The dual 980‐nm and 1470‐nm diode laser for vascular lesions

ALA photodynamic therapy combined with dual 980nm/1470nm diode laser for classic Kaposi's sarcoma

A 84-year old man who has a history of refractory Kaposi's sarcoma (KS) was treated with ALA-PDT combined with the dual 980-nm/1470-nm diode laser for 6 times every other week. Satisfactory result was noted without any unbearable adverse effects. The combination of the dual 980nm/1470 nm diode laser and ALA-PDT may be astrategy in treating local KS with good tolerance, especially in elder patients who can not tolerate radiotherapy and chemotherapy.

Cavernous hemangioma of the lip: combined treatment with intralesional laser and surgery

Infantile cavernous hemangioma is a benign vascular tumor in childhood. Cavernous hemangiomas have a tendency of slow enlargement with subsequent complications such as ulceration and bleeding. We report a case of a large cavernous hemangioma affecting the median upper lip in an 11-year-old girl. The lesion was growing and painful on pressure. The patient felt stigmatized. Treatment was wished for by patient and parents. After careful examination including Doppler ultrasound, we suggested a combined approach. In the first step the lesion was coagulated with an intralesional neodymium-YAG laser using a blunt tip. In the second step, immediately after the action of the laser, the lesion was removed completely by surgery. Defect closure was realized with bilateral tissue-expanding vermillion myocutaneous flaps. The patient was followed-up to 5 months. Disfigurement and functional impairment were eliminated. The result was satisfying for both patient and parents. Vascular lesions of the upper lip-particularly when close to Cupid's bow-can become disfiguring and cause functional impairment. We propose a combined approach with intralesional neodymium-YAG laser photocoagulation to avoid bleeding and to shrink the lesion before complete surgical removal. For defect closure, bilateral tissue-expanding vermillion myocutaneous flaps (Goldstein technique modified by Sawada) were used.

Dye Laser to Treat an Arteriovenous Malformation of the Tongue: 40-Month Follow-Up

Arteriovenous malformations (AVMs) are abnormal connections between blood vessels that bypass the normal capillary bed. To avoid the invasiveness of the gold standard surgical excision, the use of dye laser has been suggested as an alternative. A 53-year-old man in good overall health presented with a large bluish-red nodular growth covered by intact mucosa on the left side of his tongue. The growth had a hard-elastic consistency and was not painful to touch. Imaging investigations revealed a capsulated growth consistent with a diagnosis of AVM. The patient underwent two sessions of rhodamine dye laser treatment using the following parameters: fluence of 12 J/cm2, 6 mm laser spot, a single pulse with repetition up to 1.0 Hz, and a pulse duration of 3.0 ms. Follow-up examinations were conducted at 12, 24, 36, and 40 months after the treatment. At the 40-month follow-up, the lesion had reduced in size, with a more organized vascular network, and was not clinically detectable. Considering the limitations of this case report, the application of dye laser appears to be a potentially successful treatment option for AVMs.

Comparison of 980-nm/1470-nm Dual-Wavelength Fiber Laser Versus Ultrasonic Scalpel Device in Open Thyroidectomy

Background: To investigate the application value of 980-nm/1470-nm dual-wavelength fiber laser in thyroidectomy. Methods: The clinical data of 130 patients undergoing thyroid surgery from March 2017 to December 2018 were retrospectively analyzed. According to the use types of energy devices, the patients were divided into laser group and ultrasonic scalpel group, with 65 patients in each group. The baseline data, operation-related indicators, operation complications, postoperative pathological conditions, and follow-up results of the two groups were compared. Results: The operations were successfully completed in both groups. The median operative time of total thyroidectomy (TT), lobectomy+central lymph node dissection (CLND), TT+CLND in the laser group were longer than that in the harmonic scalpel group, and the difference was statistically significant (p < 0.05). The incidence of parathyroid gland congestion in the laser group (10.3%) was lower than that in the harmonic scalpel group (19.2%), and the difference was statistically significant (p < 0.05). No significant differences were found in operative type, intraoperative blood loss, postoperative drainage volume, operative complications, postoperative hospital stay, and lymph node metastasis rate between the two groups (p > 0.05). No incidence was noted of recurrence, metastasis, or death in both groups. Conclusions: The 980-nm/1470-nm dual-wavelength fiber laser had an efficacy in open thyroidectomy similar to that of the harmonic scalpel, was safe and feasible, and less damage to the parathyroid gland blood supply than a scalpel. It can be used as a new option for thyroid surgery.

Retrospective analysis of 1470-/980-nm dual-wavelength laser en bloc resection versus transurethral resection of bladder tumor for primary non-muscle-invasive bladder cancer

