Hunter J G, Burt R W, Becker J M, Lee R G, Dixon J A
Department of Surgery, University of Utah, School of Medicine, Salt Lake City.
Gastrointest Endosc. 1989 Jan-Feb;35(1):16-21. doi: 10.1016/s0016-5107(89)72679-1.
This study determined the optimum laser energy for ablation of colonic mucosal lesions and small sessile polyps in the canine colon. Neodymium (Nd):YAG laser, argon laser, and monopolar electrocautery were applied to exposed canine colonic mucosa for various application times at various power settings. At the minimum energy level necessary to ablate mucosa, the Nd:YAG laser caused greater muscularis injury than the argon laser and monopolar electrocautery. At higher energy levels, monopolar electrocautery and Nd:YAG laser caused greater muscularis injury than argon laser. Small surgically created polyps in the canine colon were ablated endoscopically with the three energy sources. Single-session complete polyp ablation occurred most frequently with Nd:YAG laser and least frequently with argon laser. The depth of tissue injury beneath polyp ablation sites was least with argon laser and greatest with Nd:YAG laser. This study suggests that the argon laser is safer than the Nd:YAG laser or monopolar electrocautery for coagulation of flat colonic mucosal lesions. Although the argon laser is safer for the coagulation of small sessile colonic polyps, it may be less effective than monopolar electrocautery or the Nd:YAG laser for the single-session fulguration of polyps greater than 5 mm in diameter.
本研究确定了用于消融犬结肠黏膜病变和小的无蒂息肉的最佳激光能量。将钕(Nd):钇铝石榴石激光、氩激光和单极电灼在不同功率设置下应用于暴露的犬结肠黏膜不同时间。在消融黏膜所需的最低能量水平下,Nd:YAG激光比氩激光和单极电灼造成的肌层损伤更大。在更高能量水平下,单极电灼和Nd:YAG激光比氩激光造成的肌层损伤更大。用这三种能量源在内镜下消融犬结肠中手术制造的小息肉。Nd:YAG激光单次完成息肉消融最为常见,氩激光最少见。息肉消融部位下方的组织损伤深度氩激光最小,Nd:YAG激光最大。本研究表明,对于扁平结肠黏膜病变的凝固,氩激光比Nd:YAG激光或单极电灼更安全。虽然氩激光对小的无蒂结肠息肉的凝固更安全,但对于直径大于5mm息肉的单次电灼,它可能比单极电灼或Nd:YAG激光效果更差。