Prasetyono Theddeus O H, Permatasari Erythrina, Soetrisno Esti
1 Division of Plastic Surgery, Department of Surgery, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Int Surg. 2014 Nov-Dec;99(6):807-11. doi: 10.9738/INTSURG-D-13-00184.1.
Among many techniques independently reported to manage neuroma formation, manipulation of the nerve stump inside muscle and vein is the most advantageous technique. This study aimed to enrich the basic data of macroscopic appearance and histo-pathology regarding which technique generates less neuroma: nerve stump implantation inside vein or inside muscle. An experimental study with posttest-only control-group design was conducted in 24 rats that were randomly arranged into 3 groups. One centimeter of the lateral branch of the right ischiadic nerve was cut. Group A served as the control group, where the proximal nerve stumps were left as they were after the excision; whereas the stumps of groups B and C were implanted inside muscles and veins, respectively. The samples were assessed with histologic examination after 4 weeks to measure the morphometric changes in the nerve endings. The data were statistically analyzed with t test. All rats healed uneventfully. No thrombosis was found within group C, and the stumps were free of neuroma formation. The muscle group formed smaller neuroma than the control group. Statistical analysis showed significant differences between the groups (P < 0.05). The outcome of nerve stump implantation inside the lumen of a vein is superior to the implantation inside a muscle in preventing neuroma formation.
在众多独立报道的用于处理神经瘤形成的技术中,将神经残端置于肌肉和静脉内进行操作是最具优势的技术。本研究旨在丰富关于哪种技术产生神经瘤较少的大体外观和组织病理学的基础数据:将神经残端植入静脉内还是肌肉内。采用仅设后测对照组设计的实验研究,对24只大鼠进行随机分组,分为3组。切断右侧坐骨神经的外侧分支1厘米。A组作为对照组,切除后近端神经残端保持原状;而B组和C组的残端分别植入肌肉和静脉内。4周后进行组织学检查以评估样本,测量神经末梢的形态学变化。数据采用t检验进行统计学分析。所有大鼠均顺利愈合。C组未发现血栓形成,残端无神经瘤形成。肌肉组形成的神经瘤比对照组小。统计学分析显示各组之间存在显著差异(P < 0.05)。在预防神经瘤形成方面,将神经残端植入静脉腔内的效果优于植入肌肉内。