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视频尸检——法医学中一种使用内镜技术的微创尸检方法:临床特征

Videoautopsy-A Minimally Invasive Autopsy Method Using Endoscopic Techniques in Forensic Medicine: Clinical Features.

作者信息

Świderski Paweł, Rzepczyk Szymon, Bożek Beata, Żaba Czesław

机构信息

Department of Forensic Medicine, Poznan University of Medical Sciences, ul. Rokietnicka 10, 60-806 Poznań, Poland.

出版信息

Diagnostics (Basel). 2024 Apr 24;14(9):884. doi: 10.3390/diagnostics14090884.

Abstract

In light of falling global autopsy rates, one of the causes of which is the resulting body disfigurement, it has become crucial to search for new, minimally invasive post-mortem diagnostic tools. One of these methods is videoautopsy, a minimally invasive autopsy technique using endoscopic methods. In the years 2020-2023, 15 videoautopsies were conducted at the Department of Forensic Medicine of the Poznan University of Medical Sciences in order to determine the usefulness of the method in forensic approaches. Each post-mortem examination included laparoscopy and thoracoscopy, followed by a classic autopsy to assess the effectiveness of the method. In total, the endoscopic examination allowed for determining the cause of death in 53.3% of cases, and when the cause of death was located in the abdominal cavity or chest, the percentage increased to 80%. Traumatic lesions had good recognition efficiency. In addition, it was also possible to collect material for histopathological and toxicological tests. Retroperitoneal organs were difficult to assess. The main limitation of the method is the inability to assess the inside of the skull and the structures of the central nervous system. Videoautopsy may become an important tool in post-mortem diagnostics and in forensic cases, especially when the alternative is to not perform an autopsy. Further research is necessary to standardise the examination protocol, optimise the instrumentation, and assess the potential synergistic effect with other methods of minimally and non-invasive post-mortem examination.

摘要

鉴于全球尸检率不断下降,其中一个原因是尸检会导致尸体外形受损,因此寻找新的微创尸检诊断工具变得至关重要。其中一种方法是视频尸检,这是一种使用内镜方法的微创尸检技术。2020年至2023年期间,波兹南医科大学法医学系进行了15例视频尸检,以确定该方法在法医鉴定中的实用性。每次尸检都包括腹腔镜检查和胸腔镜检查,随后进行经典尸检以评估该方法的有效性。总体而言,内镜检查在53.3%的病例中确定了死因,当死因位于腹腔或胸腔时,这一百分比增至80%。创伤性损伤具有良好的识别效率。此外,还可以收集用于组织病理学和毒理学检测的材料。腹膜后器官难以评估。该方法的主要局限性在于无法评估颅骨内部和中枢神经系统结构。视频尸检可能成为尸检诊断和法医案件中的重要工具,尤其是在别无选择只能不进行尸检的情况下。有必要进一步开展研究,以规范检查方案、优化器械,并评估其与其他微创和非侵入性尸检方法的潜在协同效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25c6/11083916/cb870bf110c3/diagnostics-14-00884-g001.jpg

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