Abstract Sclerosing fluids to achieve pleurodesis could be hardly replaced for bed-side procedures, but other devices may be successfully applied during thoracoscopy. Thulium Cyber Laser was experimented for this purpose and compared to talc poudrage. Twenty pigs underwent operative videothoracoscopy (VATS). Ten models were subjected to double-port VATS and parietal pleura photoevaporation using Thulium Cyber LaserTM (TCL) 150 W 2010 nm on the poste- rior third of three ribs; the pleural surface was homogeneously treated inside the target perimeter. The remaining ten pigs underwent uniportal thoracoscopy; talc poudrage was per- formed using the current clinical practice dosage (1 g/18 kg) with accurate talc powder spread over the whole pleural sur- face. All models were followed up for 60 days. Pleurodesis firmness was graded on a three-tier scale (none-moderate- Andrea Droghetti and Jacopo Vannucci contributed equally to this work. firm) and site-matching topographical expectancy was evalu- ated. TCL produced pleurodesis in all models: 7/10 were firm and 3/10 moderate. Talc poudrage pleurodesis was firm in 4/ 10 and moderate in 6/10. Pleural adhesions were found exclu- sively in the treated area after laser treatment, while talc cre- ated a wide spectrum of effects, most commonly anarchic jagged adhesions obliterating less than 50 % of the pleural cavity (7/10), mostly declivous. The pathologist found more aggressive inflammation (sometimes severe) in the talc group. Expected localized pleurodesis was always registered in laser group (10/10), while talc poudrage was found poorly effective if consistent pleurodesis is expected in an apico-dorsal posi- tion (2/10). Laser pleurodesis appears more homogeneous, qualitatively not inferior, and topographically more predict- able than talc pleurodesis. Parietal photoevaporation seems effective and the localized pleurodesis is reproducible.
Pleurodesis with Thulium Cyber Laser versus talc poudrage: a comparative experimental study
Marulli Giuseppe;
2016-01-01
Abstract
Abstract Sclerosing fluids to achieve pleurodesis could be hardly replaced for bed-side procedures, but other devices may be successfully applied during thoracoscopy. Thulium Cyber Laser was experimented for this purpose and compared to talc poudrage. Twenty pigs underwent operative videothoracoscopy (VATS). Ten models were subjected to double-port VATS and parietal pleura photoevaporation using Thulium Cyber LaserTM (TCL) 150 W 2010 nm on the poste- rior third of three ribs; the pleural surface was homogeneously treated inside the target perimeter. The remaining ten pigs underwent uniportal thoracoscopy; talc poudrage was per- formed using the current clinical practice dosage (1 g/18 kg) with accurate talc powder spread over the whole pleural sur- face. All models were followed up for 60 days. Pleurodesis firmness was graded on a three-tier scale (none-moderate- Andrea Droghetti and Jacopo Vannucci contributed equally to this work. firm) and site-matching topographical expectancy was evalu- ated. TCL produced pleurodesis in all models: 7/10 were firm and 3/10 moderate. Talc poudrage pleurodesis was firm in 4/ 10 and moderate in 6/10. Pleural adhesions were found exclu- sively in the treated area after laser treatment, while talc cre- ated a wide spectrum of effects, most commonly anarchic jagged adhesions obliterating less than 50 % of the pleural cavity (7/10), mostly declivous. The pathologist found more aggressive inflammation (sometimes severe) in the talc group. Expected localized pleurodesis was always registered in laser group (10/10), while talc poudrage was found poorly effective if consistent pleurodesis is expected in an apico-dorsal posi- tion (2/10). Laser pleurodesis appears more homogeneous, qualitatively not inferior, and topographically more predict- able than talc pleurodesis. Parietal photoevaporation seems effective and the localized pleurodesis is reproducible.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
