Wallwiener D, Rimbach S, Pollmann D, von Fournier D, Bastert G
Universitäts-Frauenklinik, Heidelberg.
Zentralbl Gynakol. 1994;116(1):1-15.
A comparative study on thermal, mainly laser and high frequency electrosurgical techniques, was conducted. Indications, handling and morphometric results were correlated. Morphometrical findings suggest that minimal thermal tissue damage is associated by a decrease in the hemostatic effect. Additional bipolar coagulation is necessary when using the carbon dioxide laser or high frequency electrodes. As thermal tissue lesion is concerned, the two techniques differ only slightly, by fractions of millimeters. Concerning clinical handling and practicability at our department, as well as in the centers participating at the European Consensus Study on Lasers in Gynaecology, high frequency electrosurgery has proven the method of choice for endoscopic ablative procedures. The carbon dioxide laser (at laparoscopy) and the Nd:YAG contact laser (at hysteroscopy) are preferentially employed for reconstructive surgery (e.g. the carbon dioxide laser for treatment of distal tubal pathology or endometriosis, the Nd:YAG contact laser for hysteroscopic synechiolysis).
开展了一项关于热技术（主要是激光和高频电外科技术）的对比研究。对适应证、操作方法和形态测量结果进行了关联分析。形态测量结果表明，最小程度的热组织损伤与止血效果的降低相关。使用二氧化碳激光或高频电极时，需要额外进行双极电凝。就热组织损伤而言，这两种技术仅相差几毫米。关于我们科室以及参与欧洲妇科激光共识研究的中心的临床操作和实用性，高频电外科已被证明是内镜消融手术的首选方法。二氧化碳激光（用于腹腔镜检查）和钕:钇铝石榴石接触激光（用于宫腔镜检查）优先用于重建手术（例如，二氧化碳激光用于治疗远端输卵管病变或子宫内膜异位症，钕:钇铝石榴石接触激光用于宫腔镜粘连松解术）。
