Sawabata N, Nezu K, Tojo T, Kitamura S
Department of Surgery III, Nara Medical College, Japan.
Ann Thorac Surg. 1996 Nov;62(5):1485-8. doi: 10.1016/0003-4975(96)00753-9.
The Argon Beam Coagulator (ABC) and neodymium:yttrium-aluminum garnet (Nd:YAG) laser are used for lung tissue contraction. Assessing the damage of treated lung tissue is helpful in choosing devices for pulmonary volume reduction by pneumoplastic procedures.
We assessed the damage of in vitro lung lobes resected at operation for pulmonary carcinoma. Samples were irradiated with noncontact Nd:YAG laser and ABC. One hundred forty-four samples obtained from 24 lobes were examined by light microscopy. The lung tissue showing destructive degeneration at the pleura and slight coagulation at the residual parenchyma was defined as showing "air leak pattern" based on a previously reported experiment of the air inflation test.
At the power of clinical use (Nd:YAG, 15 W; ABC, 80 W), most of the visceral pleura treated with the Nd:YAG laser was classified as presenting amorphous degeneration, and that treated with ABC showed destructive degeneration. Air leak pattern occurred in all samples treated with ABC. At the power of 40 W, ten (42%) of 24 visceral pleuras irradiated with the Nd:YAG laser were classified as presenting destructive degeneration, and of those irradiated with the ABC, 18 (75%) showed destructive degeneration (p < 0.05). Air leak patterns were found in 3 (13%) of the samples treated with the Nd:YAG laser and in 16 (63%) of those treated with the ABC (p < 0.05).
The ABC had more potential to damage the pleura and less potential to produce underlying parenchymal coagulation in the lung tissue than did the Nd:YAG laser. This information may be useful in the selection of devices for pulmonary volume reduction by pneumoplastic procedures.
氩离子凝固器（ABC）和钕：钇铝石榴石（Nd：YAG）激光用于肺组织收缩。评估经治疗的肺组织损伤有助于通过肺成形术选择用于肺减容的设备。
我们评估了因肺癌手术切除的体外肺叶的损伤情况。样本分别用非接触式Nd：YAG激光和ABC进行照射。对从24个肺叶获取的144个样本进行了光学显微镜检查。根据先前报道的充气试验实验，将在胸膜处显示破坏性变性且在残余实质处有轻微凝固的肺组织定义为呈现“漏气模式”。
在临床使用功率下（Nd：YAG为15瓦；ABC为80瓦），用Nd：YAG激光治疗的大部分脏层胸膜被分类为呈现无定形变性，而用ABC治疗的则显示为破坏性变性。所有用ABC治疗的样本均出现漏气模式。在40瓦功率下，用Nd：YAG激光照射的24个脏层胸膜中有10个（42%）被分类为呈现破坏性变性，而用ABC照射的脏层胸膜中有18个（75%）显示为破坏性变性（p<0.05）。在用Nd：YAG激光治疗的样本中有3个（13%）发现有漏气模式，在用ABC治疗的样本中有16个（63%）发现有漏气模式（p<0.05）。
与Nd：YAG激光相比，ABC对肺组织胸膜的损伤潜力更大，而对肺组织潜在实质凝固的产生潜力更小。该信息可能有助于通过肺成形术选择用于肺减容的设备。
