超声刀气雾对胃癌肿瘤细胞播散种植的影响

目的探讨超声刀对胃癌组织标本切割时产生的烟雾对胃癌细胞的播散种植的影响。方法用超声刀和电刀分别对胃癌组织标本中周围正常组织和胃癌组织进行不同时间（5、10、15、20s）、不同功率（超声刀的3档和5档,电刀的电切40W和电凝80W）的切割,收集气雾悬浮液进行涂片和细胞学观察。结果超声刀和电刀对胃癌组织标本周围正常组织进行切割产生的气雾悬浮液涂片观察均未见肿瘤细胞。在电刀切割胃癌组织电切功率为40W/20s时,电凝80W/15s、20s时,5次收集的气雾中发现有1次、2次和3次收集气雾中发现有胃癌肿瘤细胞。超声刀切割胃癌组织在3档功率/20s时,5档功率/15s、20s时,5次收集的气雾中发现有2次,1次和4次收集气雾中发现胃癌肿瘤细胞。结论和电刀相比,超声刀切割正常胃组织和胃癌组织,均无增加胃癌肿瘤细胞的播散种植。为超声刀在胃癌手术中的安全使用提供初步的理论依据。

Effect of the aerosol produced by ultrasonic scalpel on tumor cell dissemination and seeding in the dissection of gastric cancer

Objective To explore the effect of the aerosol produced by ultrasonic scalpel on tumor cell dissemination and seeding in the dissection of gastric cancer.Methods The aerosol suspensions was collected after the normal gastric tissue and cancer tissue cutted by ultrasonic scalpel or electrotome,used different power（ultrasonic scalpel：third grade/fifth grade;electrotome：electrocuted 40W/ electrocoagulated 80 W） and lasted different times（5,10,15,20 s）.Cytologic examination of the aerosol suspensions filtrate was performed after the filtration process,smear,cell block,and staining.Results No tumor cells were observed in the aerosol suspensions collected after the normal gastric tissue cutted by ultrasonic scalpel or electrotome.gastric tumor cells were found in the aerosol suspension collected after the gastric cancer tissue cutted by electrotome（40W/20s,80W/15s,20s）,gastric tumor cells were found for 1,2 and 3 times of the five sub-collection of the aerosol suspension.gastric tumor cells were found in ultrasonic scalpel group（third grade/20s,grade/15s,20s）.gastric tumor cells were found for 2,1 and 4 times of the five sub-collection of the aerosol suspension.Conclusions In this study,ultrasonic scalpel used in gastric cancer surgery are not associated with a greater risk for intraperitoneal dissemination of cancer cells than electrotome.