Cardiac enzymes after transmyocardial laser treatment with CO2 laser

OBJECTIVES: The aim of the present study was to examine postoperative serum levels of cardiac enzymes after transmyocardial laser treatment (TML) and to evaluate any associations between this release, postoperative cardiac events and change in ejection fraction after 3 months' follow-up. DESIGN: Forty-nine patients with angina pectoris Canadian Cardiovascular Society Angina Score Class III & IV refractory to medical therapy and untreatable by coronary artery bypass or percutaneous transluminal angioplasty treated with CO2 laser were included. Inclusion criteria were age less than 75 years, left ventricular ejection fraction greater than or equal to 30% and myocardial regions with reversible ischemia. Serum levels of aspartate aminotranspherase (ASAT), alanine aminotranspherase (ALAT) and MB-isoenzymes of creatine kinase (CK-MB) were followed during the first 72 h after surgery. Ejection fractions were estimated by multiple-gated acquisition ventriculography at inclusion and 3 months postoperatively. RESULTS: A significant increase in serum markers of myocardial necrosis was observed 8 h after surgery. A subsequent increase from 8 to 24 h after surgery was associated with the presence of postoperative cardiac adverse events. An inverse correlation was found between peak level of cardiac enzymes and change in ejection fraction from baseline to 3 months' follow-up. CONCLUSIONS: TML with CO2 laser is followed by a significant increase in serum levels of cardiac enzymes after 8 h. Further significant increases are associated with cardiac adverse events postoperatively. Peak enzyme values are inversely correlated with change in ejection fraction from baseline to 3 months' follow-up.     

CO2 laser treatment of supraglottic cancer

BACKGROUND: The aim of the study was to evaluate the effectiveness of endoscopic CO(2) laser microsurgery in the management of supraglottic cancer. METHODS: One hundred twenty-four patients (116 men and eight women; mean age, 59 years; range 31-81 years) with supraglottic cancer underwent CO(2) laser surgery (mean follow-up 5 years). The study patients were classified as follows: 45 patients, T1N0M0; 61 patients, T2N0M0; and 18 patients, T3N0M0. According to the staging, the following procedures were adopted: epiglottectomy, resection of aryepiglottic fold or false vocal cord in T1 patients (group A); resection of the false vocal cord and adjacent structures in T2 patients (group B); and supraglottic laryngectomy in T3 patients (group C). Statistical comparison of survival parameters was carried out with Wilcoxon test, considering p <.05 the minimum significance value. RESULTS: Overall actuarial survival, adjusted actuarial survival, and no evidence of disease at 5 years were 91%, 97%, and 82% in group A; 88%, 94%, and 59% in group B; and 81%, 81%, and 51% in group C, respectively. The statistical analysis of survival parameters showed a significant difference in the comparison of T1 versus T2 and T2 versus T3 tumors (p <.01). Actuarial local control, actuarial nodal control, and actuarial distant metastasis control at 5 years were 82%, 82%, and 100% in T1 patients; 63%, 90%, and 98% in T2 patients; and 77%, 75%, and 93% in T3 patients. Laryngeal preservation rate was 88.6% in T1 patients, 85.4% in T2 patients, and 93.7% in T3 patients. Patients in groups A and B were discharged after 3 to 12 days, and patients in group C, were discharged after 14 to 20 days. CONCLUSIONS: The results of this study show that endoscopic CO(2) laser surgery is highly effective in the treatment of T1 and T2 supraglottic cancer. In T3 cancer, the CO(2) laser should be implemented in those cases where radical excision by endoscopic route is feasible.     

