Boutteville C, Querleu D, Brunneteau J P, Bethouart M, Crépin G
Clinique Universitaire de Gynécologie-Obstétrique et de Biologie de la Reproduction, Roubaix.
Rev Fr Gynecol Obstet. 1987 Nov;82(11):633-40.
Forty Wistar female rats were the subject of a laser resection of the uterine horn with microsurgical anastomosis, comparing the effect of various available lasers with blade section. The animals were divided in four groups. The first group, with 10 animals, underwent a resection of each uterine horn, using the CO2 laser, with a one layer anastomosis using ethilon 10/10, under microscope. Five of them were examined one week later and the five others three weeks later, with evaluation of the adhesions, patency of the anastomosis and its histological examination. The three other groups underwent a resection using an Argon laser, Yag laser or scissors. With the Yag laser, the lumen disappeared completely and the mucosa as well as the musculosa were totally destroyed. In the other groups, adhesions were noted as well as a variable inflammatory reaction, in early and late evaluations. However, this reaction is minimal after a resection with scissors, moderate after CO2 laser, significant after Argon laser. It is concluded that only the CO2 laser is suitable for gynecological microsurgery; however, the only advantage over a scissor resection is a faster operating time and a better hemostasis; the other parameters are in favor of blade resection. Thus, it seems that laser resection is not an ideal procedure in humans, for tubal resection before anastomosis.
40只雌性Wistar大鼠接受了子宫角激光切除并显微外科吻合术，比较了各种可用激光与刀片切除的效果。将动物分为四组。第一组有10只动物，使用二氧化碳激光对每个子宫角进行切除，在显微镜下用10/10的Ethilon进行单层吻合。其中5只在一周后检查，另外5只在三周后检查，评估粘连情况、吻合口通畅情况及其组织学检查。其他三组分别使用氩激光、钇铝石榴石激光或剪刀进行切除。使用钇铝石榴石激光时，管腔完全消失，黏膜和肌层完全被破坏。在其他组中，在早期和晚期评估中均观察到粘连以及不同程度的炎症反应。然而，剪刀切除后的反应最小，二氧化碳激光切除后为中度，氩激光切除后显著。得出的结论是，只有二氧化碳激光适用于妇科显微手术；然而，与剪刀切除相比，唯一的优势是手术时间更快和止血效果更好；其他参数则有利于刀片切除。因此，对于人类在吻合术前进行输卵管切除，激光切除似乎不是一种理想的手术方法。
