Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy
Identifieur interne : 000C88 ( Pmc/Curation ); précédent : 000C87; suivant : 000C89Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy
Auteurs : Olivier Gié ; Marie-Laure Matthey-Gié ; Pedro-Manuel Marques-Vidal ; Nicolas Demartines ; Maurice MatterSource :
- BMC Surgery [ 1471-2482 ] ; 2017.
Abstract
Seroma formation and lymphoedema are frequently encountered complications after radical lymph node dissection (RLND). Attempts to reduce the lymphatic morbidity include the use of Ultrasonic Scalpel. The aim of the present analysis was to assess the impact of the ultrasonic scalpel on the amount of drained lymph after lymph node dissection.
Patients listed for a RLND or completion lymph node dissection (CLND) were enrolled in a prospective randomized trial to compare the impact of two surgical dissection techniques (USS versus control) on the amount of drained lymph. The lymph drained in 24 h was collected. Our primary endpoint was to compare the daily amount of drained lymph between the two groups. Secondary endpoints were the comparison of drained lymph with the BMI of the patients, the gender and the surgical site (axilla, groin).
Eighty patients were randomly assigned to the USS group or the Control (C) group. No difference was measured in the total amount of lymph drained (USS: 2908 ± 2453 ml vs. C: 3898 ± 5791 ml;
The study suggests that the use of Harmonic scalpel did not influence the amount of lymph drained after RLND and not support the theory that USS induces oversealing of lymphatics.
Clinical Trial
Url:
DOI: 10.1186/s12893-017-0222-1
PubMed: 28327108
PubMed Central: 5360050
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy</title><author><name sortKey="Gie, Olivier" sort="Gie, Olivier" uniqKey="Gie O" first="Olivier" last="Gié">Olivier Gié</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Matthey Gie, Marie Laure" sort="Matthey Gie, Marie Laure" uniqKey="Matthey Gie M" first="Marie-Laure" last="Matthey-Gié">Marie-Laure Matthey-Gié</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Marques Vidal, Pedro Manuel" sort="Marques Vidal, Pedro Manuel" uniqKey="Marques Vidal P" first="Pedro-Manuel" last="Marques-Vidal">Pedro-Manuel Marques-Vidal</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28327108</idno><idno type="pmc">5360050</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360050</idno><idno type="RBID">PMC:5360050</idno><idno type="doi">10.1186/s12893-017-0222-1</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000C89</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000C89</idno><idno type="wicri:Area/Pmc/Curation">000C88</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000C88</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy</title><author><name sortKey="Gie, Olivier" sort="Gie, Olivier" uniqKey="Gie O" first="Olivier" last="Gié">Olivier Gié</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Matthey Gie, Marie Laure" sort="Matthey Gie, Marie Laure" uniqKey="Matthey Gie M" first="Marie-Laure" last="Matthey-Gié">Marie-Laure Matthey-Gié</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Marques Vidal, Pedro Manuel" sort="Marques Vidal, Pedro Manuel" uniqKey="Marques Vidal P" first="Pedro-Manuel" last="Marques-Vidal">Pedro-Manuel Marques-Vidal</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">BMC Surgery</title><idno type="eISSN">1471-2482</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Seroma formation and lymphoedema are frequently encountered complications after radical lymph node dissection (RLND). Attempts to reduce the lymphatic morbidity include the use of Ultrasonic Scalpel. The aim of the present analysis was to assess the impact of the ultrasonic scalpel on the amount of drained lymph after lymph node dissection.</p></sec><sec><title>Methods</title><p>Patients listed for a RLND or completion lymph node dissection (CLND) were enrolled in a prospective randomized trial to compare the impact of two surgical dissection techniques (USS versus control) on the amount of drained lymph. The lymph drained in 24 h was collected. Our primary endpoint was to compare the daily amount of drained lymph between the two groups. Secondary endpoints were the comparison of drained lymph with the BMI of the patients, the gender and the surgical site (axilla, groin).</p></sec><sec><title>Results</title><p>Eighty patients were randomly assigned to the USS group or the Control (C) group. No difference was measured in the total amount of lymph drained (USS: 2908 ± 2453 ml vs. C: 3898 ± 5791 ml; <italic>p</italic>-value = 0.382). The result was also similar after adjusting for gender, age, and BMI. A significant higher amount of lymph was measured after inguinal dissection with USS compared to axillary (<italic>p</italic> < 0.001).