McNicholas T A, Steger A C, Bown S G
Institute of Urology and National Medical Laser Centre, University College, London.
Br J Urol. 1993 Apr;71(4):439-44. doi: 10.1111/j.1464-410x.1993.tb15989.x.
We describe a percutaneous, low power, interstitial method of controlled coagulation of prostatic tissue by laser light which may prove an alternative or adjunct to existing therapy for benign and malignant prostatic disease. One or more 200-600 micron diameter fibres were implanted within the substance of the elderly male beagle prostate (n = 11) through which Neodymium-Yttrium Aluminium Garnet (Nd-YAG) laser energy could be transmitted. Using longer exposures (400-1500s) and lower powers (1-2W) than used in routine endoscopic laser therapy, well defined areas of coagulative necrosis could be created with little tissue charring or damage to the fibre. For an energy dose of 1000J a lesion approximately 1 cm in diameter resulted at 4 days. Ultrasound scanning methods could detect the fibre(s), the area(s) of coagulation and the healed lesions. Treatments were well tolerated. At 6 weeks the treated areas of canine prostate healed by fibrosis surrounding an area of cystic degeneration. Multiple fibre experiments produced larger volume lesions relevant to more extensive cancer or to the coagulation of benign adenomatous hyperplasia causing outflow symptoms. This technique may prove of value for the treatment of moderate benign enlargement of the prostate and for the destruction of small, focal prostatic tumours.
我们描述了一种经皮、低功率、间质内通过激光对前列腺组织进行可控凝固的方法，该方法可能成为治疗良性和恶性前列腺疾病现有疗法的替代方法或辅助方法。将一根或多根直径200 - 600微米的光纤植入老年雄性比格犬前列腺组织内（n = 11），通过这些光纤可传输钕钇铝石榴石（Nd - YAG）激光能量。与常规内镜激光治疗相比，使用更长的曝光时间（400 - 1500秒）和更低的功率（1 - 2瓦），可以形成界限清晰的凝固性坏死区域，几乎没有组织炭化或光纤损伤。对于1000焦耳的能量剂量，在4天时会形成直径约1厘米的损伤灶。超声扫描方法能够检测到光纤、凝固区域和愈合的损伤灶。治疗耐受性良好。在6周时，犬前列腺的治疗区域通过围绕囊性变区域的纤维化而愈合。多光纤实验产生了更大体积的损伤灶，适用于更广泛的癌症或导致流出道症状的良性腺瘤样增生的凝固。这项技术可能对治疗中度前列腺良性增生以及破坏小的局灶性前列腺肿瘤具有价值。
