Godlewski G, Rouy S, Bureau J P, Fesquet J, Eledjam J J, Gay C, Cousineau J
Arch Anat Histol Embryol. 1984;67:119-29.
The morphological effects of liver resection in 15 pigs performed with a Nd-YAG laser beam are reported. A regular cut surface was obtained and overlayed an ischemic layer which was thinnest at a 80 W power output and a short exposure time. Hemostasis was satisfying when the encountered vessels did not exceed 4,5 mm in diameter. Semi-thin and electron microscopic examination showed "ghost" cells in the layer of coagulation necrosis, shrunken hepatocytes and red blood cells in oedematous layer and "swollen" mitochondria in the deepest layer. Clamping of the hepatic pedicle - increasing local hyperthermia by suppression of cooling vascular inflow - majorated the depth of cellular alterations and the intensivity of the post-operative inflammatory reaction. Numerous biliary ductules and active hepatocytes meant parenchymal regeneration. Good healing evolution free of complications was observed after a one year's follow up.
报告了用钕钇铝石榴石激光束对15头猪进行肝切除的形态学影响。获得了规则的切面，其覆盖着一层缺血层，该缺血层在80瓦功率输出和短暴露时间时最薄。当遇到的血管直径不超过4.5毫米时，止血效果令人满意。半薄切片和电子显微镜检查显示，凝固性坏死层中有“幽灵”细胞，水肿层中有皱缩的肝细胞和红细胞，最深层中有“肿胀”的线粒体。肝蒂夹闭——通过抑制冷却的血管流入增加局部热疗——加剧了细胞改变的深度和术后炎症反应的强度。大量胆小管和活跃的肝细胞意味着实质再生。随访一年后观察到愈合良好且无并发症。
