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To Evaluate the Clinical Value of High-frequency Electrotome in Cervical Cancer and Endometrial Carcinoma

Author: ZhangHaiBo
Tutor: KangShan
School: Hebei Medical University
Course: Obstetrics and Gynaecology
Keywords: Laparoscope Monopolar hookelectrode instrument High-frequency electrotome Ultrasonic scalpel Pelvic lymph node Abdominalperiaortic lymph node Gynecologic malignancies
CLC: R737.33
Type: Master's thesis
Year: 2012
Downloads: 44
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Abstract


Objective: To evaluate the clinical value of High-frequency electrotome inCervical Cancer and endometrial carcinoma.Methods: From November2006to December2011, laparoscopic pelvicand/or abdominal periaortic lymph node dissection and hysterectomy on269patients was performed by two different instruments. One hundred andsixty-seven patients were selected to join the research as research group, whoreceived operation by high-frequency electrotome from November2006toNovember2010, including57patients with pelvic and abdominal periaorticlymph node dissection,110patients with pelvic ymph node dissection,89patients with radical hysterectomy and78patients with extrafascialhysterectomy. Another102patients were selected as control group, whoreceived operation by ultrasonic scalpel from November2010to December2011, including49patients with pelvic and abdominal periaortic lymph nodedissection,53patients with pelvic lymph node dissection,65patients withradical hysterectomy and37patients with extrafascial hysterectomy. In thefirst part of experiment, the data of pelvic and/or abdominal periaortic lymphnode dissection by monopolar hookelectrode instrument compare with the dataof pelvic and/or abdominal periaortic lymph node dissection by ultrasonicscalpel. In the second part of experiment, the data of radical hysterectomy byhigh-frequency electrotome compare with the data of radical hysterectomy byultrasonic scalpelResults:1Patient in research group was converted to laparotomy. The operationswere successful for other patients.(1) The data of lymph node dissection by monopolar hookelectrodeinstrument compare with the data of lymph node dissection by ultrasonic scalpel: The operating time for the abdominal periaortic lymph nodedissection of research group was22.68±3.59min(range18min~30min), andthat of control group was24.58±4.65min(range19min~34min). The operatingtime was no significant difference between them (P=0.43); the operating timeforthe pelvic lymph nodes dissection of research group was43.25±6.74min(range35min~55min), and that of control group was46.24±8.46min(range37min~59min). The operating time was no significant differrence betweenthem(P=0.38); The blood loss for the abdominal periaortic lymph nodedissection in operation of research group was14.30±5.26ml(range8ml~29ml),and that of control group was13.46±7.34ml(range10ml~32ml). The bloodloss was no significant difference between them(P=0.37); the blood loss forthe pelvic lymph nodes dissection in operation of research group was43.90±13.22ml(range23ml~67ml), and that of control group was42.89±14.31ml(range21ml~69ml). The blood loss was no significant differencebetween them (P=0.62); the numbers of the pelvic lymph nodes dissection inresearch group was15.13±3.68, and that for control group was16.32±5.13,and no significant difference(P=0.21) between two groups, The numbers ofthe abdominal periaortic lymph node dissection in research group was range2~5, and that of control group was range3~6.(2) The data of hysterectomy between two groups: the stay time ofpostoperative catheter a demeure for research group and control group were14.53±6.58day and15.68±2.34day respectively, and no significant differencebetween them(P=0.61); The stay time of postoperative catheter for two groupswas2day.(3) The data of the operating time of research group was210.40±67.39(range185min~395min), and that of control group was227±46.68min(range197min~401min). The operating time was no significant difference betweenthem(P=0.31); the blood loss in operation of research group was220.90±161.34ml(range45ml~680ml), and that of control group was218.10±179.41ml(range50ml~700ml). The blood loss was no significant differencebetween them(P=0.29); the time of exhaust for research group and control group were60.53±0.57h and63.24±5.29h, there was no significant differencebetween them(P=0.76); the length of postoperative hospitalization for researchgroup and control group were9.29±3.34day and10.00±4.24day respectively,and the difference was no significant between two groups(P=0.89); complic-ations of lymph node resection:3cases of lymphocyst,1case of nephrydrosisin research group. Three cases of lymphocyst,1case of nephrydrosis in controlgroup. Complications of radical hysterectomy:4cases of ureteral fistula,1case of bladder fistula in research group;1case of ureteral fistula in controlgroup. Complications of total operation: the intestinal obstruction for researchgroup and control group were2cases and1cases respectively. The postop-erative complications were11cases and7cases for research groups andcontrol group respectively, no significant difference between them (P=0.45).Conclusion: Monopolar hookelectrode instrument is a good device forreducing blood loss and operative injury durning laparoscopic operation. Theuse of monopolar hookelectrode instrument in laparoscopic pelvic orabdominal periaortic lymph node dissection possesses the advantages ofconvenience, inexpensive, better homostasis, shorter operation time, easy Tomaster, and fewer operation complications. It is safe, feasible, effective andreliab le for laparoscopic.

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CLC: > Medicine, health > Oncology > Genitourinary tumors > Female genital tumors > Uterine tumors
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