[Teaching for the improvement of communication technic and its effects].
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Biomedical subjects
Publications and source records attributed to N Hira.
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There have been claims that the use of lasers in surgery is associated with reduced operative blood loss, trauma, postoperative pain and improved postoperative mobility. With the development of sapphire probes capable of transmitting neodymium yttrium aluminium garnet (Nd: YAG) laser light, it is now feasible to perform direct-contact low-power laser surgery. In a small randomized controlled trial, we have compared cholecystectomy performed by conventional methods (n = 11) with the same operation performed by contact laser (n = 10). Operative time, blood loss, operative stability, analgesic requirement, mobility and response to the trauma of surgery were compared. The only differences between the two groups were a significantly increased wound infection rate (P = 0.051) in the laser surgery group and a significantly increased length of operating time (P = 0.001). Thus, the laser did not confer any advantage over conventional surgery.
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The palliative treatment of inoperable cancers of the oesophagus, gastric fundus and rectum can be difficult and unsuccessful. Laser beam irradiation therapy offers good palliation in the majority of patients but requires several treatment sessions to achieve this. We describe a small series of patients treated with a new direct contact low power laser technique using artificial sapphire probes. After one treatment, in patients with malignant dysphagia, two thirds could swallow solids and in patients with rectal cancers bleeding was stopped or reduced and diarrhoea stopped. The interval before a second treatment was needed was three and a half weeks. We feel this technique is a useful adjuvant to conventional laser therapy of inoperable gastrointestinal tract tumours, especially in providing effective palliation in one treatment session.
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