To compare the safety and efficacy of en bloc resection of non-muscle-invasive bladder cancer (NMIBC) using a 1470-/980-nm dual-wavelength laser (DwLRBT) compared to the gold standard, transurethral resection (TURBT). The study group included 251 patients with a confirmed diagnosis of NMIBC, 97 in the DwLRBT group and 154 in the TURBT group. Clinical characteristics, complications, and recurrence-free survival were compared between the two groups. There were no differences between the two groups with regard to age, sex, mean tumor size, mean tumor number, tumor location, risk, fever, and reoperation. Compared to TURBT, DwLRBT was associated with a shorter hospitalization time (mean±standard deviation: 5.81±1.48 days vs. 4.96±1.32, respectively, p=0.001), shorter catheterization time (4.98±1.47 vs. 4.20±1.48 days, respectively; p=0.035), and smaller volume of intraoperative bleeding (8.43±6.21 ml vs. 6.15±5.08, respectively; p=0.003). Recurrence-free survival (RFS) was better for DwLRBT than TURBT in the overall cohort (hazard ratio [HR], 0.4323; 95% confidence interval [CI], 0.2852-0.6554; p=0.0004) and for the following subgroups and tumor types: intermediate-risk (HR, 0.2654; 95%CI, 0.1020-0.6904; p=0.0245) and high-risk (HR, 0.4461; 95% CI, 0.2778-0.7162; p=0.0027) groups; and for pedunculate bladder tumors (HR, 0.4158; 95%CI, 0.2401-0.7202; p=0.0063), single bladder tumors (HR, 0.4136; 95%CI, 0.2376-0.7293; p=0.0072), and multiple bladder tumors (HR, 0.2727; 95%CI, 0.1408-0.5282; p=0.0014). DwLRBT is associated with better operative and postoperative outcomes, including, importantly, a longer RFS, compared to TURBT.

Importance of the Right Protocol in Using a Diode Laser (980 nm) for Small Oral Vascular Malformation Treatment

Small vascular anomalies are commonly present on the lips and other areas of the oral mucosa. These lesions are also known as venous lake lesions, and they can be treated in many ways with surgical and non-surgical methods. Laser is an arising technique for this type of procedure and its use has been growing in dental practices in the last years. The technique that uses the diode laser delivers the energy in a non-contact treatment, leading to the coagulation of the lesion in a minimally invasive manner, and for this reason, there is less chance of developing scar formation. In this report, a 56-year-old female patient had a vascular lesion on her lower lip measuring about 3.0 mm in diameter. The patient reported having it for more than 10 years. A first approach using a high-power diode laser had already been done but with no success. At this time, the diode laser was used under local anesthesia, with a flexible quartz fiber held 2 to 3 mm from the lesion, using the continuous wave mode set, 1.0 W of power for 10 seconds, with an interval of 30 seconds to prevent heat damage to the adjacent tissue. The laser was applied until the lesion appeared white and with evidence of shrinkage. In this case, two rounds of irradiation were done. After a 30-day follow-up, the lesion was repaired with no signs of scars on the lip. The diode laser is an effective technique for treating this type of lesion, with many advantages, such as providing coagulation, excellent healing, no postoperative complication, and no need for suturing. Besides all, it is also a low-cost procedure, small lesions usually require only one appointment, and this treatment is also better accepted by the patients.

1470 nm/980 nm dual-wavelength laser is safe and efficient for the en-bloc resection of non-muscle invasive bladder cancer: A propensity score-matched analysis

OBJECTIVE

To evaluate the efficacy and safety of a 1470 nm/980 nm dual-wavelength laser system used for the en-bloc resection of non-muscle invasive bladder cancer (NMIBC) compared with transurethral resection of bladder tumour (TURBT).

METHODS

This retrospective study analysed the demographic and clinical data from patients diagnosed with NMIBC that were treated by either dual laser or TURBT. Intraoperative characteristics, postoperative characteristics and outcomes between the two groups were compared.

RESULTS

This study analysed 64 patients, 32 in each group. No severe complications were identified in either group. After propensity score-matching, there were no significant differences between the two groups in terms of the demographics, clinical and tumour characteristics. There was no significant difference between the two groups in terms of specimen quality. In the laser group, intraoperative blood loss was significantly lower and significantly fewer patients required continuous bladder irrigation after surgery, compared with the TURBT group. No significant differences were observed in the catheterization time, gross haematuria time and hospitalization time. Operation time in the laser group was significantly longer compared with the TURBT group. No significant difference was found in the recurrence and progression rates between the two groups.

CONCLUSIONS

The 1470 nm/980 nm dual-wavelength laser provides a safe and effective surgical treatment option for patients with NMIBC.

Medical Applications of Diode Lasers: Pulsed versus Continuous Wave (cw) Regime

The paper deals with the medical application of diode-lasers. A short review of medical therapies is presented, taking into account the wavelength applied, continuous wave (cw) or pulsed regimes, and their therapeutic effects. Special attention was paid to the laryngological application of a pulsed diode laser with wavelength 810 nm, and dermatologic applications of a 975 nm laser working at cw and pulsed mode. The efficacy of the laser procedures and a comparison of the pulsed and cw regimes is presented and discussed.

[Complications after laser treatment of facial vascular lesions]

Laser technology represents a major advance in the treatment of vascular changes. Excellent knowledge combined with technological advances in new laser sources form the basis of this safe and effective option in many acquired or congenital vascular changes on the face. With regard to the different laser sources, the pulsed dye laser (PDL) has the best efficacy-to-safety ratio. This type of laser remains the gold standard for vascular lesions. Neodymium-doped yttrium aluminium garnet (Nd: YAG) lasers and diode lasers, among others, as well as intensed pulsed light (IPL), play an important role in addressing vascular changes in the face. Good knowledge of the laser approach to vascular lesions and technological progress have led to safety features that seek to minimize side effects. These advances mainly include the introduction of cooled tips, cooling devices and cooling systems, changes in pulse duration, and the introduction of different wavelengths, among others. However, undesirable side effects can still occur. Although these are mostly discrete and resolve spontaneously, some complications can be serious and difficult to manage. Therefore, the prevention and early management of complications are all the more important in the treatment of vascular changes on the face.