内科胸腔镜下内脏神经切断术的动物实验

doi:10.6040/j.issn.1671-7554.0.2024.0092

摘要/Abstract

摘要： 目的通过动物实验初步探索在内科胸腔镜下行内脏神经切断术的可行性。方法对4头实验猪给予静脉麻醉联合肋间神经阻滞麻醉,保留实验动物自主呼吸,应用内科胸腔镜开展内脏神经切断术,记录手术时间、出血量及并发症、技术问题等情况。结果用4头猪开展的内科胸腔镜下内脏神经切断术成功,无术中大出血、脏器损伤及死亡等并发症。结论内科胸腔镜下内脏神经切断术动物试验可行,为内科胸腔镜下内脏神经切断术治疗上腹部癌痛的临床应用提供参考。

关键词: 内科胸腔镜, 上腹部癌痛, 内脏神经, 实验动物, 猪

Abstract: Objective To explore the feasibility of medical thoracoscopic splanchnotomy through animal experiments. Methods Four experimental pigs were given intravenous anesthesia combined with intercostal nerve block anesthesia, and preserved the spontaneous breathing state. Splanchnotomy was performed by medical thoracoscope. The operation time, blood loss, complications and technical problems were recorded. Results Medical thoracoscopic splanchnotomy was successfully performed in 4 pigs. There were no complications such as intraoperative hemorrhage, organ injury and death. Conclusion The animal experiment of medical thoracoscopic splanchnotomy is feasible, Which can provide a research basis for the clinical application of medical thoracoscopic splanchnotomy in the treatment of epigastric cancer pain.

Key words: Medical thoracoscopy, Epigastric cancer pain, Splanchnic nerves, Experimental animal, Pig

中图分类号:

R730.56

白晓亮,孙盼盼,王泓力,龚顺之,孙云起,舒梦,戚晓良. 内科胸腔镜下内脏神经切断术的动物实验[J]. 山东大学学报 (医学版), 2024, 62(4): 9-13.

BAI Xiaoliang, SUN Panpan, WANG Hongli, GONG Shunzhi, SUN Yunqi, SHU Meng, QI Xiaoliang. Animal experiment of medical thoracoscopic splanchnotomy[J]. Journal of Shandong University (Health Sciences), 2024, 62(4): 9-13.

