Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany.
Fertil Steril. 2011 Mar 15;95(4):1328-32. doi: 10.1016/j.fertnstert.2011.01.138.
To investigate the peritoneal adhesion formation of two pulsed noncontact argon plasma coagulation (APC) modes in a rat model.
Prospective, randomized, controlled, and blinded study.
Laboratory facilities of a university department of obstetrics and gynecology.
ANIMAL(S): Ten female Wistar rats.
INTERVENTION(S): Bilateral lesions were created on the abdominal wall with low and high APC energy in a standard fashion. After 10 days the rats were killed to evaluate the peritoneal trauma sites.
MAIN OUTCOME MEASURE(S): Adhesion incidence, quantity, and quality were scored 10 days after surgery and studied by histopathologic analysis.
RESULT(S): The area of coagulation was 30 ± 8.4 mm(2) in the case of high APC energy and 12 ± 5.6 mm(2) (low APC energy). Macroscopic thermal damage of the peritoneum is significantly higher when applying high APC energy. Adhesions due to APC with high energy occurred in 64% and with low energy in 6% of cases. High energy results mainly in dense adhesions. The lesions in the high-energy group showed intense granulation tissue formation with centrally located myocyte necrosis with intense neutrophilic inflammation.
CONCLUSION(S): This study describes for the first time that different noncontact APC energy settings induce peritoneal adhesions in a reproducible rat model. Higher energy produced significantly deeper tissue defects and adhesions of higher grade. A plasma coagulation system that develops fewer adhesions can be achieved by lower temperature and a more homogeneous application and if the application area desiccates more slowly.
研究两种脉冲非接触式氩等离子体凝固（APC）模式在大鼠模型中的腹膜粘连形成。
前瞻性、随机、对照、盲法研究。
一所大学妇产科系的实验室设施。
10 只雌性 Wistar 大鼠。
以标准方式在腹壁上用低能和高能 APC 分别造成双侧损伤。10 天后处死大鼠，评估腹膜创伤部位。
术后 10 天，粘连发生率、数量和质量通过组织病理学分析进行评分。
高能 APC 时凝固面积为 30 ± 8.4mm(2)，低能 APC 时为 12 ± 5.6mm(2)。当应用高能 APC 时，腹膜的宏观热损伤明显更高。高能 APC 导致粘连的发生率为 64%，低能 APC 为 6%。高能 APC 主要导致致密粘连。高能组的病变表现为中心部位肌细胞坏死伴强烈中性粒细胞炎症的强烈肉芽组织形成。
本研究首次描述了不同的非接触式 APC 能量设置在可重复的大鼠模型中引起腹膜粘连。更高的能量产生了更深的组织缺陷和更高等级的粘连。通过更低的温度、更均匀的应用以及如果应用区域干燥更缓慢，可以实现产生更少粘连的血浆凝固系统。
