Ultrasonically activated shears can reduce estimated blood loss in open distal gastrectomy for gastric cancer: A randomized controlled study

Abstract

Introduction: Although UAS have been used increasingly in open gastric surgery, only a limited number of randomized controlled studies have evaluated its safety and efficacy for this procedure. In addition, these studies used only a small number of patients or did not control for the type of anastomosis or surgery. Methods: From October 2011 to November 2012, 56 gastric cancer patients eligible for open distal gastrectomy were randomized into a UAS dissection group (USD group) or a monopolar dissection group (MPD group

clinical trial registration number: NCT01971775). The primary endpoints were the estimated blood loss during surgery and amount of drainage through the 5th postoperative day. Secondary endpoints were operation time, hospital stay, serum laboratory results, inflammatory cytokine levels in the serum and peritoneal irrigation saline, cytology, and postoperative morbidity. Results: The demographics and pathologic parameters were similar in both groups. The estimated blood loss was lower in the USD group than that in the MPD group (339.8 cc vs. 428.6 cc, p = 0.021). However, the amount of postoperative drainage was not significantly different between the two groups. In terms of the secondary endpoints, no statistical differences were observed between the two groups. Conclusions: UAS can reduce blood loss and can be an alternative device for conventional monopolar electrocautery in open distal gastrectomy for gastric cancer.