Transbronchial lung volume reduction by diode laser heat probe (Indigo 830) for lung emphysema

点击翻译按钮获取中文摘要

(1) Irradiation effect on pulmonary parenchyma by a heat probe (indigo 830)Under general anesthesia and unilateral ventilation, transbronchial irradiation by a heat probe was performed. Under the condition of 80 degree centigrade for 5 minutes, coagulation area was 25 by 10 mm, which was equivalent to that under 90 and 100 degrees for 5 minutes. However, Under 90 and 100 degrees, a part of the lung was changed necrosis, static compliance was decreased from 21.2 to 7.1 ml/cmH2O (33.5% reduction).(2) The best condition of pulmonary coagulation for lung volume reductionUnder the three conditions as follows, irradiation was performed and the best condition for volume reduction was evaluated. 1) Under spontaneous ventilation with lung expansion, 2) no ventilation with lung expansion and 3) no ventilation with lung collapse by thoracotomy. No heat elevation was observed under the condition #1. A small coagulation was observed under the condition #2. Well coagulation was observed under the condition #3.(3) Lung emphysema modelOne month after inhalation of 40 mg/kg of papain to a mini pig, lung mechanics (intra-bronchial air pressure, flow volume, airway resistance and compliance) was measured. Static compliance elevated from 23 +/- 3.5 ml/H2O before inhalation to 33.3 +/- 4.6 ml/H2O after inhalation(n=3). Pathologically, lung emphysema was confirmed.(4) The effect of laser irradiation on emphysema lungThe static compliance was reduced from 21.2 +/- 3.7 ml/H2O to 7.1 +/- 2.5 ml/H2O (33% reduction) after papain inhalation. After irradiation, that was re-elevation to 13.8 ml/H2O.