Cargando…

Impact of the Cusa and Operative Ultrasound on Hepatic Resection

New technologies have been developed for liver surgery, and, like all new technologies, they have a glamour which makes them seem desirable. There is an understanding abroad that they make liver surgery easier and open up the field to those without special training. But there is no proof that the ne...

Descripción completa

Detalles Bibliográficos
Autores principales: Little, J. M., Hollands, M. J.
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 1991
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423610/
https://www.ncbi.nlm.nih.gov/pubmed/1859801
http://dx.doi.org/10.1155/1991/62986
_version_ 1782156143106195456
author Little, J. M.
Hollands, M. J.
author_facet Little, J. M.
Hollands, M. J.
author_sort Little, J. M.
collection PubMed
description New technologies have been developed for liver surgery, and, like all new technologies, they have a glamour which makes them seem desirable. There is an understanding abroad that they make liver surgery easier and open up the field to those without special training. But there is no proof that the new devices are in any way cost-effective, and certainly no proof that liver surgery has become safer since their advent. Fifty consecutive elective liver resections have been studied, almost half performed with the aid of the ultrasonic dissector and aspirator and diagnostic intraoperative ultrasound. There was no mortality in the whole group, but a 24% morbidity. Operative diagnostic ultrasound was thought to allow more precise planning of surgery. Its use was not associated with any increase in operative time, nor was there any increase in postoperative morbidity. The ultrasonic dissector and aspirator improved technique, reflected in a lower blood loss for each case, in fewer transfusions required, in a shorter postoperative hospital stay and in an ability to achieve these benefits in older patients. Neither device could be said to offer an entree to instant liver surgery. The use of the two devices apparently offered savings measured by a fall in the median postoperative hospital stay of 4.5 days, by a saving of 700 mls in median blood requirement and by a fall in transfusion rate from 64% to 9%.
format Text
id pubmed-2423610
institution National Center for Biotechnology Information
language English
publishDate 1991
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-24236102008-07-08 Impact of the Cusa and Operative Ultrasound on Hepatic Resection Little, J. M. Hollands, M. J. HPB Surg Research Article New technologies have been developed for liver surgery, and, like all new technologies, they have a glamour which makes them seem desirable. There is an understanding abroad that they make liver surgery easier and open up the field to those without special training. But there is no proof that the new devices are in any way cost-effective, and certainly no proof that liver surgery has become safer since their advent. Fifty consecutive elective liver resections have been studied, almost half performed with the aid of the ultrasonic dissector and aspirator and diagnostic intraoperative ultrasound. There was no mortality in the whole group, but a 24% morbidity. Operative diagnostic ultrasound was thought to allow more precise planning of surgery. Its use was not associated with any increase in operative time, nor was there any increase in postoperative morbidity. The ultrasonic dissector and aspirator improved technique, reflected in a lower blood loss for each case, in fewer transfusions required, in a shorter postoperative hospital stay and in an ability to achieve these benefits in older patients. Neither device could be said to offer an entree to instant liver surgery. The use of the two devices apparently offered savings measured by a fall in the median postoperative hospital stay of 4.5 days, by a saving of 700 mls in median blood requirement and by a fall in transfusion rate from 64% to 9%. Hindawi Publishing Corporation 1991 /pmc/articles/PMC2423610/ /pubmed/1859801 http://dx.doi.org/10.1155/1991/62986 Text en Copyright © 1991 Hindawi Publishing Corporation. http://creativecommons.org/licenses/by/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Little, J. M.
Hollands, M. J.
Impact of the Cusa and Operative Ultrasound on Hepatic Resection
title Impact of the Cusa and Operative Ultrasound on Hepatic Resection
title_full Impact of the Cusa and Operative Ultrasound on Hepatic Resection
title_fullStr Impact of the Cusa and Operative Ultrasound on Hepatic Resection
title_full_unstemmed Impact of the Cusa and Operative Ultrasound on Hepatic Resection
title_short Impact of the Cusa and Operative Ultrasound on Hepatic Resection
title_sort impact of the cusa and operative ultrasound on hepatic resection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423610/
https://www.ncbi.nlm.nih.gov/pubmed/1859801
http://dx.doi.org/10.1155/1991/62986
work_keys_str_mv AT littlejm impactofthecusaandoperativeultrasoundonhepaticresection
AT hollandsmj impactofthecusaandoperativeultrasoundonhepaticresection