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Khirurgii

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Year 2015 Vol. 23 No 3

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

V.V. BOYKO1, N.A. REMNYOVA2, N.S. CHERNYAYEV3, N.N. BRISKAYA1

SOME PATHOMORPHOLOGICAL FEATURES OF THE RESECTION EDGE OF THE LIVER IMMEDIATELY AFTER USING THE APPARATUS OF HIGH-FREQUENCY ELECTROSURGICAL WELDING AND MONOPOLAR ELECTROCOAGULATOR

SE "Zaycev V.T. Institute of General and Emergency Surgery NAMS of Ukraine"1,
"Kharkov National University Named after V.N. Karazin" 2,
Kharkov National Medical University3,
Kharkov, Ukraine

Objectives. To study some pathomorphological features of resection edge of rabbit liver after using the apparatus of high-frequency electrosurgical welding "Patonmed EKVZ-300" in automatic mode and monopolar electrocoagulator in the 1st day after surgery.
Methods. Experimental animals were divided into two main groups according to the type of the coagulator used: group A – 15 cases of study of the liver resection edge after application of the high frequency electrosurgical welding "Patonmed EKVZ-300" automatically; group B – 15 cases of study of the liver resection edge after application of monopolar electrocoagulator. The edges of resected rabbit liver were withdrawn immediately after treating with electrocoagulators to achive hemostasis (the 1st day). Four liver samples of healthy rabbits were used as a control group (C). Tissues were stained with hematoxylin, eosin and by van Gieson method. The general nature of the liver resection edge tissues, morphological features of hepatocytes, Kupffer cells, and the state of the vascular bed had been assessed microscopically.
Results. Within the first 24 hours after using the apparatus of high frequency electrosurgical welding "Patonmed EKVZ-300" in the automatic mode (group A) and monopolar electrocoagulator (group B) it was revealed that in the resection edge in using of both electrocoagulation methods two morphological zones – the zone of necrosis (the 1st zone) and the zone of necrobiosis (the 2nd zone) were reliably registered.
Electrosurgical welding with the apparatus "Patonmed EKVZ-300" in the automatic mode leads to the superficial injury of the liver parenchyma (depth – 4,6±0,08 mm), minimal inflammation and the injury of the vascular endothelium, moderate impairment of hepatic microcirculation. Monopolar electrocoagulator leads to more severe injury of liver parenchyma at the resection edge (depth – 5,6±0,04 mm), causes intense inflammation significantly expanding the primary zone of the damage, leads to severe impairment of microcirculation, venous stasis and endothelial damage.
Conclusion. High-frequency electrosurgical welding "Patonmed EKVZ-300" in the automatic mode is considered as a sparing method of the liver resection.

Keywords: high-frequency welding, electrocoagulation, liver resection, surgical hemostasis, damage of the liver parenchyma, electrosurgical instruments, microcirculation
p. 256-261 of the original issue
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Address for correspondence:
61103, Ukraina,
g. Kharkov, v'ezd Balakireva, d. 1,
GU "Institut obschey i neotlozhnoy khirurgii im.V.T.Zaytseva NAMNU,"
otdelenie khirurgii pecheni, zhelchnyih protokov i podzheludochnoy zhelezyi,
tel.mob.: 380 506 15-45-55,
e-mail: dr.chernyayev@mail.ru,
Chernyayev Nikita Svyatoslavovich
Information about the authors:
Boyko V.V. MD, professor, director of SE "Zaycev V. T. Institute of General and Emergency Surgery NAMS of Ukraine"
Remnyova N.A. PhD, an associate professor of the general and clinical pathology chair of "Kharkov National Institute named after V.N. Karazin".
Chernyayev N.S. A day-time post-graduate student of the 3rd year of the surgery chair №1 of Kharkov State Medical University.
Briskaya N.N. PhD, surgeon of the department of the liver, bile ducts and pancreas surgery of SE "Zaycev V.T. Institute of General and Emergency Surgery NAMS of Ukraine".
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