不同能量器械分离肺段间交界面的离体实验研究

Separating the intersegmental plane by different energy devices in segmentectomy:results from ex vivo animal

目的:对比研究电刀和超声刀两种能量器械在肺段切除术中分离段间交界面效果的差异。方法:建立离体猪肺的肺段切除术模型,使用两种能量器械分别行段间交界面的分离,比较两组肺段切除术模型的漏气、切缘损伤等指标。结果:使用电刀和超声刀分割后,段间交界面的漏气程度无明显差异[(17.3±1.0)cmH 2O对(16.4±2.9)cmH 2O,1 cmH 2O=0.098 kPa, P=0.17]。超声刀导致的切缘热损伤深度显著小于电刀[(354.35±98.81)μm对(819.70±158.00)μm, P<0.01]。 结论:使用电刀和超声刀分割段间交界面各具优缺点,在实际临床工作中应根据情况合理选择能量器械。

Objective Comparing the different effects between using electrotome and ultrasonic scalpel in segmentectomy for separating intersegmental plane.Methods The ex vivo porcine lungs were chosen for experiments,the a segment of the cranial lobe of the right lung(RS1a)was removed by using electrotome(coagulation mode)or ultrasonic scalpel,the values of minimum air leak pressure among them were compared,and also the hematoxylin and eosin staining for evaluating the injury degree of incision edge.Results The mean values of minimum air leak pressures for the intersegmental plane after segmentectomy were(17.3±1.0)cmH2O by electrotome,(16.4±2.9)cmH2O by ultrasonic scalpel,the differences did not reach significance between electrotome and ultrasonic scalpel(P=0.17).When focused on heat injury degree of incision edge,electrotome caused a heavier damage than ultrasonic scalpel[(819.70±158.00)μm vs.(354.35±98.81)μm,respectively,P<0.01].Conclusion Electrotome and ultrasonic scalpel presented different merits and defects,and we should opt energy devices rationally for separating inter-segmental plane.