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经尿道使用圆柱形扩散光纤对犬前列腺进行切除术后的病理变化

Pathologic changes following transurethral canine prostatectomy with a cylindrically diffusing fiber.

作者信息

Cromeens D M, Price R E, Johnson D E

机构信息

Department of Veterinary Medicine and Surgery, University of Texas M.D. Anderson Cancer Center, Houston 77030.

出版信息

Lasers Surg Med. 1994;14(4):306-13. doi: 10.1002/lsm.1900140403.

Abstract

Transurethral laser prostatectomy was performed on eight mongrel dogs employing a cylindrically diffusing fiber delivery system and a 1.06 mu Nd:YAG laser. Each dog received 15,000 joules of laser energy delivered to the prostate in one continuous dose of 25 watts for 10 minutes. Gross and histopathologic examinations of serial sections of the prostate were performed postoperatively after intervals of 2 hours to 7 weeks. Grossly, a spherical zone of destruction averaging 2.8 cm in diameter was present in dogs except one. Histopathologic changes in the prostate consisted of acute coagulative necrosis with interstitial edema at 2 hours, becoming hemorrhagic by 24 hours. A prominent circular area of acute coagulative necrosis with progressively larger areas of liquefaction and hemorrhage was present in prostates harvested from 4 days to 1 week after lasing. Initial re-epithelization of the resulting cavity was observed at 3 weeks with nearly complete epithelialization 7 weeks after laser treatment. The simplified fiber placement and lack of postoperative complications in this small group of dogs suggest that the cylindrically diffusing fiber could offer significant advantages over laterally deflecting fibers for transurethral prostatectomies in the dog model.

摘要

对八只杂种狗实施经尿道激光前列腺切除术,采用圆柱形扩散光纤传输系统和1.06微米钕钇铝石榴石激光。每只狗接受15000焦耳激光能量,以25瓦的连续剂量输送至前列腺,持续10分钟。术后在2小时至7周的间隔时间后,对前列腺连续切片进行大体和组织病理学检查。大体上,除一只狗外,其他狗的前列腺均出现一个平均直径为2.8厘米的球形破坏区。前列腺的组织病理学变化包括2小时时出现急性凝固性坏死伴间质水肿,24小时时变为出血性。在激光治疗后4天至1周收获的前列腺中,可见一个明显的圆形急性凝固性坏死区域,伴有逐渐增大的液化和出血区域。激光治疗3周时观察到所形成腔隙开始重新上皮化,7周后几乎完全上皮化。在这一小群狗中,光纤放置简单且无术后并发症,这表明在狗模型中,对于经尿道前列腺切除术,圆柱形扩散光纤可能比侧向偏转光纤具有显著优势。

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