Xanthelasma palpebrarum: treatment with the ultrapulsed CO2 laser

BACKGROUND AND OBJECTIVE: Due to its delicate location near the eye and the high recurrence rate, the therapy of xanthelasma palpebrarum is a difficult surgical task. Besides chemical, physical, and surgical procedures, various laser systems have been used to treat these lesions (argon laser, pulsed dye laser, and CO2 laser). This study was designed to critically evaluate the use of the ultrapulsed CO2 laser for the treatment of xanthelasma palpebrarum. STUDY DESIGN/MATERIALS AND METHODS: We report about the standardized treatment of 23 patients (52 periorbital xanthelasmas) and the results obtained after one treatment with a new generation, ultrapulsed CO2 laser (COHERENT Ultrapulse 5000C, Palo Alto, CA; 250-500 mJ; 600-900 microsec; 10,600 nm). The followup time was 10 months. RESULTS: All lesions could be removed completely with a single laser treatment. As for side effects, only transient pigmental changes (4% hyperpigmentations, 13% hypopigmentations) and no visible scarring was observed. Three patients (13%) developed a recurrence of xanthelasma. CONCLUSIONS: The ultrapulsed CO2 laser is an effective and safe therapeutic alternative to the hitherto described approaches.     

Superpulse CO2 laser treatment of facial syringomata

Eight patients with facial syringomata have been treated with the superpulse CO2 laser and followed for periods up to 3 years. Superpulse capability allows satisfactory photovaporization of overlying skin and exposure and liberation of the underlying cyst. Healing was satisfactory with minimal scarring and no persistence or recurrence of syringomata in five of eight cases.     

Brooke-Spiegler syndrome: treatment of cylindromas with CO2 laser.

Brooke-Spiegler syndrome is an autosomal dominant inherited disease characterized by the development of multiple trichoepitheliomas and cylindromas. We report two patients with Brooke-Spiegler syndrome whose scalp cylindromas were treated with a high-energy continous wave CO2 laser after debulking with bipolar scissors in one of the patients. The special feature in our report is the coexistence of three adnexal skin neoplasms in one case, and the close association of cylindroma and eccrine spiradenoma in the same lesion. We also support that debulking with bipolar scissors prior to laser therapy can be a technique of great benefit in large tumors.     

CO2激光联合咪喹莫特乳膏治疗甲周疣疗效观察

目的:观察CO2激光联合咪喹莫特乳膏治疗甲周疣的临床疗效,并与单纯CO2激光治疗做比较.方法:将入选的182例甲周疣患者随机分为两组:对照组91例,单纯CO2激光手术治疗;治疗组91例,CO2激光加咪喹莫特乳膏治疗.3个月后分别对两组有效率及复发率进行随访.结果:对照组有效率84.5％,治疗组有效率90.2％,复发率分别是12.5％、7.9％.两组疗效比较,差异有统计学意义(P＜0.05).结论:CO2激光联合5％咪喹莫特乳膏治愈率高,复发率低.联合治疗对特殊部位疣有一定推广价值.     

CO2 laser treatment of benign juvenile acanthosis nigricans

Acanthosis nigricans is a rare disease, which presents with symmetrical dark pigmentation and hyperkeratosis. The most common sites for this disorder are the axillae, neck and genitalia. In this case report, a patient with widespread involvement including the face is presented. The affected skin was thickened, hyperkeratotic and had a gray brown color with pronounced warty papillomatosis, having a velvety texture. Several treatment modalities have been suggested; however, the results are mostly disappointing. The treatment chosen was CO₂ laser therapy for the face. This resulted in an alleviation of symptoms and an excellent aesthetic improvement. Received: 6 August 1999 / Accepted: 11 October 1999     

CO2激光结合Nd:YAG激光治疗色素痣的临床观察

目的：评价CO2激光结合Nd：YAG激光治疗色素痣的疗效。方法：先用CO2激光选择连续脉冲，小功率输出，烧灼皮损到周围正常皮肤水平，继之用Nd：YAG激光治疗，治疗面部色素痣128例、768个皮损。结果：Ⅰ、Ⅱ级(痊愈 显效)率为96．76％。治疗次数平均为1.32次。结论：采用CO2激光结合Nd：YAG激光治疗面部色素痣疗效肯定，治愈率高，疗程短。多数患者无明显瘢痕形成。     

