Radiofrequency-induced heating versus mechanical stapler for pancreatic stump closure: in vivo comparative study
Radiofrequency-induced heating versus mechanical stapler for pancreatic stump closure: in vivo comparative study
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DOI：
10.3109/02656736.2015.1136845
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发表时间：
2016-05-01
影响因子：
3.1
通讯作者：
Berjano, Enrique
中科院分区：
文献类型：
--
作者：
Burdio, Fernando;Dorcaratto, Dimitri;Berjano, Enrique
目的：本研究的目的是评估两种胰残端闭合手术方法在降低胰瘘形成 (POPF) 风险方面的能力：射频诱导加热与机械吻合器。材料和方法：十六头猪接受腹腔镜胰颈横切术。为了使用容易发生 POPF 的实验模型，始终避免进行胰腺吻合术。通过吻合器（ST 组，n=8）或射频能量（RF 组，n=8）进行胰残端闭合。比较两组的 POPF 发生率和胰腺残余物的组织病理学改变。结果：ST 组中的 6 只动物（75%）和 RF 组中的一只动物（14%）被诊断为 POPF（p=0.019）。 RF组中的一只动物和ST组中的三只动物有与两个胰腺残端紧密接触的假性囊肿。术后第30天（PO），当主胰管被有效密封时，观察到外分泌远端胰腺几乎完全萎缩。结论：我们的研究结果表明，射频诱导加热比机械吻合器更能有效地闭合胰腺残端，并导致远端残余胰腺完全萎缩。
Purpose: The aim of this study was to assess the capacity of two methods of surgical pancreatic stump closure in terms of reducing the risk of pancreatic fistula formation (POPF): radiofrequency-induced heating versus mechanical stapler. Materials and methods: Sixteen pigs underwent a laparoscopic transection of the neck of the pancreas. Pancreatic anastomosis was always avoided in order to work with an experimental model prone to POPF. Pancreatic stump closure was conducted either by stapler (ST group, n=8) or radiofrequency energy (RF group, n=8). Both groups were compared for incidence of POPF and histopathological alterations of the pancreatic remnant. Results: Six animals (75%) in the ST group and one (14%) in the RF group were diagnosed with POPF (p=0.019). One animal in the RF group and three animals in the ST group had a pseudocyst in close contact with both pancreas stumps. On day 30 post-operation (PO), almost complete atrophy of the exocrine distal pancreas was observed when the main pancreatic duct was efficiently sealed. Conclusions: Our findings suggest that RF-induced heating is more effective at closing the pancreatic stump than mechanical stapler and leads to the complete atrophy of the distal remnant pancreas.