Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China.
Department of Urology, Xianyang Central Hospital, Xianyang, P.R. China.
Lasers Surg Med. 2022 Sep;54(7):1002-1009. doi: 10.1002/lsm.23561. Epub 2022 Jul 23.
Due to the precise vaporization of the novel 450 nm blue diode laser in soft tissues (i.e., bladder and colon) in our previous studies, porcine stomach tissues were applied here to certify its efficacy in endoscopic mucosal resection (ESR)/endoscopic submucosal dissection (ESD) for hypothetical lesions ex vivo and in vivo.
In an ex vivo study of ESR, 20 pieces of tissues (8 cm × 6 cm) from 7 fresh stomachs after spraying saline were vaporized with a three-dimensional scanning system using the blue diode laser at a maximum of 30 W, a different treatment speed and working distance (WD). In ex vivo ESD, 18 pieces of tissues from 6 fresh stomachs were used and the same laser parameters were used to perform the procedure. The depth, width, and coagulation of the laser vaporization were measured. Furthermore, the large scales (2.0 cm × 1.5 cm) for 18 hypothetical lesions of the gastric mucosa and submucosa of the 6 fresh stomachs were also resected with a modified flexible endoscope. In vivo, six hypothetical lesions of six porcine were vaporized by the novel blue laser, and the resultant lesions at the acute and chronic stages were assessed by the naked eye and hematoxylin and eosin staining.
In the contact mode, more tissue was vaporized, and the thickness of the coagulation was stable when the WD was 0-2 mm, whose value varied from 0.33 to 1.73 mm. In the gastroscopy model, the mean thickness of coagulation from the mucosa was 0.67 mm, and a significant carbonization zone was not observed. In vivo, the laser beam could accurately act on the hypothetical target. No bleeding and clear vision were present in the procedure. After 3 weeks, tissue healing was well recovered after laser coagulation, resection, and submucosal dissection.
In the present study, the novel 450 nm blue diode laser exhibited ideal vaporization and thinner coagulation thickness in the porcine stomach, which indicated that it could be alternately used as a new device for stomach lesions.
在我们之前的研究中，新型 450nm 蓝光二极管激光能够精确地汽化软组织（如膀胱和结肠），因此我们将猪胃组织应用于此，以验证其在模拟病变的内镜黏膜切除术（ESR）/内镜黏膜下剥离术（ESD）中的疗效，这些病变为离体和在体。
在离体 ESR 研究中，对 7 个新鲜胃喷洒生理盐水后的 20 块组织（8cm×6cm）进行三维扫描，使用蓝光二极管激光以最大 30W、不同的处理速度和工作距离（WD）进行汽化。离体 ESD 中，使用 6 个新鲜胃的 18 块组织，使用相同的激光参数进行手术。测量激光汽化的深度、宽度和凝固程度。此外，使用改良的软性内镜切除 6 个新鲜胃的 18 个假设胃黏膜和黏膜下层大尺度病变（2.0cm×1.5cm）。在体，用新型蓝光激光汽化 6 头猪的 6 个假设病变，并用肉眼和苏木精-伊红染色评估急性和慢性阶段的病变。
在接触模式下，当 WD 为 0-2mm 时，组织汽化量较多，凝固厚度稳定，其值为 0.33-1.73mm。在胃镜模型中，从黏膜到凝固的平均厚度为 0.67mm，且未观察到明显的碳化区。在体，激光束能够准确作用于假设目标。手术过程中无出血，视野清晰。3 周后，激光凝固、切除和黏膜下剥离后的组织愈合良好。
本研究中，新型 450nm 蓝光二极管激光在猪胃中表现出理想的汽化效果和更薄的凝固厚度，表明其可作为治疗胃部病变的新型设备交替使用。