CO2激光治疗婴幼儿体表增殖性血管瘤

目的：观察CO2激光治疗婴幼儿体表增殖性血管瘤的疗效。方法：回顾性总结近年来我科应用CO2激光治疗576例婴幼儿体表增殖性血管瘤的临床经验。结果：随访6个月到3年，1例病变面积较大的患者出现了直径3cm的瘢痕区，25例局部色素沉着，550例都取得了十分满意的效果。结论：CO2激光治疗婴幼儿体表增殖性血管瘤具有方法简便、并发症少、治愈率高等优点，值得临床上大力推广。     

Endoscopic treatment of Zenker's diverticulum using CO2 laser.

OBJECTIVES: The objective of the present study was to review the technique of endoscopic laser-assisted esophagodiverticulostomy (ELAED) for the treatment of Zenker's diverticulum. METHODS: We reviewed 83 cases of ELAED performed for the treatment of Zenker's diverticuli during the past decade. RESULTS: ELAED-treated patients had a reduced hospital stay and were able to start an oral diet earlier than were patients who underwent other surgical procedures. Two (2.4%) of our patients developed small fistulas, which closed spontaneously. An additional 2 (2.4%) of our patients required conversion to an open approach due to inadequate endoscopic exposure, and 5 (6%) required a revision endoscopic procedure for persistent symptoms. CONCLUSIONS: Our series of 83 patients treated at 2 large academic centers during the past decade with an average follow-up of 4 years demonstrates that ELAED is a safe and effective procedure for the management of Zenker's diverticulum.     

超脉冲CO2激光联合点阵铒激光治疗面部瘢痕的临床研究

目的 观察超脉冲CO2激光联合点阵铒激光治疗面部瘢痕的效果.方法 对70例面部瘢痕患者,采用超脉冲CO2激光和点阵铒激光联合治疗3次;治疗间隔为2～3个月.首先使用超脉冲CO2激光磨削,功率1～2 W,输出时间O.02 s,延迟时间1.12 s.然后使用点阵铒激光治疗,波长为2940 nm,能量500～800 mJ,光斑直径2～7 mm.结果 治疗结束后随访3～6个月,显效者51例,有效者19例.主要并发症为短暂红斑、水肿、色素沉着.结论 超脉冲CO2激光与点阵铒激光联合治疗面部瘢痕,具有疗效好、损伤小、术后恢复快、并发症少等优点.     

超脉冲CO2激光用于皮肤除皱术

观察新型超脉冲CO2激光行皮肤除皱手术的效果.用超脉冲CO2激光行皮肤除皱手术,观察手术效果及并发症.行下睑皱纹、鱼尾纹、额部皱纹及面颊部皱纹共82例,取得了良好的除皱效果,但术后3个月后仍有一定比例的色素沉着(15.9%),半年左右可逐渐消失,特别是对于肤色较深的人术后的色素沉着可能更明显,可以在术前1个月和术后3个月期间用氢醌类药物来预防和治疗,方法有效.未发现顽固性色素沉着的病例.新型超脉冲CO2激光行皮肤除皱手术的效果可靠,与传统方法相比有更多的优点,但色素沉着问题需引起足够重视.     

Laryngeal carcinoma: Transoral treatment utilizing the CO2 laser

The CO₂ laser has been found to be a useful adjunct in our efforts to treat laryngeal carcinoma. Utilized endoscopically, it has been of help in establishing the proper staging, in diagnosing recurrence after radiation therapy, in reestablishing airways blocked with tumor, in debulking tumor mass prior to radiation and/or chemotherapy, and as a primary mode of excisional therapy, all accomplished with minimal morbidity. Most patients may return home the first postoperative day, eating, with serviceable voice, and requiring no tracheotomy or analgesics, ll of which provide a significant cost benefit.