Heimann T M, Slater G, Kurtz R J, Szporn A, Greenstein A J
Department of Surgery, Mount Sinai School of Medicine, City University of New York, New York 10029.
Ann Surg. 1989 Dec;210(6):787-91.
A technique for performing mucosal proctectomy in patients with ulcerative colitis using ultrasonic fragmentation is described. Twenty-eight patients undergoing colectomy and ileoanal anastomosis were studied. Removal of the mucosal layer of the distal rectum was performed using a titanium probe vibrating at 23 kHZ with an amplitude of 300 microns. This method produces complete mucosal destruction and the resulting debris and irrigating fluid is removed through the hollow central portion of the probe. Healing of the ileoanal anastomosis does not appear to be adversely affected by the use of this technique. Because ultrasonic fragmentation is not dependent on the integrity of the submucosal plane, it may be advantageous in those cases in which severe inflammation and submucosal scarring make manual dissection of the rectal mucosa difficult to perform.
描述了一种使用超声破碎技术对溃疡性结肠炎患者进行黏膜直肠切除术的方法。对28例行结肠切除术和回肠肛管吻合术的患者进行了研究。使用频率为23kHz、振幅为300微米的钛探头切除直肠远端的黏膜层。该方法可实现黏膜的完全破坏，产生的碎片和冲洗液通过探头的中空中心部分排出。使用该技术似乎不会对回肠肛管吻合口的愈合产生不利影响。由于超声破碎不依赖于黏膜下层平面的完整性，因此在严重炎症和黏膜下瘢痕导致直肠黏膜手动剥离困难的情况下可能具有优势。
