【摘要】 目的:结直肠癌切除后需要进行肠道吻合术,缝合线和吻合钉会残留异物引起并发症,射频热焊接技术既可完成无异物残留的快速肠道吻合,又可以应用在腹腔镜手术中。利用射频能量和压力作用于肠壁,完成肠道吻合,研究压合压强和能量对爆破压的影响。方法:从屠宰场采集猪结肠,2小时内运至实验室,在特制的模拟射频肠吻合器上完成焊接吻合,采用2种压合压强和2种射频能量,共4组。焊接部位插入热电偶,测量焊接过程的最高温度,爆破压测量装置测量吻合口爆破压,病理切片H&E染色和扫描电镜图像观察焊接部位。统计学方法分析焊接爆破压差异。结果:射频能量一定时,压合压强改变对爆破压的影响不显著(p>0.05),但焊接部位最高温度随压合压强增大而升高,最高温度达142°C。压合压强一定时,射频总能量改变对爆破的影响不显著(p>0.05),焊接部位最高温度变化不明显。结论:射频焊接时,仅增大压合压强或仅提高射频能量不能有效的提升爆破压,但焊接温度会随压力提高,不利于控制对周围组织的热损伤。更多还原

【Abstract】 Objective:Intestinal anastomosis should be conducted after resection of colorectal cancer.While residual of foreign materials by suture and stapler results in complications.Radio frequency-induced thermo-fusion applied in colonic anastomosis is faster without any foreign material,which can be used in laparoscopic surgery.Compete colonic anastomosis by radio frequency-induced thermo-fusion and study effect of energy and compressive pressure on burst pressure.Methods:Fresh colon were harvested from slaughter house and delivered to lab within 2 hours.Two levels of compressive pressure and energy were applied to weld colon samples exvitroona customer-made device that simulating an anastomotic instrument.Thermal couple was inserted into fusion area torecord temperature during welding process.Burst pressure was measured and observed fused area by pathological sections(H&E) and scan electrical microscopy.Results:No significant different on burst pressure was observed when use different compressive pressure but the same energy though temperature increases with rising compressive pressure.The maximal temperature was142°C.Similarly,no differenton burst pressure and temperature when use different energy but the same compressive pressure.Conclusions:Burst pressure cannot be enhanced by increasing compressive pressure or RF energy independently.Temperature rising with increasing compressive pressure dose not benefit to limit thermal spread.更多还原