胸腔鏡下食道亜全摘術における気腹下施術用システムAIRSEAL<SUP>®</SUP>の有用性  [in Japanese] The Usefulness of Airseal<SUP>®</SUP> Intelligent Flow System in Video Assisted Thoracoscopic Esophagectomy  [in Japanese]

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Author(s)

    • 大塚 耕司 OTSUKA Koji
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 渡辺 誠 WATANABE Makoto
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 青木 武士 AOKI Takeshi
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 加藤 貴史 KATO Takashi
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 村上 雅彦 MURAKAMI Masahiko
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 有吉 朋丈 ARIYOSHI Tomotake
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 広本 昌裕 KOHMOTO Masahiro
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 加藤 礼 KATO Rei
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 山下 剛史 YAMASHITA Takeshi
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 五藤 哲 GOTO Satoru
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 山崎 公靖 YAMAZAKI Kimiyasu
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University
    • 藤森 聰 FUJIMORI Akira
    • 昭和大学医学部消化器・一般外科学教室 Department of Gastroenterological & General Surgery, School of Medicine, Showa University

Abstract

目的:常時循環型排煙システムAIRSEALの有用性について検討を行った.<BR>対象と方法:基礎実験ではAIRSEALの気流の流れ,大動物実験では圧の維持性を,臨床検討として胸腔鏡下食道手術におけるAIRSEAL群とUHI-4群の手術成績について比較検討を行った.<BR>結果:基礎実験では,ポート先端より外反する気流と撹拌状況が描出された.大動物実験ではAIRSEAL群の視認性・操作性が有意に示された.臨床検討では,胸腔内操作時間,胸腔内出血量はAIRSEAL群が有意に優れていた.術中体温は手術開始後1時間,胸腔内操作終了時に,有意にAIRSEAL群において体温低下を認めたが,手術終了時において有意差は認めなかった.<BR>結語:AIRSEALは,循環型排煙により良好な視野を維持し,手術時間短縮・出血量軽減に寄与した.

The AirSeal Intelligent Flow System (iFS) presents some advantages in maintaining stable pneumoperitoneum (even under automatic and continuous suction) and continuous smoke evacuation throughout a surgical procedure. We evaluated the usefulness of the AirSeal iFS in an animal model and in a clinical setting. The suitability of the AirSeal iFS with respect to ease of operation and the suitability of the workspace were evaluated in the animal model. A total of 120 patients who underwent video-assisted thoracoscopic surgery for esophageal cancer were comparatively evaluated for surgical outcomes by dividing them into two graups ; 60 patients using the AirSeal iFS and another 60 patients using a conventional system. Thoracoscopic operative time, thoracoscopic blood loss, and intraoperative body temperature were analyzed. The mean thoracoscopic operative time was significantly shorter in the AirSeal iFS group than in the conventional group. The mean thoracoscopic operative blood loss in the AirSeal iFS group was significantly less than that in the conventional group. Intraoperative body temperature was significantly lower in the AirSeal iFS group than the other at 1 hour after the commencement of the operation and at the completion of procedures in the thoracic cavity. The difference in the body temperature between the two systems 1 hour after the operation had been completed was not statistically significant. The results indicate that the AirSeal iFS is a good smoke evacuation system, provides a good field of view, and maintains pressure well. All these factors lead to a shorter procedure time and less blood loss, with good maintenance of pneumoperitoneum.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 76(6), 1266-1271, 2015

    Japan Surgical Association

Codes

  • NII Article ID (NAID)
    130005116717
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • ISSN
    1345-2843
  • NDL Article ID
    030764313
  • NDL Call No.
    Z19-227
  • Data Source
    NDL  J-STAGE 
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