Department of General Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Zhejiang Univ Sci B. 2012 Mar;13(3):186-91. doi: 10.1631/jzus.B1100096.
To evaluate the feasibility and superiority of a new coagulating and hemostatic method named "saline conducted electric coagulation (SCEC)".
The Peng's multifunction operative dissector (PMOD) was modified to enable saline to effuse persistently out of its nib at a constant speed. In a group of six New Zealand rabbits, two hepatic lobes of each rabbits were resected respectively by SCEC and conventional electric coagulation (EC). The features of SCEC were recorded by photo and compared with conventional EC. After 7 d, the coagulating depth was measured in each residual hepatic lobe. Hepatic tissue was dyed by hematoxylin and eosin (HE) and studied under a microscope.
The coagulating depth increased with the continuation of SCEC time. Hepatectomies were performed successfully, no rabbit died in the perioperative period. The incisal surface of SCEC was gray-white with no red bleeding point. There was a thick solidified layer at the margin and a thin red-white intermittent layer between the solidified layer and normal hepatic tissue at the vertical section of SCEC. The mean coagulating depth of SCEC was 1.8 cm vs. 0.3 cm of conventional EC. Pathological examination showed a mild inflammatory reaction by SCEC.
SCEC is a feasible and safe method for surgical hemostasis. As a new technique for liver resection, SCEC shows better coagulating effect and milder inflammatory reaction than conventional EC. Our study shows bloodless liver resection can also be performed by SCEC, especially for liver malignant tumor.
评估一种名为“盐水引导电凝(SCEC)”的新型止血方法的可行性和优越性。
对彭氏多功能手术解剖器(PMOD)进行改良,使盐水能以恒定速度持续从其尖端渗出。在一组 6 只新西兰兔中,每只兔的两个肝叶分别采用 SCEC 和常规电凝(EC)进行切除。通过照片记录 SCEC 的特点,并与常规 EC 进行比较。7d 后,测量每个残留肝叶的凝固深度。用苏木精和伊红(HE)对肝组织进行染色,并在显微镜下进行研究。
SCEC 的凝固深度随时间的延长而增加。肝切除术均成功完成,围手术期无兔死亡。SCEC 的切割面呈灰白色,无红色出血点。在 SCEC 的垂直切片上,边缘有一层厚的凝固层,凝固层与正常肝组织之间有一层薄的红白相间的间断层。SCEC 的平均凝固深度为 1.8cm,而常规 EC 为 0.3cm。病理检查显示 SCEC 有轻度炎症反应。
SCEC 是一种安全可行的外科止血方法。作为一种新的肝切除术技术,SCEC 比常规 EC 具有更好的凝血效果和更轻微的炎症反应。我们的研究表明,SCEC 也可用于无血肝切除术,特别是肝恶性肿瘤。