参考文献

[1] Neufeld NJ, Elnahal SM, Alvarez RH. Cancer pain: a review of epidemiology, clinical quality and value impact[J]. Future Oncol, 2017, 13(9): 833-841.
[2] Woodrow A, Teramoto M, Thapliyal M, et al. Procedural education for cancer-related pain in Pain Medicine fellowships: a national program survey[J]. Reg Anesth Pain Med, 2023: rapm-2023-104630. doi:10.1136/rapm-2023-104630.
[3] Goyal S, Kumar A, Goyal D, et al. Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: a systematic review and meta-analysis[J]. Indian J Anaesth, 2023, 67(12): 1036-1050.
[4] Paul AK, Smith CM, Rahmatullah M, et al. Opioid analgesia and opioid-induced adverse effects: a review[J]. Pharmaceuticals, 2021, 14(11): 1091. doi:10.3390/ph14111091.
[5] Kwon HJ, Jang K, Leem JG, et al. Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study[J]. Korean J Pain, 2021, 34(4): 479-486.
[6] Cao J, He Y, Liu HQ, et al. Effectiveness of percutaneous celiac plexus ablation in the treatment of severe cancer pain in upper abdomen and evaluation of health economics[J]. Am J Hosp Palliat Care, 2017, 34(2): 142-147.
[7] 景仕银, 仲崇俊. 肝癌顽固性疼痛行左侧单孔胸腔镜内脏神经切断术的效果及安全性[J]. 肝脏, 2020, 25(7): 769-771. JING Shiyin, ZHONG Chongjun. Effect and safety of left single-port thoracoscopic visceral neurotomy for intractable pain of liver cancer[J]. Chinese Hepatology, 2020, 25(7): 769-771.
[8] Pacheco-Feijoó GM, Amado-Tineo JP, Plancarte-Sánchez R, et al. Efficacy and safety of celiac plexus neurolysis in the treatment of chronic pain secondary to oncological pathology of the upper hemiabdomen: a systematic review and meta-analysis[J]. Indian J Palliat Care, 2023, 29(4): 394-406.
[9] Grigoriadis S, Tsitskari M, Ioannidi M, et al. Computed tomography-guided percutaneous radiofrequency ablation of the splanchnic nerves as a single treatment for pain reduction in patients with pancreatic cancer[J]. Diagnostics, 2021, 11(2): 303.
[10] Lu F, Wang XJ, Tian J, et al. Early versus delayed computed tomography-guided celiac plexus neurolysis for palliative pain management in patients with advanced pancreatic cancer: a retrospective cohort study[J]. Front Neurol, 2023, 14: 1292758. doi:10.3389/fneur.2023.1292758.
[11] Kang CM, Lee HY, Yang HJ, et al. Bilateral thoracoscopic splanchnicectomy with sympathectomy for managing abdominal pain in cancer patients[J]. Am J Surg, 2007, 194(1): 23-29.
[12] Munavvar M, Khan MA, Edwards J, et al. The autoclavable semirigid thoracoscope: the way forward in pleural disease?[J]. Eur Respir J, 2007, 29(3): 571-574.
[13] 中国医师协会整合医学分会呼吸专业委员会. 内科胸腔镜诊疗规范[J]. 中华肺部疾病杂志(电子版), 2018, 11(1): 6-13.
[14] 李光忠, 张本斯. 内脏神经切除治疗顽固性腹痛的解剖学基础研究[J]. 中国临床康复, 2004, 8(35): 8000-8002. LI Guangzhong, ZHANG Bensi. Anatomical basis of splanchnicectomy for intractable abdominal pain[J]. Chinese Journal of Clinical Rehabilitation, 2004, 8(35): 8000-8002.
[15] Bosanquet DC, Wilcox CR, Rasheed A. Bilateral thoracoscopic splanchnotomy to alleviate pain in chronic pancreatic disease[J]. Ann Thorac Surg, 2016, 101(3): 91-93.
[16] Orhan O, Duzler A. Anatomy of the thoracic splanchnic nerves in pigs[J]. Vet Res Commun, 2007, 31(3): 237-243.
[17] Matsumoto T, Yoshimatsu R, Osaki M, et al. Percutaneous splanchnic nerve neurolysis analgesic efficacy and safety for cancer-related pain: a systematic review and meta-analysis[J]. Support Care Cancer, 2023, 31(6): 324.
[18] Cai ZH, Zhou XL, Wang ML, et al. Splanchnic nerve neurolysis via the transdiscal approach under fluoroscopic guidance: a retrospective study[J]. Korean J Pain, 2022, 35(2): 202-208.
[19] Zhang WX, Wei YP, Jiang H, et al. T3 versus T4 thoracoscopic sympathectomy for palmar hyperhidrosis: a meta-analysis and systematic review[J]. J Surg Res, 2017, 218: 124-131.
[20] 刘会宁, 彭军, 任迎春, 等. 34例胸腔镜下肺楔形切除与21例肺段切除对位于肺段P区的ⅠA1期非小细胞肺癌治疗比较[J]. 山东大学学报(医学版), 2022, 60(11): 38-43. LIU Huining, PENG Jun, REN Yingchun, et al. Comparison of 34 cases of thoracoscopic wedge resection and 21 cases of segmental resection for stage ⅠA1 non-small cell lung cancer in area P[J]. Journal of Shandong University(Health Sciences), 2022, 60(11): 38-43.
[21] 邵广强,庞大志,张吉天,等. 超微5 mm单孔胸腔镜交感神经链切断术在原发性手汗症手术中的临床应用[J]. 中国胸心血管外科临床杂志, 2022, 29(3): 306-310. SHAO Guangqiang,PANG Dazhi,ZHANG Jitian, et al. Clinical application of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis [J]. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(3): 306-310.
[22] Kuijpers M, Klinkenberg TJ, Bouma W, et al. Single-port videoscopic splanchnotomy for palliation of refractory chronic pancreatitis[J]. Interact Cardiovasc Thorac Surg, 2016, 22(4): 393-396.
[23] 马维江, 王高俊, 欧阳询, 等. 非气管插管保留自主呼吸麻醉在电视胸腔镜手术中应用效果的Meta分析[J]. 山东大学学报(医学版), 2020, 58(12): 29-37. MA Weijiang, WANG Gaojun, OUYANG Xun, et al. Effect of non-intubated spontaneous ventilation anesthesia used in video-assisted thoracoscopic surgery: a Meta-analysis[J]. Journal of Shandong University(Health Sciences), 2020, 58(12): 29-37.
[24] Iwata Y, Hamai Y, Koyama T. Anesthetic management of nonintubated video-assisted thoracoscopic surgery using epidural anesthesia and dexmedetomidine in three patients with severe respiratory dysfunction[J]. J Anesth, 2016, 30(2): 324-327.
[25] 沈友素, 周标, 石喜玲, 等. 非气管插管麻醉在胸腔镜双侧交感神经链切断术中的应用[J]. 江西医药, 2023, 58(8): 902-904. SHEN Yousu, ZHOU Biao, SHI Xiling, et al. Application of non-tracheal intubation anesthesia in thoracoscopic bilateral sympathectomy[J]. Jiangxi Medical Journal, 2023, 58(8): 902-904.
[26] Cuschieri A, Shimi SM, Crosthwaite G, et al. Bilateral endoscopic splanchnicectomy through a posterior thoracoscopic approach[J]. J R Coll Surg Edinb, 1994, 39(1): 44-47.
[27] Tomaszewski S, Szyca R, Jasiński A, et al. Bilateral posterior thoracoscopic splanchnicectomy in a face-down position in the management of chronic pancreatic pain[J]. Pol Merkur Lekarski, 2007, 22(131): 399-401.

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