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CO激光在脑肿瘤显微手术切除中的实用性评估。

The evaluation of the usefulness of CO laser in microsurgical resection of brain tumors.

作者信息

Nerntengian Ntenis, Tanrikulu Levent, Manoussos Michael Anthony, Barettas Nikolaos, Gkasdaris Grigorios, Birbilis Theodosios

机构信息

Department of Neurosurgery, University Hospital of Alexandroupolis, Medical School of Democritus University of Thrace, Dragana, Alexandroupolis, Greece.

Department of Neurosurgery, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Germany.

出版信息

Surg Neurol Int. 2022 Mar 31;13:118. doi: 10.25259/SNI_158_2022. eCollection 2022.

Abstract

BACKGROUND

Since its introduction to surgery, the CO laser has been used in the treatment of various neurosurgical pathologies as it combines cutting, vaporizing, and coagulating properties in one tool and has a safe penetration depth. In this case series of 29 patients, we present the evaluation of the usefulness of the closed system type - sealed tube surgical CO laser in the surgical removal of brain tumors.

METHODS

The Sharplan 40C model SurgiTouch, sealed tube type CO laser, was used in the resection of 29 brain tumors; 13 meningiomas, six metastases, nine gliomas, and one acoustic neuroma. The same senior surgeon (BT) assessed and classified the benefit provided by the CO laser in the resection of the neoplasms to considerable (Group 1), moderate (Group 2), and poor (Group 3).

RESULTS

Group 1 included 14 patients with 13 meningiomas and one acoustic neuroma, Group 2 included six patients, all of whom had metastases, and Group 3 included nine patients of which six had glioblastoma and three astrocytoma. No complications or technical problems occurred due to the use of the CO laser.

CONCLUSION

The CO laser is a valuable complementary tool in brain tumor surgery displaying high efficacy and practicality in the resection of neoplasms which are fibrous and have hard consistency. It has high acquisition and maintenance cost and cannot replace the bipolar diathermy. The newest generation of flexible CO laser fiber provides more ergonomy and promises new perspectives of its neurosurgical use in the modern era.

摘要

背景

自引入外科手术以来,CO2激光已被用于治疗各种神经外科疾病,因为它在一种工具中兼具切割、汽化和凝固特性,且具有安全的穿透深度。在这个包含29例患者的病例系列中,我们展示了对封闭式系统类型——密封管手术用CO2激光在脑肿瘤手术切除中的实用性评估。

方法

使用Sharplan 40C型号的SurgiTouch密封管型CO2激光切除29例脑肿瘤;其中13例为脑膜瘤,6例为转移瘤,9例为胶质瘤,1例为听神经瘤。同一位资深外科医生(BT)评估并将CO2激光在肿瘤切除中提供的益处分为显著(第1组)、中等(第2组)和差(第3组)。

结果

第1组包括14例患者,其中13例为脑膜瘤,1例为听神经瘤;第2组包括6例患者,均为转移瘤;第3组包括9例患者,其中6例为胶质母细胞瘤,3例为星形细胞瘤。使用CO2激光未出现并发症或技术问题。

结论

CO2激光是脑肿瘤手术中有价值的辅助工具,在切除纤维性且质地硬的肿瘤时显示出高疗效和实用性。它的购置和维护成本高,不能替代双极电凝。最新一代的柔性CO2激光光纤提供了更高的人体工程学特性,并为其在现代神经外科手术中的应用带来了新的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc0d/9062927/2219b48bea69/SNI-13-118-g001.jpg

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