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Posterior laryngofissure using a surgical contact diode laser: an experimental feasibility study

  • Arteiro Queiroz Menezes
  • Paulo Francisco Guerreiro CardosoEmail author
  • Christopher Kengo Nagao
  • Helio Minamoto
  • Benoit Jacques Bibas
  • Isaac de Faria Soares Rodrigues
  • José Pinhata Otoch
  • Marisa Dolhnikoff
  • Mauro Canzian
  • Marilia Wellichan Mancini
  • Paulo Manuel Pêgo-Fernandes
Original Article

Abstract

To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight Landrace pigs (15–20 kg) were anesthetized, intubated, ventilated, and submitted to a cervical tracheostomy. An anterior and posterior midline longitudinal laryngofissure incision was created according to randomization—control (n = 4), posterior laryngofissure with a scalpel blade; electrocautery (n = 12), posterior laryngofissure by electrocautery (10, 15, 20, 25 W powers); CDL (n = 12), posterior laryngofissure by the CDL (10, 15, 20, 25 W peak powers in pulsed mode). Larynx and proximal trachea were excised, prepared for histopathology, and digital morphometric analysis. Measurements in and within each group were analyzed (Kruskal-Wallis and Dunn test) with a level of significance of p < 0.05. Incision width was not different between the groups, as well as in the powers used in CDL (p = 0.161) and electrocautery group (p = 0.319). The depth of the incisions was smaller in the Laser group compared to control (p = 0.007), and in the electrocautery compared to control (p = 0.026). Incision area was smaller in CDL compared with the control (p = 0.027), and not different between laser and electrocautery groups (p = 0.199). The lateral thermal damage produced by electrocautery was the largest, with a significant difference between laser and electrocautery (p = 0.018), and between electrocautery and control (p = 0.004), whereas the comparison between laser and control showed no significant differences (p = 0.588). The posterior laryngofissure incision using a 980-nm CDL is feasible resulting in smaller incisional area and less lateral thermal damage.

Keywords

Contact diode laser Larynx Pigs Tracheal stenosis Surgery 

Notes

Role of funding source

This study was funded by Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, Brazil (FAPESP grants 2015/17847-1 and 2016/25437-0). Funding covered the experimental expenses, the equipment used in the study, and a scholarship for a medical student.

Compliance with ethical standards

Conflict of interest statement

The author Marilia Wellichan Mancini is a physicist working at the company DMC at the department of research and development of the laser equipment used in this study. The author Paulo Francisco Guerreiro Cardoso was the recipient of the FAPESP grants 2015/17847-1 and 2016/25437-0. The remaining authors have no conflict of interest to disclose.

Ethical approval

The research protocol was approved on by the ethics committee (CEUA 153/14) of the Faculty of Medicine of the University of Sao Paulo, Brazil.

Informed consent

Not applicable in the current animal experimental protocol.

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  • Arteiro Queiroz Menezes
    • 1
    • 2
    • 3
  • Paulo Francisco Guerreiro Cardoso
    • 1
    Email author
  • Christopher Kengo Nagao
    • 1
  • Helio Minamoto
    • 1
  • Benoit Jacques Bibas
    • 1
  • Isaac de Faria Soares Rodrigues
    • 1
  • José Pinhata Otoch
    • 4
  • Marisa Dolhnikoff
    • 5
  • Mauro Canzian
    • 6
  • Marilia Wellichan Mancini
    • 7
  • Paulo Manuel Pêgo-Fernandes
    • 1
  1. 1.Division of Thoracic Surgery, Thoracic Surgery Research Laboratory (LIM-61)Heart Institute (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao PauloSão PauloBrazil
  2. 2.Department of SurgeryUniversidade do Estado do AmazonasManausBrazil
  3. 3.Universidade Federal do AmazonasManausBrazil
  4. 4.Discipline of Surgical Technique and Experimental Surgery (LIM 26)Faculdade de Medicina da Universidade de Sao PauloSao PauloBrazil
  5. 5.Department of PathologyFaculdade de Medicina da Universidade de Sao PauloSao PauloBrazil
  6. 6.LABPAC Pathology LabSão PauloBrazil
  7. 7.Núcleo de Pesquisa e Ensino de Fototerapia nas Ciências da Saúde–NUPENSão CarlosBrazil

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