Salcı Hakan, Acar Hilal, Taşkapılıoğlu Mevlüt Özgür, Melek Hüseyin, Bayram Ahmet Sami
Department of Surgery, Uludağ University, Faculty of Veterinary Medicine, Bursa, Turkey.
Department of Brain and Nerve Surgery, Uludağ University Faculty of Medicine, Bursa, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):669-673. doi: 10.5606/tgkdc.dergisi.2020.19412. eCollection 2020 Oct.
This study aims to examine the efficacy of clipping in thoracic sympathectomy based on electrophysiological evaluation and to investigate whether nerve conduction can be formed by collateral nerve extensions as a result of the clipping procedure to different levels of sympathetic nerve.
Newly sacrificed six sheep hemithoraces were studied between August 2016 and October 2016. Thoracic sympathectomy was performed by clipping at T2, T3, T4, and T5 sympathetic chain levels and their branches. Electrophysiological studies were performed with an electromyography device and the filter range was 1 Hz with 20 μV/D amplification. Signals were processed digitally; bipolar subdermal needle electrodes were used as stimulation and recording electrodes (Ø 0.75 mm); and the ground electrode was placed in the intercostal muscle where the thoracic sympathectomy procedure would be performed.
Electrophysiological evaluations showed that clips placed on the main sympathetic chain branches and sympathetic nerve trunk prevented collateral impulse conduction and stimulated potentials were not recorded. However, sympathetic conduction continued at the same intensity after removal of the clips.
Clipping of different regions of the sympathetic nerve provides electrophysiological blockage of the sympathetic nerve, and conduction continues after removal of the clips. However, the shortand long-term postoperative electrophysiological results after removal of the clips over the sympathetic nerve is still a question mark.
本研究旨在基于电生理评估来检验胸交感神经切除术夹闭术的疗效，并调查夹闭术至不同水平交感神经后是否可通过侧支神经延伸形成神经传导。
2016年8月至2016年10月间对新处死后的6只羊的半侧胸腔进行研究。通过夹闭T2、T3、T4和T5交感神经链水平及其分支来实施胸交感神经切除术。使用肌电图设备进行电生理研究，滤波范围为1Hz，放大倍数为20μV/D。信号进行数字处理；使用双极皮下针电极作为刺激和记录电极（直径0.75mm）；接地电极置于将进行胸交感神经切除术的肋间肌中。
电生理评估显示，置于交感神经主链分支和交感神经干上的夹子可阻止侧支冲动传导，未记录到刺激电位。然而，移除夹子后交感神经传导以相同强度持续。
交感神经不同区域的夹闭可导致交感神经的电生理阻断，移除夹子后传导仍会继续。然而，交感神经移除夹子后的术后短期和长期电生理结果仍是一个问号。
