Histological characteristics of collagen denaturation and injuries in bipolar radiofrequency-induced colonic anastomoses
Histological characteristics of collagen denaturation and injuries in bipolar radiofrequency-induced colonic anastomoses
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双极射频结肠吻合术中胶原变性和损伤的组织学特征
DOI：
10.1016/j.prp.2014.10.010
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Shi, Debing
中科院分区：
文献类型：
--
作者：
Zhao, Lingxi;Zhuo, Changhua;Shi, Debing
双极射频热融合已被认为是一种先进的肠道吻合手术方法，然而，胶原变性的组织学特征以及由此引起的损伤仍不清楚。本研究旨在探讨不同损伤参数下融合区的微观变化及组织损伤情况。将猪的体外结肠在两个载体环上进行浆膜-浆膜融合，并安装在自制的吻合器上。在160W的射频功率下，施加171~313kPa的5个压缩压力5s，观察融合区的胶原变性情况。光镜下观察印天狼星红染色的组织切片，观察不同射频功率(120W对140W)和手术时间(5W对10 S)下组织损伤情况。透射电子显微镜显示，随着压缩压力的增加，变性的胶原纤维变厚，每个胶原纤维之间的间隙变宽。浆膜粘附区胶原丰富。S 5号和10号在120W功率下组织学无明显差异，S 5号在140W功率下融合时出现明显的肌肉断裂，延长至10个S时，140W融合紧密，肌肉裂开较少。这些结果表明，较高的压缩压力会导致更严重的胶原蛋白松解，也会减少融合结肠中的胶原交联物。提高射频功率，延长手术时间，可避免射频结肠吻合术中的组织损伤。(C)2014年爱思唯尔股份有限公司。版权所有。
Bipolar radiofrequency-induced thermo-fusion has been explored as an advanced surgical method for intestinal anastomoses; however, the histological characteristics of collagen denaturation and injuries arising from this process remain unclear. The aim of this study was to investigate the microcosmic changes and tissue damage of fusion regions with various parameters of injury. Ex vivo colons of pigs were fused serosa-serosa on two carrier rings, which were installed on a homemade anastomotic device. Five levels of compressive pressure from 171 to 313 kPa were applied for 5s to fuse the colons under radiofrequency power of 160W, and then the collagen denaturation of the fused region was examined by transmission electron microscopy. Light microscopy was utilized to observe histological slices that were stained with picrosirius red in order to visualize the tissue injuries under two levels of radiofrequency power (120 vs. 140W) and operation time (5 vs. 10 s). Transmission electron micrographs showed that increased compressive pressure led to thicker denatured collagen fibrils and wider gaps between each collagen fibril. Serosa adhesion regions appeared abundant in collagen. No histological differences were observed when 120W of power was applied for 5 and 10 s. Significant muscle cracking occurred when colons were fused using 140W for 5 s. When the operation time was extended to 10 s, 140W led to tight fusion and less splitting on muscles. These results suggest that higher compressive pressure results in more severe collagen unfolding and also reduces collagen crosslinking in fused colons. Improved radiofrequency power along with operation time could avoid tissue injury upon radiofrequency-induced colonic anastomoses. (C) 2014 Elsevier GmbH. All rights reserved.