微波手术器械在封闭淋巴管中的应用。
Utility of a microwave surgical instrument in sealing lymphatic vessels.
机构信息
Department of Gastroenterological Surgery, Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
出版信息
Am J Surg. 2013 Aug;206(2):229-33. doi: 10.1016/j.amjsurg.2012.07.048. Epub 2013 May 28.
BACKGROUND
This study assessed the ability of a novel microwave coagulation surgical instrument (MWCX) to seal lymphatic vessels when compared with LigaSure (Valleylab, Boulder, CO), the Harmonic Scalpel (HS; Ethicon Endo-Surgery, Cincinnati, OH), and electric cautery.
METHODS
The burst pressure of pig inguinal lymphatic vessels was assessed after the sealing of vessels with each surgical instrument. The rate of lymphorrhea from pig mesenteric lymphatic vessels was also investigated using indocyanine green and visualized with the Photodynamic Eye system (Hamamatsu Hotoniks, Hamamatsu, Japan).
RESULTS
Burst pressures were higher with MWCX (average, 300 mm Hg), LigaSure (average, 290 mm Hg), and HS (average, 253 mm Hg) when compared with electric cautery (average, 152.3 mm Hg; vs MWCX: P = .002, vs LigaSure: P = .002, vs HS: P = .004). The rate of lymphorrhea was significantly lower with LigaSure (13.3%), HS (18.8%), and MWCX (13.3%) when compared with electric cautery (77.3%; vs LigaSure: P < .001, vs HS: P < .001, vs MWCX: P < .001).
CONCLUSIONS
MWCX was equivalent to LigaSure and HS in terms of the ability to seal lymphatic vessels.
背景
本研究评估了一种新型微波凝血手术器械（MWCX）与 LigaSure（Valleylab，Boulder，CO）、Harmonic Scalpel（HS；Ethicon Endo-Surgery，Cincinnati，OH）和电烙术相比封闭淋巴管的能力。
方法
在使用每种手术器械封闭血管后，评估猪腹股沟淋巴管的破裂压力。还使用吲哚菁绿（ICG）研究了猪肠系膜淋巴管的淋巴漏率，并使用 Photodynamic Eye 系统（日本滨松光电）可视化。
结果
与电烙术（平均 152.3mmHg）相比，MWCX（平均 300mmHg）、LigaSure（平均 290mmHg）和 HS（平均 253mmHg）的破裂压力更高（与 MWCX 相比：P=0.002，与 LigaSure 相比：P=0.002，与 HS 相比：P=0.004）。与电烙术（77.3%）相比，LigaSure（13.3%）、HS（18.8%）和 MWCX（13.3%）的淋巴漏率明显更低（与 LigaSure 相比：P<0.001，与 HS 相比：P<0.001，与 MWCX 相比：P<0.001）。
结论
MWCX 在封闭淋巴管的能力方面与 LigaSure 和 HS 相当。
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