Laser-induced thermotherapy for lung tissue--evaluation of two different internally cooled application systems for clinical use.

摘要: Thermal ablation techniques like radiofrequency or laser-induced thermotherapy (LITT) are increasingly used to treat tumors of parenchymatous organs. Minimal access, parenchymal preservation, and a low complication rate render them suitable for pulmonary as well. Their successful clinical application depends on the induction sufficiently large lesions knowledge energy parameters required complete thermal ablation. The aim this study was establish dose–response relationship percutaneous an intraoperative system LITT lung tissue. were induced in healthy porcine lungs using Nd:YAG laser (1,064 nm). performed with group I (n = 18) II 90). Laser applied 600–1,200 s power range 20–32 W (12,000–38,400 J). longitudinally transversally measured, volume calculated after intervention. Furthermore, open perform under vivo conditions during perfusion ventilation domestic pigs. Lesion volumes both groups showed plateau-like curve when increased from initial level 25 W. With puncture (group I), 28 (16,800 J) 10 min generated largest 12.54 ± 1.33 cm3, axial diameter 39.33 2.52 mm, diametrical 24.67 1.15 mm. A longer time not possible due instability applicator. Moreover, started developing extensive carbonizations at 22 (13,200 II) achieved lesion 11.03 2.54 cm3 diameters 34.6 4.22 mm (axial) 25.6 2.51 (diametrical) by exposure 20 32 (38,400 Here only occur (33,600 Under conditions, all pigs tolerated procedure well without complications. Besides typical cooling effect vicinity blood vessels, about three times smaller than ex lesions. Both reproducible, clinically relevant set lesions, although its usability is limited restricted capacity high carbonization risk. It powers up allows higher induce larger volumes. This elucidates dose–effect relation two sets.