Histological evaluation of prostatic tissue following transurethral laser resection (TULaR) using the 980 nm diode laser.
Histological evaluation of prostatic tissue following transurethral laser resection (TULaR) using the 980 nm diode laser.
复制标题
使用 980 nm 二极管激光进行经尿道激光切除术 (TULaR) 后前列腺组织的组织学评估。
DOI：
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发表时间：
2010
影响因子：
1.4
通讯作者：
S. Lanzafame
中科院分区：
文献类型：
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作者：
R. Leonardi;R. Caltabiano;S. Lanzafame
目标
在本研究中，我们进行了第一次的组织学评价后，980 nm半导体激光治疗膀胱出口梗阻继发于良性前列腺肥大（BPH）。其目的是证明获得足够组织进行组织学检查的可能性以及通过激光切除获得的标本获得组织学诊断的可能性。
材料和方法
选择86例BPH患者行激光手术，10例经尿道前列腺电切术。将从激光手术和经尿道前列腺切除术（TURP）收集的前列腺组织样品固定在10%福尔马林中，并连续切片，切片厚度为5-7微米，包埋在石蜡中并用苏木精和伊红染色。
结果
使用980 nm二极管激光器获得的样品的尺寸范围为4 mm至30 mm，并显示出褐色的光滑边缘。激光组织显示出0.5 mm的凝固边缘（范围：0.2-1 mm），邻近汽化组织，可见凝固的结缔组织和腺上皮。在该区域之外，观察到腺上皮从结缔组织完全脱离。还检索到与血管扩张相关的间质水肿，但无红细胞外渗、含铁血黄素沉积和出血区域。所有病例均显示凝固组织区以外的小血管闭塞。与激光治疗不同，从TURP获得的样本显示红细胞外渗、含铁血黄素沉积和出血区域。
结论
980 nm半导体激光器提供了高速率的组织消融，并具有出色的止血效果。它已被证明，组织样本可以获得与此技术，这使得BPH的组织学诊断要作出。目前的方法涉及980 nm二极管激光诱导前列腺组织的汽化切除术，因此创建了TULaR（经尿道激光切除术）的首字母缩略词来描述这种技术。
OBJECTIVES
In the present study, we performed for the first time an histological evaluation after 980 nm diode laser treatment of bladder outlet obstruction secondary to benign prostatic hypertrophy (BPH). The aim was to demonstrate the possibility of obtaining sufficient tissue for histological examination and the possibility of obtaining an histological diagnosis on the specimen obtained by laser resection.
MATERIALS AND METHODS
86 patients with BPH were selected for laser surgery and 10 patients for transurethral prostate resection. The prostate tissue samples collected from laser surgery and transurethral resection of the prostate (TURP) were fixed in 10% formalin and serial sections with a slice thickness of 5-7 micron embedded in paraffin and stained with haematoxylin and eosin.
RESULTS
Samples obtained using the 980 nm diode laser ranged in size from 4 mm to 30 mm and showed brownish, smooth margins. Lasered tissue showed a coagulation rim of 0.5 mm (range: 0.2-1 mm) and adjacent to the vaporized tissue, coagulated connective tissue and glandular epithelia were seen. Beyond this zone a complete detachment of glandular epithelia from the connective tissue was observed. Stromal oedema associated with ectasic vessels but without extravasation of red blood cells, haemosiderin deposition and haemorrhagic areas were also retrieved. All cases showed occlusion of small vessels beyond the zone of coagulated tissue. Unlike laser treatment, samples obtained from TURP showed extravasation of red blood cells, haemosiderin deposition and haemorrhagic areas.
CONCLUSIONS
The 980 nm diode laser provides high rates of tissue ablation, associated with excellent haemostasis. It has been shown that tissue samples can be obtained with this technique, which allow a histological diagnosis of BPH to be made. The current method involving the 980 nm diode laser induces a vaporesection of prostate tissue and the acronym of TULaR (transurethral laser resection) has therefore been created to describe this technique.