Passacantilli Emiliano, Antonelli Manila, D'Amico Alberto, Delfinis Catia P, Anichini Giulio, Lenzi Jacopo, Santoro Antonio
Department of Neurological Sciences, Neurosurgery, University of Rome Sapienza, Rome, Italy. e.passacantilli@gmail
Photomed Laser Surg. 2012 May;30(5):286-92. doi: 10.1089/pho.2011.3137. Epub 2012 Mar 9.
The authors evaluated the histological effects of the 2-μm thulium laser on meningioma tissue, comparing them to the results obtained using bipolar forceps and an ultrasonic aspirator.
The authors analyzed nine samples of intracranial meningiomas. Four slices were obtained for every sample, and one incision was performed on each slice. Two incisions were made with a 2-μm thulium laser (one set to a 6 W and another set to a 12 W power level). One incision was made using a bipolar forceps and the other using an ultrasonic aspirator. Tissue was addressed and analyzed. Upon microscope analysis, three zones of laser action were identified: (A) a central crater; (B) a vaporized zone; and (C) a shrunken layer. These three layers were measured and compared.
When addressed with the laser, all nine meningiomas presented a crater having an average depth of 1 mm. Three layers were clearly distinguished and measured: A (average depth: 0.8 mm at 6 W and 1.24 mm at 12 W); B (average depth: 0.32 mm at 6 W and 0.72 mm at 12 W); and C (average depth: 0.39 mm at 6 W and 0.44 mm at 12 W). On slices treated with bipolar forceps incisions, only zones B and C were identified. Ultrasonic aspirator incisions showed a deeper A zone (average depth: 2.93 mm), no B zone, and a tiny C zone (average depth: 0.16 mm).
Thulium laser can be safely used for the surgical removal of intracranial meningiomas; beyond 2 mm under the surface of action, no tissue alterations were found. The lesions produced on meningiomas were characterized by vaporization and shrinking. When compared with bipolar forceps, the thulium laser offers cutting precision and vaporization of the tissue. When compared to the cavitron ultrasonic surgical aspirator (CUSA), the laser offers shrinking and coagulation of small vessels.
作者评估了2微米铥激光对脑膜瘤组织的组织学影响，并将其与使用双极镊子和超声吸引器所获得的结果进行比较。
作者分析了9个颅内脑膜瘤样本。每个样本获取4片切片，每片切片进行1次切口。用2微米铥激光进行2次切口（一次设置为6瓦功率水平，另一次设置为12瓦功率水平）。一次切口使用双极镊子，另一次切口使用超声吸引器。对组织进行处理和分析。经显微镜分析，确定了激光作用的三个区域：（A）中央凹陷；（B）汽化区；（C）收缩层。对这三层进行测量和比较。
用激光处理时，所有9个脑膜瘤均呈现出平均深度为1毫米的凹陷。清晰区分并测量了三层：A层（平均深度：6瓦时为0.8毫米，12瓦时为1.24毫米）；B层（平均深度：6瓦时为0.32毫米，12瓦时为0.72毫米）；C层（平均深度：6瓦时为0.39毫米，12瓦时为0.44毫米）。在双极镊子切口处理的切片上，仅识别出B区和C区。超声吸引器切口显示A区更深（平均深度：2.93毫米），无B区，C区微小（平均深度：0.16毫米）。
铥激光可安全用于颅内脑膜瘤的手术切除；在作用表面以下2毫米以外，未发现组织改变。脑膜瘤上产生的病变以汽化和收缩为特征。与双极镊子相比，铥激光具有组织切割精度和汽化能力。与超声外科吸引器（CUSA）相比，激光具有小血管收缩和凝固作用。
