George Katherine S, Hyde Nicholas C, Wilson Philip, Smith Graham I
Department of Maxillofacial Surgery, St. George's Hospital NHS Trust, Blackshaw Road, London SW17 0QT, UK.
Br J Oral Maxillofac Surg. 2013 Oct;51(7):600-3. doi: 10.1016/j.bjoms.2013.03.016. Epub 2013 Jul 4.
It is important to obtain tumour-free resection margins in patients with oral cancer. Pathological processing is known to cause tissue to shrink, which affects the reported margins, and it is postulated that the method of resection also has an effect. We marked standardised simulated lesions on the tongues of 15 live anaesthetised pigs and divided each lesion into four equal sections. They were resected each with a margin of 10mm using cutting diathermy, coagulative diathermy, Harmonic scalpel, and a conventional scalpel. After processing, the excision margins were measured. With cutting diathermy and coagulative diathermy, shrinkage of the soft tissues was minimal relative to the margin of the simulated lesion compared with the Harmonic scalpel (p=0.001) and conventional scalpel (p=0.001). Cutting diathermy and coagulative diathermy caused significant thermal damage (p=0.001). The method of resection affects the surgical margin. Diathermy resulted in thermal injury and denaturing of the underlying muscle, but there was less tissue contraction than when the Harmonic scalpel and conventional scalpel were used. The ethics committee approved the study, which was undertaken in a registered European Scientific Institute in Hamburg.
在口腔癌患者中获得无肿瘤切缘很重要。已知病理处理会导致组织收缩，这会影响报告的切缘，并且据推测切除方法也有影响。我们在15只活体麻醉猪的舌头上标记了标准化的模拟病变，并将每个病变分成四个相等的部分。分别使用切割透热法、凝固透热法、超声刀和传统手术刀以10毫米的切缘进行切除。处理后，测量切除边缘。与超声刀（p = 0.001）和传统手术刀（p = 0.001）相比，使用切割透热法和凝固透热法时，相对于模拟病变的边缘，软组织的收缩最小。切割透热法和凝固透热法造成了显著的热损伤（p = 0.001）。切除方法会影响手术切缘。透热法导致深层肌肉的热损伤和变性，但与使用超声刀和传统手术刀时相比，组织收缩较少。伦理委员会批准了这项研究，该研究在汉堡一家注册的欧洲科学研究所进行。
