van de Berg Nick J, Nieuwenhuyzen-de Boer Gatske M, Gao Xu Shan, Rijstenberg L Lucia, van Beekhuizen Heleen J
Department of Gynaecological Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands.
Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands.
Cancers (Basel). 2023 Apr 20;15(8):2386. doi: 10.3390/cancers15082386.
Medical use of (non-)thermal plasmas is an emerging field in gynaecology. However, data on plasma energy dispersion remain limited. This systematic review presents an overview of plasma devices, fields of effective application, and impact of use factors and device settings on tissues in the female pelvis, including the uterus, ovaries, cervix, vagina, vulva, colon, omentum, mesenterium, and peritoneum. A search of the literature was performed on 4 January 2023 in the Medline Ovid, Embase, Cochrane, Web of Science, and Google Scholar databases. Devices were classified as plasma-assisted electrosurgery (ES) using electrothermal energy, neutral argon plasma (NAP) using kinetic particle energy, or cold atmospheric plasma (CAP) using non-thermal biochemical reactions. In total, 8958 articles were identified, of which 310 were scanned, and 14 were included due to containing quantitative data on depths or volumes of tissues reached. Plasma-assisted ES devices produce a thermal effects depth of <2.4 mm. In turn, NAP effects remained superficial, <1.0 mm. So far, the depth and uniformity of CAP effects are insufficiently understood. These data are crucial to achieve complete treatment, reduce recurrence, and limit damage to healthy tissues (e.g., prevent perforations or preserve parenchyma). Upcoming and potentially high-gain applications are discussed, and deficits in current evidence are identified.
(非)热等离子体在医学上的应用是妇科领域一个新兴的研究方向。然而,关于等离子体能量扩散的数据仍然有限。本系统综述概述了等离子体设备、有效应用领域,以及使用因素和设备设置对女性盆腔组织(包括子宫、卵巢、宫颈、阴道、外阴、结肠、网膜、肠系膜和腹膜)的影响。于2023年1月4日在Medline Ovid、Embase、Cochrane、Web of Science和谷歌学术数据库中进行了文献检索。设备分为利用电热能的等离子体辅助电外科手术(ES)、利用动能粒子能量的中性氩等离子体(NAP)或利用非热生化反应的冷大气等离子体(CAP)。总共识别出8958篇文章,其中310篇进行了筛选,14篇因包含所到达组织深度或体积的定量数据而被纳入。等离子体辅助ES设备产生的热效应深度<2.4毫米。相应地,NAP的效应仍局限于表面,<1.0毫米。到目前为止,人们对CAP效应的深度和均匀性了解不足。这些数据对于实现彻底治疗、降低复发率以及限制对健康组织的损伤(例如,防止穿孔或保留实质组织)至关重要。文中讨论了即将出现的、可能有高收益的应用,并指出了当前证据中的不足。