Harmonic Scalpel-Assisted Endonasal Endoscopic Resection of the Vascular Tumors of the Anterior Skull Base
Harmonic Scalpel-Assisted Endonasal Endoscopic Resection of the Vascular Tumors of the Anterior Skull Base
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DOI：
10.1097/scs.0000000000009245
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发表时间：
2023-05-01
影响因子：
0.9
通讯作者：
Pupic-Bakrac, Ana
中科院分区：
文献类型：
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作者：
Jurlina, Martin;Pupic-Bakrac, Jure;Pupic-Bakrac, Ana
血管肿瘤是外科治疗的一个具有挑战性的病理亚组，因为它们显示出大量眼睑的倾向。这尤其适用于颅底区域，由于其复杂的解剖结构，手术进入是困难的。为了克服这一问题，作者介绍了超声刀在内窥镜颅底血管肿瘤手术中的使用。在此，作者报告了6例青少年血管纤维瘤和2例血管瘤的内窥镜Harmonic超声刀辅助手术结局。所有手术均使用Ethicon Endo-Surgery HARMONIC ACE 5 mm直径超声刀头进行。术中失血量中位数为400 mL（范围：200-1500 mL）。中位住院时间为7天（范围：5-10天）。1例青少年血管纤维瘤患者记录了复发，通过翻修手术成功解决。在该机构的经验中，与传统内窥镜器械相比，超声技术显示出精确的切割和最小的出血，从而降低了手术发病率。
Vascular tumors represent a challenging pathologic subset for surgical treatment as they show a propensity for profuse bleedings. This is especially applicable to the skull base region, where surgical access is difficult due to its complex anatomy. To overcome this problem, the authors introduced the use of a harmonic scalpel in endoscopic skull base surgery for vascular tumors. Here, the authors report the outcomes of endoscopic harmonic scalpel-assisted surgery in 6 juvenile angiofibromas and 2 hemangiomas. All surgeries were performed using Ethicon Endo-Surgery HARMONIC ACE 5 mm Diameter Shears. The median intraoperative blood loss was 400 mL (range: 200-1500 mL). The median length of hospital stay was 7 days (range: 5-10 days). Recurrence was recorded in 1 patient with juvenile angiofibroma, which was successfully resolved with revision surgery. In this institutional experience, ultrasonic technology showed precise cutting with minimal bleeding, resulting in reduced surgical morbidity compared with conventional endoscopic instruments.