Żywicka Bogusława, Bujok Jolanta, Janeczek Maciej, Czerski Albert, Szymonowicz Maria, Dobrzyński Maciej, Świderski Jacek, Rybak Zbigniew
Department of Experimental Surgery and Biomaterial Research, Wroclaw Medical University, Bujwida 44, 50-368 Wroclaw, Poland.
Division of Animal Physiology, Department of Animal Physiology and Biostructure, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 31, 50-375 Wroclaw, Poland.
Materials (Basel). 2021 Apr 16;14(8):2000. doi: 10.3390/ma14082000.
The aim of this study was to evaluate the usefulness of a thulium-doped fiber laser and a diode laser in zero ischemia kidney surgery, by carrying out a comparative study in a pig model.
Research was carried out on 12 pigs weighing 30 kg each. A thulium-doped fiber laser (TDFL) and a diode laser (DL) operating at wavelengths of 1940 and 1470 nm, respectively, were used. The cut sites were assessed both macroscopically and microscopically. The zone of thermal damage visible in the histopathological preparations was divided into superficial and total areas.
During partial nephrectomy, moderate to minimal bleeding was observed, which did not require additional hemostatic measures. All animals survived the procedure. On day 0, the total thermal damage depth was 837.8 µm for the TDFL and 1175.0 µm for the DL. On day 7, the depths were 1556.2 and 2301.7 µm, respectively. On day 14, the overall thermal damage depth for the DL was the greatest (6800 µm). The width of the superficial zone was significantly reduced on days 7 and 14 after TDFL application.
Both lasers are suitable for partial wedge nephrectomy without ischemia in pigs. The TDFL produced similar or better hemostasis than the DL, with a smaller zone of thermal damage and, therefore, seems more suitable for application in human medicine.
本研究的目的是通过在猪模型中进行对比研究，评估掺铥光纤激光器和二极管激光器在零缺血肾脏手术中的实用性。
对12头体重均为30千克的猪进行研究。使用了分别在1940纳米和1470纳米波长下工作的掺铥光纤激光器（TDFL）和二极管激光器（DL）。对切割部位进行了宏观和微观评估。将组织病理学切片中可见的热损伤区域分为浅层和总面积。
在部分肾切除术中，观察到中度至轻度出血，无需额外的止血措施。所有动物均在手术后存活。在第0天，TDFL的总热损伤深度为837.8微米，DL为1175.0微米。在第7天，深度分别为1556.2微米和2301.7微米。在第14天，DL的总体热损伤深度最大（6800微米）。应用TDFL后，在第7天和第14天浅层区域的宽度显著减小。
两种激光器均适用于猪的无缺血部分楔形肾切除术。TDFL产生的止血效果与DL相似或更好，热损伤区域更小，因此似乎更适合应用于人类医学。
