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1、微創(chuàng)外科在頸廓清術(shù)中應(yīng)用臨床前評(píng)價(jià)作者：易慧明況光儀白殿卿許晨耘趙質(zhì)彬魏欣龔選舉符志龍【摘要】目的于動(dòng)物實(shí)驗(yàn)中探討微創(chuàng)外科在頸廓清手術(shù)中應(yīng)用的可行性。方法選取12只免疫后的健康成年土狗，以3%戊巴比妥鈉(30mg/kg)施行靜脈麻醉，其中6只取頸側(cè)中部30mm長(zhǎng)的模型切口，游離頸皮肌皮瓣后，用兩把常規(guī)小拉鉤拉開(kāi)皮瓣，置入0。內(nèi)鏡4mm鼻竇內(nèi)鏡為照明光源，在直視或電視介導(dǎo)下用常規(guī)外科器械實(shí)施改良根治性頸廓清術(shù)加頜下腺、甲狀腺和半邊甲狀軟骨板切除手術(shù)；另外6只取頸側(cè)100mm長(zhǎng)斜行切口實(shí)施改良根治性頸廓清術(shù)加頜下腺、甲狀腺和半邊甲狀軟骨板切除手術(shù)。結(jié)果(
2、1)小切口組術(shù)中耗時(shí)(100土20)min,術(shù)中出血量為(50±30)ml,實(shí)驗(yàn)狗術(shù)后(2±0,5)天自由進(jìn)食并自由活動(dòng)，術(shù)后(7±1)天傷口愈合拆線(xiàn)，術(shù)后(10±2)天基本恢復(fù)術(shù)前體重。(2)大切口組術(shù)中耗時(shí)(80±20)min,術(shù)中出血量為(30±20)ml,實(shí)驗(yàn)狗術(shù)后(3土0.5)天自由進(jìn)食并自由活動(dòng)，術(shù)后(8±1)天傷口愈合拆線(xiàn)，術(shù)后(13+4)天基本恢復(fù)術(shù)前體重。所有實(shí)驗(yàn)狗術(shù)后無(wú)傷口感染、皮下積液、明顯消瘦、死亡等并發(fā)癥出現(xiàn)。結(jié)論在電視內(nèi)鏡介導(dǎo)下用常規(guī)外科器械通過(guò)一個(gè)微小切口即可實(shí)施狗頸廓清術(shù)而達(dá)到微創(chuàng)外科目的，此微創(chuàng)頸廓清技術(shù)值得進(jìn)一步在
3、臨床試用?！娟P(guān)鍵詞】微創(chuàng)外科頸廓清術(shù)臨床前評(píng)價(jià)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
