OBJECTIVES : This study aims to investigate operative and economic outcomes of patients who underwent gastrectomy with ultrasonic surgical and electrosurgical system (USES group) versus conventional ultrasonic scalpel (CUS group) in real-world situation of China.

 

METHODS : This is a single center, retrospective study. The number of hemoclips, intraoperative blood loss, operative time and length of stay (LOS) between two groups were compared. Procedure-related costs including cost of hemoclips and hospitalization expense were estimated. Descriptive statistical analyses were conducted including T test, Chi-Square tests, Wilcoxon test and Fisher’s exact test.

 

RESULTS : Totally of 87 eligible patients were consecutively identified between January 2018 to June 2019, USES group (40 patients) and CUS group (47 patients). There was no difference in age (mean 58 vs.59 years), gender (30% vs.28.3% female), medical history and stages of cancer (Stage I 51.4%vs. 42.1%; Stage II 8.6 % vs. 21.1%; Stage III 31.4% vs. 28.9%; Stage IV 8.6% vs. 7.9%) between USES group and CUS group. The number of hemoclips in USES group compared with CUS group was significantly decreased (19.0±5.9 vs. 23.4±7.8, P=0.004), and intraoperative blood loss also was significantly lower (61.6±31.0ml vs.103.6±57.8ml, P<0.001). Whereas operative time was shorter (184.5±60.2 vs. 205.0±62.5 minutes, P=0.124) and the identified shorter LOS (13.4±3.6 vs 14.1±4.0 days, P=0.347) in USES group, the differences were not significant. The USES also had lower procedure-related cost due to less hemoclips and shorter LOS, which totally saved 3,287.7 RMB. No postoperative severe adverse events were reported.

 

CONCLUSIONS : Compared with the CUS, the USES was feasible with fewer hemoclips and decreased intraoperative blood loss in treating patients undergoing gastrectomy. Though the cost of USES is 2,000 RMB higher than CUS, it can result in less operative time and shorter LOS as well as lower procedure-related medical costs, which led to total cost saving 1,287.7 RMB.