间(6.83±0.75vs7.43±2.27天，p=0.174)，血清肿（3.3%vs.0%）伤口感染（3.3%vs0%），皮瓣坏死（16.7%vs.3.3%,P=0.195),住院时间（8.57±0.77vs8.43±1.61天，p=0.684）。
结论：谐波手术刀比电烧刀有一些优势，但不划算。
目的：该研究比较了使用谐波手术刀抬高皮瓣与使用电灼术抬高皮瓣的术中和术后结局的发生率。
方法：60例经活检证实的乳腺癌患者必须接受MRM，在乳房切除术期间随机分配使用电灼术或谐波手术刀进行皮瓣抬高。30例患者接受了电灼术（第1组）和30例谐波手术刀（第2组）的手术。
结果：与电刀相比，使用谐波手术刀的平均手术时间明显更长（140.67±28.55vs.122.00±19.16分钟，P=0.004)。使用谐波手术刀组的术中失血量（178.33±21.06vs138.50±28.53mLP=0.001）较少，具有统计学意义。两组之间的总排水量没有显着差异（310.83±88.93vs298.20±127.87mL，P=0.659),排水持续时间(6.83±0.75vs7.43±2.27天，p=0.174)，血清肿（3.3%vs.0%）伤口感染（3.3%vs0%），皮瓣坏死（16.7%vs.3.3%,P=0.195),住院时间（8.57±0.77vs8.43±1.61天，p=0.684）。
结论：谐波手术刀比电烧刀有一些优势，但不划算。
