Experimental Research On Electrovaporization And The Clinical Application In Urology

A. Experimental research on electrovaporizationTo investigate the effect of electrovaporization on different tissues and provide experimental data for clinical application.1. To investigate the effect of electrovaporization on different tissue in vitro. The current intensity and vaporizing effect of high frequency electric current was determined on muscle,skin,and subcutaneous fatty tissue of swine as well as human prostate in different output power. There were significant differences between each other of four different tissues about current intensity and vaporizing effect. The electric resistance of fatty tissue was the highest but the vaporized extent was the lowest, so that it was not easy to be perforated. The current intensity and vaporized extent of tissue could be strengthend by enhancing output power. Carbonized layer in 0.7～2.0mm depth and hyaline denaturalized layer in 1.5～2.0mm depth was under the surface of vaporized tissues, in which, coagulated necrosis was seen in blood vessels, on light microscope. However, denaturalized layer of fatty tissue was significantly less than others. The vaporizing effect on tissue in pure coagulative current was less than that in pure cut current. These results suggest that the electrovaporizing effect and electric resistance on different tissues are quite different according to their tissue density.2. To investigate the effect of electrovaporization on renal,muscle anddermis. Electric current intensity, vaporized depth at central area and vaporized surface area in renal, muscle and dermis of rabbits was determined in vivo after electrovaporization under different output power of electric current. The alteration was observed at 0～6mm depth under or 0～6mm wide around the vaporized surface on light microscopy and electronic microscopy. As the output power of electric current was increased, electric current intensity, vaporized depth at central area and vaporized surface area in the vaporized renal, muscle and dermis were also increased. Light microscopy and electronic microscopy examination showed that the effect of electric current at different distance to the vaporized center on different tissues was not the same. The farther the distance from the vaporized center, the slighter the alteration of injury. Significant histological changes could be seen 5-6mm under the vaporized surface in renal and muscle but just 3-4mm in dermis.3. To investigate the effect of electrovaporization on prostatic tissue structure in vivo. The effect of electrovaporization was determined on prostate before planned suprapubic prostatectomy and transurethral electrovaporization of prostate. 26 cases who suffer from benign prostatic hyperplasia (BPH) and had indication for prostatectomy were enrolled. The depth and area of vaporization were observed by light microscopic and electron microscopic examination at the central area of vaporized prostate. The vaporizing effect in pure cut current including depth and area of vaporization was stronger than that in pure coagulative current, the greater the output power, the stronger the vaporizing effect. But the histological lesions under this level varied with the cut and coagulative current. The histological lesions can be observed 5-6mm under the vaporized surface in coagulative current,otherwise there were slightly in cut current. These findings indicated that it is important to understand the biophysics characteristic of the electrovaporization in order to avoid the damage of surrounding or deep tissues.B. Clinical application research about electrovaprization Ⅰ,Clinical application research about transurethral electrovaprization of prostate1. To evaluate the safety of transurethral electrovaprization of prostate (TUVP) perioperatively. 289 cases were enrolled in this study.103 cases underwent suprapubic prostatectomy as control group,186 cases underwent TUVP.Blood pressure and pulse rate were recorded between 24h preoperation and 6h postoperation.Grade of health,anesthesia met...