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Adly AS, Adly MS, Cuisinier F, Egea JC, Panayotov I, Adly AS, Malthiery E. Laser-Induced Blood Coagulation for Surgical Application: A Scoping Review. Semin Thromb Hemost 2024; 50:236-252. [PMID: 37611623 DOI: 10.1055/s-0043-1772573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
There is a lack of evidence-based reviews on the effects of laser irradiation on blood coagulation in the literature, despite a large number of clinical trials. We therefore evaluated the available evidence on laser irradiation parameters used in coagulation of blood to optimize physical parameters. We performed a literature search for recent scientific studies indexed between 2017 and 2023 using the databases of PubMed and ScienceDirect. Articles were selected based on defined inclusion and exclusion criteria, and 78 publications in total were eventually included in this scoping review. The following were found to produce significant benefits in blood coagulation for surgical application: (1) dentistry and oral surgeries: 980 nm, 27 s, 2 W, 1502.7 W/cm2, 26.5 J, 622 J/cm2, 400 μm; (2) urogenital disorders: 532 nm, 4 s, 40 W, 10600 W/cm2, 1.3 J, 424 J/cm2, 600 μm; (3) ophthalmic disorders: 810 nm, 1 s, 1 W, 3540 W/cm2, 0.75 J, 1326 J/cm2, 100 μm; (4) embryological surgeries: 1064 nm, 10 s, 25 W, 35400 W/cm2, 262.5 J, 371000 J/cm2, 332.5 μm; (5) dermatological disorders: 1064 nm, 20 W, 2440 W/cm2, 0.1 J, 24 J/cm2, 670 μm; (6) gastrointestinal disorders: 532 nm, 3 s, 20 W, 1051 W/cm2, 120 J, 26500 J/cm2, 760 μm; (7) neurological surgeries: 2.5 s, 1.5 W, 1035 W/cm2, 2 J, 1584 J/cm2, 385 μm; (8) pulmonary disorders: 1320 nm, 5s, 35 W, 12450 W/cm2, 250 J, 65000 J/cm2, 700 μm (9) cardiovascular disorders: 1064 nm, 16.5 s, 5 W, 1980.5 W/cm2, 900 J, 760 J/cm2, 400 μm. In conclusion, our scoping review identifies that combining data from all clinically heterogeneous studies suggests that laser irradiation reflects an effective method for inducing blood coagulation in several medical fields.
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Affiliation(s)
| | - Mahmoud Sedky Adly
- LBN, Univ Montpellier, Montpellier, France
- Royal College of Surgeons of Edinburgh, Scotland, United Kingdom
| | - Frederic Cuisinier
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Jean-Christophe Egea
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Ivan Panayotov
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | | | - Eve Malthiery
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
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Yi Y, Li L, Li J, Shu X, Kang H, Wang C, Chang Y. Use of lasers in gastrointestinal endoscopy: a review of the literature. Lasers Med Sci 2023; 38:97. [PMID: 37022519 DOI: 10.1007/s10103-023-03755-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/27/2023] [Indexed: 04/07/2023]
Abstract
Lasers emit highly directional light with consistent wavelengths, and recent studies have demonstrated their successful applications in gastrointestinal endoscopic therapy. Although argon plasma coagulators (APC) became the preferred treatment option due to improved safety profile and lower costs, advancements in laser and optic fiber manufacturing have reignited interest in laser treatment. Different laser wavelengths have distinct features and applications based on their tissue absorption coefficient. Lasers with shorter wavelengths are effectively absorbed by hemoglobin, resulting in a good coagulation effect. Near-infrared lasers have ability to ablate solid tumors, while far-infrared lasers can make precise mucosal incisions without causing peripheral thermal damage. Lasers have proven to be highly applicable to endoscopy devices such as endoscopes, endoscopic ultrasound (EUS), double-balloon enteroscopes (DBE), and endoscopic retrograde cholangiopancreatography (ERCP), making them a potent tool to enhance the effectiveness of endoscopic treatments with minimal adverse events. This review aims to help readers understand the applications and effectiveness of lasers in gastrointestinal endoscopy, with the potential to promote the development and application of laser technology in the medical field.
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Affiliation(s)
- Yun Yi
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China
| | - Lurao Li
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China
| | - Jianghui Li
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China
| | - Xiawen Shu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China
| | - Hui Kang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China
| | - Chun Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China
| | - Ying Chang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China.
