微创外科在颈廓清术中应用临床前评价

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1、微创外科在颈廓清术中应用临床前评价作者：易慧明况光仪白殿卿许晨耘赵质彬魏欣龚选举符志龙【摘要】目的于动物实验中探讨微创外科在颈廓清手术中应用的可行性。方法选取12只免疫后的健康成年土狗，以3%戊巴比妥钠(30mg/kg)施行静脉麻醉，其中6只取颈侧中部30mm长的模型切口，游离颈皮肌皮瓣后，用两把常规小拉钩拉开皮瓣，置入0。内镜4mm鼻窦内镜为照明光源，在直视或电视介导下用常规外科器械实施改良根治性颈廓清术加颌下腺、甲状腺和半边甲状软骨板切除手术；另外6只取颈侧100mm长斜行切口实施改良根治性颈廓清术加颌下腺、甲状腺和半边甲状软骨板切除手术。结果(

2、1)小切口组术中耗时(100土20)min,术中出血量为(50±30)ml,实验狗术后(2±0,5)天自由进食并自由活动，术后(7±1)天伤口愈合拆线，术后(10±2)天基本恢复术前体重。(2)大切口组术中耗时(80±20)min,术中出血量为(30±20)ml,实验狗术后(3土0.5)天自由进食并自由活动，术后(8±1)天伤口愈合拆线，术后(13+4)天基本恢复术前体重。所有实验狗术后无伤口感染、皮下积液、明显消瘦、死亡等并发症出现。结论在电视内镜介导下用常规外科器械通过一个微小切口即可实施狗颈廓清术而达到微创外科目的，此微创颈廓清技术值得进一步在

3、临床试用。【关键词】微创外科颈廓清术临床前评价Preclinicalevaluationofapplicationofminimallyinvasivesurgeryinradicalneckdissection[Abstract]ObjectiveToevaluatetheapplicationofminimallyinvasivesurgery(MIS)inradicalneckdissectionusingdogasapreclinicalmode1.MethodsTwelveimmunizedhealthadultmongreldogswer

4、echosen.Anesthesiawasmaintainedwith3%pentobarbitalsodiumbyI.V.Sixofthedogsweretakena30mmhorizontalskinincisioninthemiddleareaoflateralneck.Aftermusculuscutaneouscolli(MCC)weredivided,twosmallconventionalretractorswereinsertedtoretractthestrapmusclesanda0.4mmsinusendoscopewasins

5、ertedaslightsource・Modifiedradicalneckdissectionplusexcisionofsubmandibularsalivary,thyroidlobeandhalf—thyroidcartilagewasperformedwithconventionalinstrumentsondirectvisualorbyvideo-assisted.Theothersixdogsweretakena100mmobliquelateralneckincision,andmodifiedradicalneckdissecti

6、onplusexcisionofsubmandibularsalivary,thyroidlobeandhalf-thyroidcartilagewasperformedwithconventionalinstTuments・ResuItsIngroupofsmallincision,theoperationtimewas(100±20)minutes.Theoperativebleedingvolumewas(50±30)mLThesedogsresumednormalfood/waterintakenandactivity(2+0.5)daysa

7、ftertheoperation.Woundhealingwascompleted(7+1)dayslater.Theweightwasrecoveredasbefore(10±2)dayslater.Ingroupofbigincision,theoperationtimewas(80±20)minutes.Theoperativebleedingvolumewas(30+20)m1.Thesedogsresumednormalfood/waterintakenandactivity(3±0.5)daysaftertheoperation.Woun

8、dhealingwascompleted(8±1)dayslater.Theweightwasrecover