经食管自然腔道手术的动物实验研究

发布时间：2018-05-21 10:43

本文选题：经自然腔道内镜外科手术 + 食管　；参考：《浙江大学》2015年硕士论文

【摘要】：目的：经自然腔道内镜外科手术可消除体表切口,减少相关并发症及不适感,被认为是微创外科的未来发展方向。通过动物实验初步探索经食管行右侧胸腔探查术、右侧星状神经节损毁术及胸膜活检术的可行性与安全性。方法：以大白猪为研究对象,共4例,其中急性实验2例,存活实验2例。急性实验行右侧胸腔探查术、右侧星状神经节损毁术,术后立即处死并行尸检；存活实验行右侧胸腔探查术、胸膜活检术,术后存活并观察2周后处死行尸检。结果：共成功进行3例操作。术中得到良好的定向及定位活检。急性实验中1例因夹持星状神经节致心律失常而死亡。存活实验在术后随访过程中1例出现钛夹游走,食管粘膜下隧道、纵隔及右侧胸腔内脓肿形成。术中均未发生周围脏器损伤、大血管损伤、严重出血、严重纵隔气肿、严重气胸等情况。结论： 1经食管中下段的右后侧做食管隧道是安全可行的。 2经食管NOTES行右胸腔探查及胸膜活检具有操作可行性。 3C02气泵可有效降低纵隔内、胸腔内压力对心肺功能的影响,减少术后气胸的发生。 4粘膜下隧道技术可安全闭合食管切口,但有效的粘膜切口闭合和术后禁食还是必要的。
[Abstract]:Objective : To explore the feasibility and safety of the right lateral thoracic exploration , right stellate ganglion damage and pleural biopsy through animal experiments , which can eliminate the incision of body surface and reduce the associated complications and discomfort .

Methods : A total of 4 cases were treated with large white pigs , including 2 cases of acute experiment and 2 cases of survival . The right chest exploration was performed on the right side and the right stellate ganglion was destroyed , and the parallel autopsy was executed immediately after the operation .
Survival was performed on the right chest , chest film biopsy , post - operative survival , and post - operative necropsies .

Results : A total of 3 cases were successfully performed . A good orientation and location biopsy were obtained in the operation . One of the acute experiments died due to the clamping of the stellate ganglion . One of the survival experiments occurred during the follow - up procedure . There were no injuries of the surrounding organs , major vascular injuries , severe bleeding , severe mediastinal emphysema and severe pneumothorax .

Conclusion :

It is safe and feasible to do esophageal tunnel on the right posterior side of the lower esophageal segment .

2 Transesophageal NOTES , right chest exploration and pleural biopsy were feasible .

3CO2 pump can effectively reduce the effect of intrathoracic pressure on cardiopulmonary function and reduce postoperative pneumothorax .

Submucous tunnel technology can safely close esophageal incision , but effective mucosal incision closure and postoperative fasting are also necessary .
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R61

【共引文献】