</p></sec><sec><title>Conclusion</title><p>The study suggests that the use of Harmonic scalpel did not influence the amount of lymph drained after RLND and not support the theory that USS induces oversealing of lymphatics.</p></sec><sec><title>Trial registration</title><p>Clinical Trial <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/results?term=02476357&pg=1">NCT02476357</ext-link>. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Surg</journal-id><journal-id journal-id-type="iso-abbrev">BMC Surg</journal-id><journal-title-group><journal-title>BMC Surgery</journal-title></journal-title-group><issn pub-type="epub">1471-2482</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28327108</article-id><article-id pub-id-type="pmc">5360050</article-id><article-id pub-id-type="publisher-id">222</article-id><article-id pub-id-type="doi">10.1186/s12893-017-0222-1</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Gié</surname><given-names>Olivier</given-names></name><address><email>olivier.gie@chuv.ch</email><uri>http://www.chirurgieviscerale.ch</uri></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Matthey-Gié</surname><given-names>Marie-Laure</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Marques-Vidal</surname><given-names>Pedro-Manuel</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Demartines</surname><given-names>Nicolas</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Matter</surname><given-names>Maurice</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0423 4662</institution-id><institution-id institution-id-type="GRID">grid.8515.9</institution-id><institution>Department of Visceral Surgery,</institution><institution>University Hospital of Lausanne,</institution></institution-wrap>Rue du Bugnon 46, Lausanne, CHUV 1011 Switzerland</aff></contrib-group><pub-date pub-type="epub"><day>21</day><month>3</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>21</day><month>3</month><year>2017</year></pub-date><pub-date pub-type="collection"><year>2017</year></pub-date><volume>17</volume><elocation-id>27</elocation-id><history><date date-type="received"><day>27</day><month>10</month><year>2016</year></date><date date-type="accepted"><day>10</day><month>3</month><year>2017</year></date></history><permissions><copyright-statement>© The Author(s). 2017</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Seroma formation and lymphoedema are frequently encountered complications after radical lymph node dissection (RLND). Attempts to reduce the lymphatic morbidity include the use of Ultrasonic Scalpel. The aim of the present analysis was to assess the impact of the ultrasonic scalpel on the amount of drained lymph after lymph node dissection.</p></sec><sec><title>Methods</title><p>Patients listed for a RLND or completion lymph node dissection (CLND) were enrolled in a prospective randomized trial to compare the impact of two surgical dissection techniques (USS versus control) on the amount of drained lymph. The lymph drained in 24 h was collected. Our primary endpoint was to compare the daily amount of drained lymph between the two groups. Secondary endpoints were the comparison of drained lymph with the BMI of the patients, the gender and the surgical site (axilla, groin).</p></sec><sec><title>Results</title><p>Eighty patients were randomly assigned to the USS group or the Control (C) group. No difference was measured in the total amount of lymph drained (USS: 2908 ± 2453 ml vs. C: 3898 ± 5791 ml; <italic>p</italic>-value = 0.382). The result was also similar after adjusting for gender, age, and BMI. A significant higher amount of lymph was measured after inguinal dissection with USS compared to axillary (<italic>p</italic> < 0.001).</p></sec><sec><title>Conclusion</title><p>The study suggests that the use of Harmonic scalpel did not influence the amount of lymph drained after RLND and not support the theory that USS induces oversealing of lymphatics.</p></sec><sec><title>Trial registration</title><p>Clinical Trial <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/results?term=02476357&pg=1">NCT02476357</ext-link>. Registered 20 of February 2015.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Lymphatics</kwd><kwd>Radical lymph node dissection</kwd><kwd>Surgical morbidity</kwd><kwd>Harmonic scalpel</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2017</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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