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Histology assessment of bipolar coagulation and argon plasma coagulation on digestive tract

机译:消化道双极凝固和氩等离子体凝固的组织学评估

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摘要

AIM: To analyze the effect of bipolar electrocoagulation and argon plasma coagulation on fresh specimens of gastrointestinal tract.METHODS: An experimental evaluation was performed at Hospital das Clinicas of the University of São Paulo, on 31 fresh surgical specimens using argon plasma coagulation and bipolar electrocoagulation at different time intervals. The depth of tissue damage was histopathologically analyzed by single senior pathologist unaware of the coagulation method and power setting applied. To analyze the results, the mucosa was divided in superficial mucosa (epithelial layer of the esophagus and superficial portion of the glandular layer of the stomach and colon) intermediate mucosa (until the lamina propria of the esophagus and until the bottom of the glandular layer of the stomach and colon) and muscularis mucosa. Necrosis involvement of the layers was compared in several combinations of power and time interval.RESULTS: Involvement of the intermediate mucosa of the stomach and of the muscularis mucosa of the three organs was more frequent when higher amounts of energy were used with argon plasma. In the esophagus and in the colon, injury of the intermediate mucosa was frequent, even when small amounts of energy were used. The use of bipolar electrocoagulation resulted in more frequent involvement of the intermediate mucosa and of the muscularis mucosa of the esophagus and of the colon when higher amounts of energy were used. In the stomach, these involvements were rare. The risk of injury of the muscularis propria was significant only in the colon when argon plasma coagulation was employed.CONCLUSION: Tissue damage after argon plasma coagulation is deeper than bipolar electrocoagulation. Both of them depend on the amount of energy used.
机译:目的:分析双极电凝和氩血浆凝结对胃肠道新鲜标本的影响。方法:在圣保罗大学医院进行的实验评估,采用氩等离子体凝结和双极电凝对31例新鲜手术标本进行评估。在不同的时间间隔。由单个高级病理学家在组织病理学上分析了组织损伤的深度,而没有意识到凝血方法和所使用的功率设置。为了分析结果,将粘膜分为浅层粘膜(食管的上皮层和胃和结肠的腺体层的浅表部分)中间粘膜(直到食管的固有层,直到食管的腺体层底部)胃和结肠)和肌层粘膜。结果:在氩气血浆中使用较高的能量时,胃的中间粘膜和三个器官的肌层粘膜受累的频率更高。在食道和结肠中,即使使用少量能量,中间粘膜的损伤也很常见。当使用较高量的能量时,双极电凝的使用导致食管和结肠的中间粘膜和肌层粘膜更频繁地受累。在胃中,这些累及很少见。结论:氩气血浆凝结后的组织损伤比双极电凝更深。仅在结肠中,固有肌层受到损伤的风险才显着。它们都取决于所使用的能量。

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