Litta Pietro, Saccardi Carlo, Gizzo Salvatore, Conte Lorena, Ambrosi Giulia, Sissi Claudia, Palumbo Manlio
Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua 35128, Italy.
Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua 35128, Italy.
Mol Med Rep. 2015 Aug;12(2):2985-90. doi: 10.3892/mmr.2015.3677. Epub 2015 Apr 24.
Electrical surgical devices may determine tissue damage through lateral thermal spread and activation of inflammatory processes. Several tissue effects are associated with the use of different surgical instruments. The aim of the present study was to compare tissue damage following the application of cold knife biopsy, bipolar electrocoagulation and the ultracision harmonic scalpel, through the analysis of inflammatory gene mediator expression. Three fragments of the round ligament (length 0.5 cm) were obtained from 22 females who had undergone total or subtotal laparoscopic hysterectomy using three different modes of resection: Cold knife biopsy, bipolar electrocoagulation and ultracision harmonic scalpel. The tissue fragments were examined by quantitative polymerase chain reaction (qPCR) analysis of selected cytokines. Gene expression analysis demonstrated large standard deviations due to individual variability among patients and indicated variability in the concentrations of cytokines in the three different samples. The quantity of cytokine mRNA in the cold knife biopsy samples was generally greater than those obtained by other techniques. Tumor necrosis factor-α expression was significantly higher in the sample obtained with the ultracision harmonic scalpel and bipolar electrocoagulation (P=0.033) when compared with cold knife biopsy. The inflammatory response was analyzed by the quantification of gene expression through the use of qPCR. The ultracision harmonic scalpel and bipolar electrocoagulation triggered the inflammatory cascade and resulted in an increased production of cytokines compared with cold knife biopsy.
电外科设备可通过侧向热扩散和炎症过程的激活来确定组织损伤。使用不同的手术器械会产生几种组织效应。本研究的目的是通过分析炎症基因介质的表达，比较冷刀活检、双极电凝和超声刀应用后的组织损伤情况。从22名接受了全腹腔镜或次全腹腔镜子宫切除术的女性中获取三段圆韧带（长度0.5厘米），分别采用三种不同的切除方式：冷刀活检、双极电凝和超声刀。通过对选定细胞因子进行定量聚合酶链反应（qPCR）分析来检测组织碎片。基因表达分析显示，由于患者个体差异，标准差较大，且表明三种不同样本中细胞因子浓度存在差异。冷刀活检样本中的细胞因子mRNA数量通常比其他技术获得的样本更多。与冷刀活检相比，超声刀和双极电凝获取的样本中肿瘤坏死因子-α表达显著更高（P = 0.033）。通过使用qPCR对基因表达进行定量分析炎症反应。与冷刀活检相比，超声刀和双极电凝引发了炎症级联反应，并导致细胞因子产生增加。
