Miyazawa T, Nawashiro H, Shima K, Bertalanffy H
Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
Acta Neurochir (Wien). 2000;142(11):1247-51. doi: 10.1007/s007010070021.
We first applied a novel haemostatic strategy involving Argon Plasma Coagulation (APC), an innovative no-touch electrocoagulation technique in which a high-frequency alternating current is delivered to the tissue through ionized argon gas, to brain tumour surgery, and report its usefulness and limitations.
The APC system we used comprised an APC 300 developed by ERBE Elektromedizin GmbH, Germany. We applied APC to 13 brain tumours in 12 patients (5 meningiomas, 4 sarcomas, 2 glioblastomas, and 2 pituitary adenomas). To avoid unnecessary thermal injury to the tissue as much as possible, power/gas flow settings of 20 and 40 W were used. The impact time was varied individually but was around several seconds per one impact. The argon jet (1.5-4.5 L/min) clears a field of pooled blood and evenly conducts electrical energy to the target tissue. A thin and flexible probe particularly increased the usefulness of APC for haemostasis on deep-seated skull base tumour operations under a microscope.
All patients were successfully treated and satisfied with the surgical results without any complications due to APC. APC appears to be an excellent alternative strategy for achieving haemostasis on vascular-rich brain tumour surgery, and may be valuable for the management of patients with coagulation defects.
我们首次将一种涉及氩等离子体凝固术（APC）的新型止血策略应用于脑肿瘤手术，APC是一种创新的非接触式电凝技术，通过电离氩气将高频交流电传递到组织，并报告其有效性和局限性。
我们使用的APC系统包括德国爱尔博电子医疗有限公司研发的APC 300。我们将APC应用于12例患者的13个脑肿瘤（5例脑膜瘤、4例肉瘤、2例胶质母细胞瘤和2例垂体腺瘤）。为尽可能避免对组织造成不必要的热损伤，使用了20瓦和40瓦的功率/气体流量设置。每次冲击的时间因人而异，但每次冲击约为几秒。氩气流（1.5 - 4.5升/分钟）可清除积血区域，并将电能均匀传导至目标组织。一种细而灵活的探头尤其提高了APC在显微镜下对深部颅底肿瘤手术止血的有效性。
所有患者均成功接受治疗，对手术结果满意，未出现因APC导致的任何并发症。APC似乎是在血供丰富的脑肿瘤手术中实现止血的一种极佳替代策略，对于凝血功能缺陷患者的管理可能具有重要价值。
