Pulsed Laser-induced Liquid Jet System for Treatment of Sellar and Parasellar Tumors: Safety Evaluation
Pulsed Laser-induced Liquid Jet System for Treatment of Sellar and Parasellar Tumors: Safety Evaluation
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DOI：
10.1055/s-0034-1396436
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发表时间：
2015-11-01
影响因子：
1
通讯作者：
Tominaga, Teiji
中科院分区：
文献类型：
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作者：
Nakagawa, Atsuhiro;Ogawa, Yoshikazu;Tominaga, Teiji
脉冲激光诱导液体喷射(LILJ)系统是一种新兴的手术器械，旨在通过保留细小血管和对周围组织的最小损伤来帮助最大限度地切除病变和维持功能。该系统通过方便的卡口形状的导管排出所需的最小脉冲量的水。我们已经证明，在单一机构系列的大型垂体和颅底肿瘤的治疗中，除了术中失血量和手术时间显著减少外，手术切除率也有显著的提高。本研究对该系统在多个机构的安全性进行了评估。方法自2011年10月至2012年6月，在6个机构的46例患者中，男性29例，女性17例(平均年龄59.1岁)，均接受了经蝶入路的垂体窝内或附近病变的显微手术/内窥镜切除。病理诊断：垂体腺瘤31例，脑膜瘤4例，颅咽管瘤3例，海绵状血管瘤2例，Rathke囊肿裂1例。病灶体积2.0~30.4 cm(3)，平均3.7 cm(3)。海绵窦侵犯11例，鞍上延伸29例。结果80%的病例保留了病变内动脉(直径：150微米)。除了由于使用了光纤石英光纤而在运动中受到一些限制外，其他的手术步骤都已实现。结论LILJ系统可以安全地切除垂体窝内或附近的病变。
ObjectiveThe pulsed laser-induced liquid jet (LILJ) system is an emerging surgical instrument intended to assist both maximal removal of the lesion and functional maintenance through preservation of fine vessels and minimal damage to the surrounding tissue. The system ejects the minimum required amount of pulsed water through a handy bayonet-shaped catheter. We have already shown a significant increase in removal rate, in addition to a noteworthy reduction of intraoperative blood loss and procedure time in the treatment of large pituitary and skull base tumors in a single-institution series. The present study evaluated the safety of the system in multiple institutions.MethodsThe study included 46 patients, 29 men and 17 women (mean age: 59.1 years) who underwent microsurgical/endoscopic resection of lesions in or in the vicinity of the pituitary fossa through the transsphenoidal approach between October 2011 and June 2012 at six institutions. The histologic diagnoses were pituitary adenoma (31 cases), meningioma (4), craniopharyngioma (3), cavernous angioma (2), and Rathke cyst cleft (1). Lesion volume ranged from 2.0 to 30.4 cm(3) (mean: 3.7 cm(3)). Cavernous sinus invasion was observed in 11 cases and suprasellar extension in 29 cases.ResultsPreservation of intralesional arteries (diameter: 150 mu m) was achieved in all situations in>80% of cases. Intended surgical steps were achieved except for some restrictions in motion due to the use of an optical quartz fiber. No complications occurred directly related to the use of the device.ConclusionsThe LILJ system can be used for safe removal of lesions in or in the vicinity of the pituitary fossa.