内镜下电凝胆囊粘膜消除术中电热效应对动物组织的影响

Experimental study on the electrothermal tissue effects during gallbladder mucosal ablation by hysteroscopic rollerball electrocoagulation

目的:通过动物实验研究在内镜下电凝法消除胆囊粘膜对组织的影响及适宜的电极功率设置。方法:健康小型猪6只,开腹行胆囊造瘘术,4周后再次开腹以前列腺电切镜自窦道插入,分别以70W、90W、120W、150W功率电凝消除胆囊粘膜,并即时用测温仪测量电凝相应部位的浆膜面温度。手术结束后剪取胆囊送病理检查,光镜下观察胆囊壁热损伤深度。结果:所选电凝功率均能有效消除胆囊粘膜,相同条件下胆囊浆膜面温度和胆囊壁热损伤深度与电凝功率呈正相关。结论:内镜下电凝胆囊粘膜消除术中适宜的电凝功率为70W。

Objective：To investigate the tissue electrothermal effects and to seek for the appropriate setting of operative wattage during gallbladder mucosal ablation by hysteroscopic rollerball electrocoagulation.Methods：6 healthy juvenile pigs were performed with cholecystostomy and underwent gallbladder ablation.After 4 weeks,open operation was performed,was inserted Storz endoscope from the epithelium of the proximal cystic duct and the mucosa of the gallbladder were ablated with the roller-ball and roller-barrel electrodes respectively.The electrocoagulation power was set at 70W,90W,120W and 150W.The serosa of the cyst temperature was recorded respectively at the same time.Then the gallbladders were resected and pathologically checked,and the depth of the thermal damage was determined.Results：The gallbladder mucosal can be ablated effectively by all electrocoagulation powers selected.Under the same conditions,the temperature of serosa of the cyst and the depth of the thermal damage have positive correlation with electrocoagulation power.Conclusion：The appropriate power setting should be 70W for coagulation.