Division of Thoracic Surgery, Thoracic Surgery Research Laboratory (LIM-61), Heart Institute (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Rua Dr. Eneas de Carvalho Aguiar 44, Bloco I, 7° andar, São Paulo, SP, 05403-000, Brazil.
Department of Surgery, Universidade do Estado do Amazonas, Manaus, Brazil.
Lasers Med Sci. 2019 Sep;34(7):1441-1448. doi: 10.1007/s10103-019-02729-0. Epub 2019 Feb 14.
To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight Landrace pigs (15-20 kg) were anesthetized, intubated, ventilated, and submitted to a cervical tracheostomy. An anterior and posterior midline longitudinal laryngofissure incision was created according to randomization-control (n = 4), posterior laryngofissure with a scalpel blade; electrocautery (n = 12), posterior laryngofissure by electrocautery (10, 15, 20, 25 W powers); CDL (n = 12), posterior laryngofissure by the CDL (10, 15, 20, 25 W peak powers in pulsed mode). Larynx and proximal trachea were excised, prepared for histopathology, and digital morphometric analysis. Measurements in and within each group were analyzed (Kruskal-Wallis and Dunn test) with a level of significance of p < 0.05. Incision width was not different between the groups, as well as in the powers used in CDL (p = 0.161) and electrocautery group (p = 0.319). The depth of the incisions was smaller in the Laser group compared to control (p = 0.007), and in the electrocautery compared to control (p = 0.026). Incision area was smaller in CDL compared with the control (p = 0.027), and not different between laser and electrocautery groups (p = 0.199). The lateral thermal damage produced by electrocautery was the largest, with a significant difference between laser and electrocautery (p = 0.018), and between electrocautery and control (p = 0.004), whereas the comparison between laser and control showed no significant differences (p = 0.588). The posterior laryngofissure incision using a 980-nm CDL is feasible resulting in smaller incisional area and less lateral thermal damage.
为了评估 980nm 接触二极管激光（CDL）作为一种在活体猪中创建后喉裂的方法的可行性。将 28 头长白猪（15-20kg）麻醉、插管、通气，并进行颈气管切开术。根据随机对照（n=4）、手术刀刀片后喉裂；电烙术（n=12）、电烙术（10、15、20、25W 功率）后喉裂；CDL（n=12），后喉裂用 CDL（10、15、20、25W 峰值功率脉冲模式）创建前后中线纵向喉裂切口。切除喉和近端气管，准备进行组织病理学和数字形态计量分析。对每组内和组间的测量值进行分析（Kruskal-Wallis 和 Dunn 检验），置信水平为 p<0.05。各组之间的切口宽度无差异，CDL（p=0.161）和电烙术组（p=0.319）的使用功率也无差异。与对照组相比，激光组的切口深度较小（p=0.007），与电烙术组相比，激光组的切口深度较小（p=0.026）。与对照组相比，CDL 组的切口面积较小（p=0.027），激光组与电烙术组之间无差异（p=0.199）。电烙术产生的侧向热损伤最大，激光与电烙术之间差异有统计学意义（p=0.018），电烙术与对照组之间差异有统计学意义（p=0.004），而激光与对照组之间差异无统计学意义（p=0.588）。使用 980nm CDL 进行后喉裂切开术是可行的，可减小切口面积和减少侧向热损伤。
