title: Pulmonary resections: cytostructural effects of different-wavelength lasers versus electrocautery.
abstract: OBJECTIVE
  There are few papers on the cytostructural effects of surgical instruments used during pulmonary resections. The aim of the present study was to evaluate the parenchymal damage caused by different surgical instruments: a new generation electrosurgical scalpel and two different-wavelength lasers.
  
  
  METHODS
  Six surgical procedures of pulmonary resection for nodules were performed using a new generation electrosurgical scalpel, a 1318 nm neodymium (Nd:YAG) laser or a 2010 nm thulium laser (two procedures for each instrument). Specimens were analyzed using optical microscopy and scansion electronic microscopy.
  
  
  RESULTS
  Severe cytostructural damage was found to be present in an average of 1.25 mm in depth from the cutting surface in the patients treated using electrosurgical cautery. The depth of this zone dropped to less than 1 mm in patients treated by laser, being as small as 0.2 mm using the laser with a 2010 nm-wavelength and 0.6 mm with the 1318 nm-wavelength laser.
  
  
  CONCLUSIONS
  These preliminary findings support the use of laser to perform conservative pulmonary resections (i.e., metastasectomies), since it is more likely to avoid damage to surrounding structures. Controlled randomized trials are needed to support the clinical usefulness and feasibility of new types of lasers for pulmonary resections.
authors.affiliation: Fondazione IRCCS National Cancer Institute, Milan, Italy. paolo.scanagatta@istitutotumori.mi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Scanagatta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pelosi
authors.forename: Francesco
authors.initials: F
authors.lastname: Leo
authors.forename: Simone
authors.initials: S
authors.lastname: Furia
authors.forename: Leonardo
authors.initials: L
authors.lastname: Duranti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fabbri
authors.forename: Aldo
authors.initials: A
authors.lastname: Manfrini
authors.forename: Antonello
authors.initials: A
authors.lastname: Villa
authors.forename: Barbara
authors.initials: B
authors.lastname: Vergani
authors.forename: Ugo
authors.initials: U
authors.lastname: Pastorino
mesh_terms: D000328:Adult; D000368:Aged; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009354:Neodymium; D011013:Pneumonectomy / Q000009:adverse effects* / Q000295:instrumentation*; D011650:Pulmonary Alveoli / Q000293:injuries* / Q000601:surgery*; D015203:Reproducibility of Results; D013525:Surgical Instruments / Q000009:adverse effects; D013932:Thulium; D016896:Treatment Outcome
chemical_list: D009354:Neodymium; D013932:Thulium