Harmonic scalpel versus traditional scissors in laparoscopic partial nephrectomy: A propensity score-based analysis

Abstract

ObjectiveThe present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor. MethodsA retrospective review was conducted in patients with localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019. Eventually, 225 patients joined this retrospective study. Patients were divided into the harmonic scalpel group or scissor group based on the method used, with 71 cases and 154 cases respectively. Propensity score matching (1:1) was performed to adjust for potential baseline confounders, and each group had 57 cases. Patient characteristics, perioperative clinical results, complications, and oncological results were compared between the two groups. ResultsAfter matching, patient characteristics were not significantly different between the two groups. The scissor group was associated with a significantly shorter operative time (105 min vs. 130 min, p < 0.001), shorter warm ischemia time (19.35 min vs. 22.07 min, p = 0.005). However, the harmonic scalpel group was associated with significantly less estimated blood loss (20 mL vs. 30 mL, p = 0.013) and shorter length of stay (8 d vs. 10 d, p = 0.040). There was no significantly difference in indwelling time of drainage tube, perioperative complication, oncological outcomes or recurrence rates. ConclusionsThe harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy, and has benefits in intraoperative blood loss and length of stay.