Kabalin J N, Gong M, Issa M M, Sellers R
Urology Section, Veterans Affairs Medical Center, Palo Alto, California.
Urology. 1995 Mar;45(3):421-6. doi: 10.1016/S0090-4295(99)80010-7.
The objective of this study was to define the actual mechanism of neodymium: yttrium-aluminum-garnet (Nd:YAG) laser prostatectomy achieved with the previously described contact-free beam technique using the Ultraline delivery system at high-power settings.
Transurethral Nd:YAG laser application was performed with the Ultraline side-firing laser fiber in canine and human prostates. Total or radical prostatectomy was performed after laser treatment to examine and measure laser tissue effects produced using the contact-free beam technique.
Minimal actual tissue evaporation or vaporization was noted in either the canine or human prostate using this technique. The extent of tissue vaporization achieved was probably insufficient to produce clinically significant voiding outcomes acutely or chronically. However, this technique, using the Nd:YAG laser, produced excellent tissue coagulation and necrosis, similar to other laser delivery systems and reports dealing with laser coagulation prostatectomy.
The primary mechanism accounting for therapeutic efficacy of the contact-free beam technique for Nd:YAG laser prostatectomy utilizing the Ultraline delivery system at high-power settings appears to be tissue coagulation with subsequent necrosis and slough, rather than tissue vaporization. This is consistent with the known tissue effects of the Nd:YAG laser wavelength in other systems.
本研究的目的是确定使用超线输送系统在高功率设置下通过先前描述的非接触光束技术实现钕：钇铝石榴石（Nd:YAG）激光前列腺切除术的实际机制。
使用超线侧射激光光纤对犬类和人类前列腺进行经尿道Nd:YAG激光治疗。激光治疗后进行全前列腺切除术或根治性前列腺切除术，以检查和测量使用非接触光束技术产生的激光组织效应。
使用该技术在犬类或人类前列腺中均未观察到明显的实际组织蒸发或汽化。所实现的组织汽化程度可能不足以急性或慢性地产生具有临床意义的排尿结果。然而，这种使用Nd:YAG激光的技术产生了出色的组织凝固和坏死，类似于其他激光输送系统以及有关激光凝固前列腺切除术的报道。
在高功率设置下，利用超线输送系统进行Nd:YAG激光前列腺切除术的非接触光束技术的治疗效果的主要机制似乎是组织凝固，随后是坏死和脱落，而不是组织汽化。这与Nd:YAG激光波长在其他系统中已知的组织效应一致。