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Wu K, Jiang D, Zhang L, Jiang S, Lin T, Luo Y, Fan J, Yang T, Chen H, Zhang P, Wang X, Wei Q, Guo J, Huang Y, He D. Efficacy and safety of a novel 450 nm blue diode laser versus plasmakinetic electrocautery for the transurethral resection of non-muscle invasive bladder cancer: The protocol and result of a multicenter randomized controlled trial. Front Oncol 2023; 12:1065735. [PMID: 36733358 PMCID: PMC9887014 DOI: 10.3389/fonc.2022.1065735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Objectives To be the first to apply a novel 450 nm blue diode laser in transurethral resection of bladder tumor (TURBt) to treat patients with non-muscle invasive bladder cancer (NMIBC) and evaluate its efficacy and safety during the preoperative period compared to the conventional plasmakinetic electrocautery. Materials and Methods Randomized controlled trial (RCT) in five medical centers was designed as a non-inferiority study and conducted from October 2018 to December 2019. Patients with NMIBC were randomized to the blue laser or plasmakinetic electrocautery group for TURBt. As the first study to evaluate this novel blue laser device, the primary outcome was the effective resection rate of bladder tumors, including effective dissection and hemostasis. The secondary outcomes were the perioperative records, including surgical time, postoperative indwelling catheter time, hospital stay length, blood loss, reoperation rate, wound healing and adverse events. Results A total of 174 patients were randomized to either the blue laser group (85 patients) or plasmakinetic electrocautery group (89 patients). There was no statistical significance in the clinical features of bladder tumors, including tumor site, number and maximum lesion size. Both the blue laser and plasmakinetic electrocautery could effectively dissect all visible bladder tumors. The surgical time for patients in the blue laser group was longer (p=0.001), but their blood loss was less than that of patients in the control group (p=0.003). There were no differences in the postoperative indwelling catheter time, hospital stay length, reoperation rate or other adverse events. However, the patients undergoing TURBt with the blue laser showed a faster wound healing at 3 months after operation. Conclusion The novel blue laser could be effectively and safely used for TURBt in patients with NMIBC, and this method was not inferior to plasmakinetic electrocautery during the perioperative period. However, TURBt with the blue laser may provide the benefit to reduce preoperative blood loss and accelerate postoperative wound healing. Moreover, longer follow-up to confirm recurrence-free survival benefit was required.
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Affiliation(s)
- Kaijie Wu
- Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Dali Jiang
- Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Lianhua Zhang
- Department of Urology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shuai Jiang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tianhai Lin
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Luo
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jinhai Fan
- Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Tao Yang
- Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Haige Chen
- Department of Urology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Peng Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xinghuan Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qiang Wei
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jianming Guo
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yiran Huang
- Department of Urology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,*Correspondence: Yiran Huang, ; Dalin He,
| | - Dalin He
- Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,*Correspondence: Yiran Huang, ; Dalin He,
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Li X, Gu L, Chen Y, Wang X, Mei Y, Zhou J, Ma M, Ma J, Chong Y, Wang X, Guo P, He D, Zeng J. A novel 450-nm laser-mediated sinoporphyrin sodium-based photodynamic therapy induces autophagic cell death in gastric cancer through regulation of the ROS/PI3K/Akt/mTOR signaling pathway. BMC Med 2022; 20:475. [PMID: 36482460 PMCID: PMC9733382 DOI: 10.1186/s12916-022-02676-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Photodynamic therapy (PDT) has become an ideal and promising therapeutic method for fighting cancer, but its common application in clinical practice is prevented by the limitations of expensive devices in light sources and phototoxicity in photosensitizers. The aim of this study was to explore the antitumor efficiency of the novel 450-nm blue laser (BL) combined with sinoporphyrin sodium (DVDMS)-mediated PDT against human gastric cancer (GC) in vitro and in vivo, focusing on autophagy pathway. METHODS Cell viability was detected by Cell Counting Kit-8 and colony formation assays in HGC27, MGC803, AGS, and GES-1 cells. Cell apoptosis was measured by flow cytometry and western blotting. The production of reactive oxygen species (ROS) was measured by fluorescence microscopy and flow cytometry. Autophagy was determined by transmission electron microscopy and western blotting. The antitumor effect of BL-PDT in vivo was detected by a subcutaneous tumor model in nude mice. RESULTS The novel 450-nm laser-mediated DVDMS-based PDT caused remarkable growth inhibition and apoptosis induction in GC cells in vitro by the production of excessive ROS. Autophagy flux was induced by BL-PDT in GC cells, as determined by LC3 conversion assay, LC3 turnover assay, and mRFP-GFP-LC3 puncta assay. Furthermore, autophagy induction was demonstrated to positively contribute to BL-PDT-induced apoptotic effects on GC cells. Mechanically, ROS/PI3K/Akt/mTOR pathway was identified to involve in the regulation of BL-PDT-induced autophagy as determined by transcriptomic analysis and functional studies. Consistently, xenograft studies confirmed the significant antitumor effect of BL-PDT and its favorable safety in vivo. CONCLUSIONS The novel 450-nm laser-mediated DVDMS-based PDT may be a safe and effective approach against GC. Our results thus provide compelling evidence for the therapeutic application of BL-PDT in human GC.
