手术腹腔镜检查期间的穿刺点电外科（透热疗法）烧伤。
Port site electrosurgical (diathermy) burns during surgical laparoscopy.
作者信息
Willson P D, van der Walt J D, Moxon D, Rogers J
机构信息
Academic Surgical Unit, Royal London Hospital, London, E1 1BB, United Kingdom.
出版信息
Surg Endosc. 1997 Jun;11(6):653-4. doi: 10.1007/s004649900414.
BACKGROUND
Direct and capacitive coupling of diathermy current have been reported as causes of occult injury during surgical laparoscopy.
METHODS
In order to determine the incidence of electrosurgical injury adjacent to metal and plastic cannulas, skin biopsies at 19 port sites used for monopolar electrosurgery were analyzed for coagulative necrosis. Prior to surgery the cannulas were randomized to either metal or plastic.
RESULTS
Coagulative necrosis was observed at nine electrosurgery port sites compared to only one control (chi2 = 4.872; df = 1; 0.05 > p > 0.02). Plastic cannulas afforded no greater protection from skin burns than metal cannulas.
CONCLUSIONS
Burns may be the result of direct or capacitive coupling to metal cannulas or capacitive coupling to the skin edge across plastic cannulas. The potential exists for burns to other tissues also in close proximity to a cannula used for electrosurgery.
背景
据报道，手术腹腔镜检查期间，透热电流的直接耦合和电容耦合是隐匿性损伤的原因。
方法
为了确定金属和塑料套管附近电外科损伤的发生率，对用于单极电外科手术的19个穿刺部位的皮肤活检组织进行凝固性坏死分析。手术前，将套管随机分为金属或塑料两种。
结果
在9个电外科穿刺部位观察到凝固性坏死，而对照组仅1例（χ2 = 4.872；自由度 = 1；0.05 > p > 0.02）。塑料套管对皮肤烧伤的防护作用并不比金属套管更好。
结论
烧伤可能是与金属套管直接耦合或电容耦合，或通过塑料套管与皮肤边缘电容耦合的结果。在电外科手术使用的套管附近，其他组织也有烧伤的可能性。
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