虽然能量基础设备（EBDs）对于微创手术至关重要，但是关于比较EBDs的现有前瞻性随机研究仍然非常有限。本研究旨在比较腹腔镜远端胃切除术（LDG）中不同EBDs的术中炎症反应和短期手术结果。在两个不同的医疗中心接受LDG的临床I期胃癌患者被前瞻性随机分为三组：超声剪切器（US）、先进双极（BP）以及超声双极混合型（HB）。分析了C反应蛋白（CRP）水平、手术时间、术中失血量（IBL）、实验室测试、细胞因子（白细胞介素（IL）-6和IL-10）、住院时间和并发症率。一种使用吲哚菁绿和近红外相机的新型半定量测量方法来测量淋巴漏的量。主要终点，即CRP水平，BP组（n = 60）的CRP水平显著低于US组（n = 57）或HB组（n = 57）[9.03±5.55与11.12±5.02或12.67±6.14，p = 0.001（术后第2和第7天）；7.48与9.62或9.48，p = 0.026（术后第4天）]。BP组的IBL明显低于US组或HB组（26.3±25.3与43.7±42.0或34.9±37.0，p = 0.032）。BP组的Jackson-Pratt引流甘油三酯明显低于US组（53.6±33.7与84.2±59.0，p = 0.11；HB组为71.3±51.4）。ICG荧光强度、手术时间、实验室结果、细胞因子、住院时间和并发症率在3个组之间没有显著差异。BP显示出术后CRP水平较低，IBL较少，表明其余热性损伤较少，密封更好。医生在选择EBDs进行腹腔镜手术时可考虑这一点。©2023 作者（s）在The International Gastric Cancer Association和The Japanese Gastric Cancer Association的独家许可下发表。

Although EBDs are essential for minimally invasive surgery, well-established prospective randomized studies comparing EBDs are scarce. This study aimed to compare the intraoperative inflammatory response and short-term surgical outcomes among different energy-based devices (EBDs) in laparoscopic distal gastrectomy (LDG).Patients with clinical stage I gastric cancer scheduled for LDG at two different medical centers were prospectively randomized into three groups: ultrasonic shears (US), advanced bipolar (BP) and ultrasonic-bipolar hybrid (HB). The C-reactive protein (CRP) level, operation time, intraoperative blood loss (IBL), laboratory tests, cytokines (interleukin (IL)-6 and IL-10), hospital stay, and complication rate were analyzed. A novel semiquantitative measurement method using indocyanine green (ICG) and a near-infrared camera measured the amount of lymphatic leakage.The primary endpoint, the CRP level, was significantly lower in the BP (n = 60) group than in the US (n = 57) or HB (n = 57) group [9.03 ± 5.55 vs. 11.12 ± 5.02 vs. 12.67 ± 6.14, p = 0.001, on postoperative day (POD) 2 and 7.48 vs. 9.62 vs. 9.48, p = 0.026, on POD 4]. IBL was significantly lower in BP than in US or HB (26.3 ± 25.3 vs. 43.7 ± 42.0 vs. 34.9 ± 37.0, p = 0.032). Jackson-Pratt drainage triglycerides were significantly lower in BP than in US (53.6 ± 33.7 vs. 84.2 ± 59.0, p = 0.11; HB: 71.3 ± 51.4). ICG fluorescence intensity, operation time, laboratory results, cytokines, hospital stay, and complication rate were not significantly different among the 3 groups.BP showed a lower postoperative CRP level and less IBL than US and HB, suggesting less collateral thermal damage and better sealing function. Surgeons may consider this when selecting EBDs for laparoscopic surgery.© 2023. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.