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Affiliation(s)
- Xing Li
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Lijiang Gu
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Yuhang Chen
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Xiaobing Wang
- Key Laboratory of Medicinal Resources and Natural Pharmaceutical Chemistry, Ministry of Education, National Engineering Laboratory for Resource Developing of Endangered Chinese Crude Drugs in Northwest of China, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, Shaanxi, China
| | - Yibo Mei
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Jinlai Zhou
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Minghai Ma
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Jianbin Ma
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Yue Chong
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China
| | - Xinyang Wang
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China.,Key Laboratory for Tumor Precision Medicine of Shaanxi Province, Xi'an, 710061, Shaanxi, China.,Oncology Research Lab, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710061, Shaanxi, China
| | - Peng Guo
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China.,Key Laboratory for Tumor Precision Medicine of Shaanxi Province, Xi'an, 710061, Shaanxi, China.,Oncology Research Lab, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710061, Shaanxi, China
| | - Dalin He
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China. .,Key Laboratory for Tumor Precision Medicine of Shaanxi Province, Xi'an, 710061, Shaanxi, China. .,Oncology Research Lab, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710061, Shaanxi, China.
| | - Jin Zeng
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yan-ta West Road, Xi'an, 710061, Shaanxi, China. .,Key Laboratory for Tumor Precision Medicine of Shaanxi Province, Xi'an, 710061, Shaanxi, China. .,Oncology Research Lab, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710061, Shaanxi, China.
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5
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Liu G, Jiang D, Ren M, Lu X, Chang Y, He S, Ren Z, Fan H, Wu K, He D. High‐power 450 nm blue diode laser for endoscopic mucosal resection/endoscopic submucosal dissection in the stomach: Preliminary results on a porcine model with a modified flexible endoscope. Lasers Surg Med Suppl 2022; 54:1002-1009. [PMID: 35870192 DOI: 10.1002/lsm.23561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Guoxiong Liu
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
- Department of Urology Xianyang Central Hospital Xianyang P.R. China
| | - Dali Jiang
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Mudan Ren
- Department of Gastroenterology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Xinlan Lu
- Department of Gastroenterology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Ying Chang
- Department of Gastroenterology Zhongnan Hospital of Wuhan University Wuhan P.R. China
| | - Shuixiang He
- Department of Gastroenterology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Zejun Ren
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Hengtong Fan
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Kaijie Wu
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Dalin He
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
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Xu X, Jiang D, Liu G, Mu L, Zeng J, Yang L, He D. In vitro evaluation of the safety and efficacy of a high-power 450-nm semiconductor blue laser in the treatment of benign prostate hyperplasia. Lasers Med Sci 2021; 37:555-561. [PMID: 33770281 DOI: 10.1007/s10103-021-03297-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/22/2021] [Indexed: 01/17/2023]
Abstract
A 450-nm blue laser may be suitable to treat benign prostate hyperplasia (BPH) due to its haemoglobin absorption characteristic. The present study compared a novel high-power 450-nm semiconductor blue laser with other lasers marketed for in vitro soft tissue ablation, to evaluate the safety and efficacy of the 450-nm laser in BPH surgery. With the in vitro tissues on an experimental platform in water, the vaporization efficiency and coagulation layer thickness of the novel 450-nm laser and commercially available 532-nm, 980-nm, and 1470-nm lasers were measured at the same power (120 W). The damage to the adjacent tissue and the working noise were also measured. The vaporization efficiency was proved to be 450-nm laser > 532-nm laser > 1470-nm laser > 980-nm laser. Comparison of coagulation layer thickness was as follow: 980-nm laser > 1470-nm laser > 532-nm laser > 450-nm laser. The degree of tissue damage caused by the 450-nm and 532-nm lasers increased with the decrease in distance and increase in time (these are safe when a sufficient distance and short irradiation time are maintained). The heating ability of 980-nm and 1470-nm lasers was much greater than that of 450-nm and 532-nm lasers. The working noise was lower in 450-nm and 1470-nm lasers. The novel 450-nm laser has the advantages of highly efficient tissue vaporization, creating a thin coagulation layer, and low working noise. These characteristics suggest that the novel 450-nm laser may be a promising choice for the surgical treatment of BPH.
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Affiliation(s)
- Xiaofeng Xu
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
- Department of Urology, Xianyang Central Hospital, Xianyang, 710061, Shaanxi, China
| | - Dali Jiang
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Guoxiong Liu
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
- Department of Urology, Xianyang Central Hospital, Xianyang, 710061, Shaanxi, China
| | - Liyue Mu
- Xi'an Lanji Medical Electronic Technology Co., Ltd., Xi'an, 710003, Shaanxi, China
| | - Jin Zeng
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Lin Yang
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
| | - Dalin He
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
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