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Establishment of evaluation method and influence of the various operative devices for the nerve in a laparoscopic autonomic nerve preserving operation

腹腔镜保留自主神经手术中神经各种手术器械的评价方法及影响的建立

基本信息

批准号：
15591387
负责人：
KOJIMA Kazuyuki
金额：
$ 2.11万
依托单位：
Tokyo Medical and Dental University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

项目摘要

As for the reason that it is not possible for to 100% in keeping it a function, it is thought that the heat damage of cautery use with lymph node dissection even if preserving nervous system. Influence for the nervous system of various devices : The detachment dew gave about 2cm thigh nervous system of a pig by a knife, cautery, harmonic, bipolar scissors and examined a change of a temperature of the nervous system and detachment distance from the nervous system and relations with a temperature. 【Result】 The temperature was an average of 227, 121, 69, 18 (℃) by the order that cautery> Harmonic> bipolar scissors> knife was each. The distance that nervous system temperature became less than 100(℃) was 1, 0.5, 0.2, 0(cm) by use of 15 seconds each. A static change by the heat damage : I extracted a copy of the nervous system just after a detachment exposure and I froze a part and saved it and Formalin fixed a part and made cDNA than a freeze specimen and examined expression at an RNA level … More of heatshock protein (HSP72) guided by the heat damage. I estimated damage degree of an axon as a nervous system sheath by S100 protein dyeing from a Formalin fixation specimen. 【Result】 HSP72 accepted expression in an electric scalpel, but did not develop with other devices. The nervous system sheath and the damage degree of an axon were 82, 14, 0, 0(%) each. Influence to give to a cancer organization of various devices : We did a slice of a Formalin fixation specimen and examined which depth in a tumor necrosis by the heat damage and neighboring apoptosis were guided to by HE dyeing and TUNEL method. 【Result】 By use of 15 seconds, apoptosis was guided each in a range of 3, 2, 0.5, 0(mm). Influence to give to a normal neurological function of various devices : A change of a source movement by evoked potential stimulation : With devices various with the pig thigh nervous system which exfoliated by a normal female as contrast added electricity stimulation to the thigh nervous system after having exfoliated, and weighed the neurotransmission speed change. 【Result】 Stimulation did not conduct it in an electric scalpel, and the other devices were equal with contrast. When I contact with nerve than the above and do cutting apart, the device which I was suitable for is bipolar scissors hold, but supersonic wave solidification incision device 5 is the equal. However, in that case, variability of a tumor becomes a problem. Bipolar scissors is most suitable and, for evasion and nervous system preservation of bleeding by an operation, should not use an cautery at a place keeping nerve. Less

对于不可能百分之百保留其功能的原因，一般认为即使保留神经系统，烧灼的热损伤也应与淋巴清扫结合使用。对各种装置对神经系统的影响：剥离露通过刀、烧、谐、双极剪等方法对猪的大腿神经系统进行了约2 cm的切割，观察了神经系统的温度变化、与神经系统的脱离距离及其与温度的关系。[结果]电灼刀、谐波刀、双极剪、刀的平均温度分别为227、121、69、18(℃)。15秒后神经系统温度降至<100(℃)的距离分别为1、0.5、0.2、0(Cm)。热损伤带来的静态变化：我刚刚脱离暴露后提取了一份神经系统的副本，我冷冻了一部分并保存下来，福尔马林固定了一部分并制作了cdna，而不是冰冻标本，并在rna水平上检测了…的表达。更多的热休克蛋白(HSP72)受热损伤的引导。我通过福尔马林固定标本的S100蛋白染色来估计作为神经系统鞘的轴突的损伤程度。[结果]HSP72可在电手术刀中表达，但不能与其他装置一起表达。神经系统鞘和轴突受损程度分别为82、14、0、0(%)。不同装置对肿瘤组织的影响：制作福尔马林固定标本切片，通过HE染色和TUNEL法检测热损伤引导肿瘤坏死的深度和邻近细胞的凋亡。[结果]以15s为单位，分别在3、2、0.5、0(Mm)的范围内引导细胞凋亡。各种设备对正常神经功能的影响：通过诱发电位刺激改变源运动：以由正常女性剥离的猪大腿神经系统为对照的各种设备，在剥离后向大腿神经系统添加电刺激，并称量神经传递速度的变化。[结果]电刺激不在电手术刀内进行，其他装置与对照组相同。当我与上面的神经接触并做切割时，我适合的装置是两极剪刀夹，而超声波凝固切割器5是一样的。然而，在这种情况下，肿瘤的变异性就成了一个问题。双极剪刀是最合适的，对于手术中出血的躲避和神经系统保护，不应在保留神经的地方使用烧灼器。较少

项目成果

期刊论文数量（65）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

実写とイラストで学ぶ鏡視下手術手技図譜-胃

通过真人动作和插图学习关节镜手术技术 - 胃

DOI：
发表时间：
2003
期刊：
影响因子：
0
作者：
小嶋一幸;杉原健一;小嶋一幸
通讯作者：
小嶋一幸

LAPAROSCOPY-ASSISTED DISTAL GASTRECTOMY FOR EARLY GASTRIC CANCER

腹腔镜辅助远端胃切除术治疗早期胃癌

DOI：
10.3919/jjsa.66.2909
发表时间：
2005
期刊：
影响因子：
0
作者：
H. Kiyochi;S. Kajiwara;K. Iwakawa;Kenzo Okada;S. Iimori;H. Sugishita;H. Inoue;Y. Kashu;Yasushi Matsumoto;T. Sakao
通讯作者：
T. Sakao

Laparoscopy-assisted resection of gastric remnant cancer