Lowe B A, Poage M D
Division of Urology and Renal Transplantation, Oregon Health Sciences University, Portland 97201.
Lasers Surg Med. 1988;8(4):377-80. doi: 10.1002/lsm.1900080407.
A comparison is made of laser anastomoses of the murine vas deferens at different energies with the neodymium (Nd):YAG laser at 1.06 micron and 1.318 micron and with the CO2 laser. A total of 28 welds were performed with a free-hand technique employing a 600-micron silicon fiber with the Nd:YAG and a hand piece with a 500-micron spot size for the CO2. After 6 weeks, all animals were sacrificed and the vasa evaluated for patency. Fifteen out of 28 controls repaired with microsurgical techniques were found to be patent; 4/10 vasa were patent with use of the Nd:YAG at 1.318 micron at laser energies of 300 mW and 500 mW. At 1.06 micron, only 1/4 anastomoses was patent at a power setting of 1 W. None of the anastomoses performed with the CO2 laser was patent. Histologic study revealed intense fibrosis in all the lasered vasa, with sperm granuloma formation associated with most anastomoses. Although this is a preliminary study, it appears that the Nd:YAG laser at 1.318 micron and a power setting of 300-500 mW provides patency rates superior to the Nd:YAG at 1.06 micron and to the CO2 lasers and is equivalent to standard micro-surgical techniques in the murine vas deferens.
对采用钕（Nd）：钇铝石榴石（YAG）激光在1.06微米和1.318微米波长以及二氧化碳（CO2）激光在不同能量下对小鼠输精管进行激光吻合术的情况进行了比较。总共进行了28次吻合术，采用徒手技术，使用600微米的硅光纤连接Nd：YAG激光，以及使用光斑尺寸为500微米的手持部件连接CO2激光。6周后，处死所有动物并评估输精管的通畅情况。发现采用显微外科技术修复的28个对照中有15个通畅；使用Nd：YAG激光在1.318微米波长、激光能量为300毫瓦和500毫瓦时，10个输精管中有4个通畅。在1.06微米波长下，在1瓦的功率设置下只有1/4的吻合术通畅。使用CO2激光进行的吻合术均不通畅。组织学研究显示，所有接受激光治疗的输精管均有严重纤维化，大多数吻合术伴有精子肉芽肿形成。虽然这是一项初步研究，但似乎1.318微米波长、功率设置为300 - 500毫瓦的Nd：YAG激光提供的通畅率优于1.06微米波长的Nd：YAG激光和CO2激光，并且在小鼠输精管中与标准显微外科技术相当。
