Lasers in Surgery and Medicine最新文献

Debulking With Excimer Laser Coronary Angioplasty Versus Balloon Angioplasty in Patients With in Stent Restenosis (ELDISR Study): A Randomized Controlled Trial

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-04-08 DOI: 10.1002/lsm.70013

Pan He, Haiwei Chen, Junjie Yang, Lei Gao, Jun Guo, Yundai Chen, Qi Wang

Objectives

Excimer laser coronary angioplasty (ELCA) is a safe and effective method for lesion preparation. However, its impact on clinical outcomes in patients with in-stent restenosis (ISR) undergoing drug-coated balloon (DCB) angioplasty remains unclear. This study aims to evaluate the effect of ELCA-based lesion preparation on the clinical outcomes of ISR patients treated with standard DCB angioplasty.

Methods

In this prospective, single-center, randomized controlled trial, patients with ISR were randomized 1:1 to either ELCA (+) or ELCA (−). The ELCA (+) group received ELCA for lesion preparation followed by standard DCB angioplasty, while the ELCA (−) group received standard DCB angioplasty alone. The primary endpoint was the rate of target lesion revascularization (TLR) within 1 year. Safety was also evaluated.

Results

A total of 110 patients were randomized to either the ELCA (+) group (n = 55) or the ELCA (−) group (n = 55). The mean age of the study participants was 64.5 years, 89 (80.9%) were men and 51 (46.4%) had diabetes mellitus. The procedure was successful in all patients. The primary endpoint event occurred in five patients (cumulative incidence, 9.1%) in the ELCA (+) group and in 13 patients (cumulative incidence, 23.6%) in the ELCA (−) group (HR, 0.38; 95% CI, 0.15–0.95; p = 0.038).

Conclusions

Lesion preparation with ELCA before DCB angioplasty is a safe and effective strategy for patients with ISR, associated with a lower incidence of TLR compared to standard DCB angioplasty alone. However, due to the limited sample size and single-center design, these findings should be considered hypothesis-generating. Future validation requires confirmation through multicenter studies with larger patient populations.

Trial Registration

Unique identifier: ChiCTR2300068962.

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引用次数: 0

Sub-diffuse Reflectance Spectroscopy Combined With Machine Learning Method for Oral Mucosal Disease Identification

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-04-08 DOI: 10.1002/lsm.70011

Limin Zhang, Qing Chang, Qi Zhang, Siyi Zou, Dongyuan Liu, Feng Gao, Chenlu Liu

Objectives

Oral squamous cell carcinoma (OSCC) is the sixth-highest incidence of malignant tumors worldwide. However, early diagnosis is complex owing to the impracticality of biopsying every potentially premalignant intraoral lesion. Here, we present a sub-diffuse reflectance spectroscopy combined with a machine learning method for oral mucosal disease identification. This method provides a noninvasive cost-effective identification option for early signs of malignancy.

Methods

Sub-diffuse spectra of three oral sites (hypoglottis, buccal, and gingiva) from healthy subjects and three types of mucosal lesions (oral lichen planus, OLP, oral leukoplakia, OLK, and OSCC) from patients were collected by using a home-made sub-diffuse reflectance spectroscopy prototype system, and three features including spectra ratio (SR), first-order derivative(DE) of the spectra and optical parameters (OP) were derived from the original spectra to enhance the insights into the optical properties of the oral mucosal tissues. To accurately classify the spectral features, a support vector machine (SVM) and probabilistic neural network (PNN) were employed.

Result

Most of the statistical distributions of the spectral features demonstrated obvious differences and the two classification methods exhibited comparable performances. For the classification in the oral sites of healthy subjects, the OP-based classification results were unsatisfactory, while the classification results utilizing DR, SR, and DE achieved a least accuracy of 0.8289, sensitivity of 0.8495, sensitivity of 0.9311, and Matthews correlation coefficient of 0.8085. Comparatively, the classification results between OLP, OLK, OSCC, and normal tissue obtained achieved high indexes even using the OP feature.

Conclusion

Integrating sub-diffuse reflectance spectroscopy measurement and suitable machine learning methods can obtain remarkable precision in differentiating different sites of oral mucosa and identifying different types of oral mucosal diseases, especially based on DE features. It is of great help in detecting OSCC and is expected to be a highly sensitive, time-sensitive, and accurate method for oral disease detection.

{"title":"Sub-diffuse Reflectance Spectroscopy Combined With Machine Learning Method for Oral Mucosal Disease Identification","authors":"Limin Zhang, Qing Chang, Qi Zhang, Siyi Zou, Dongyuan Liu, Feng Gao, Chenlu Liu","doi":"10.1002/lsm.70011","DOIUrl":"10.1002/lsm.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Oral squamous cell carcinoma (OSCC) is the sixth-highest incidence of malignant tumors worldwide. However, early diagnosis is complex owing to the impracticality of biopsying every potentially premalignant intraoral lesion. Here, we present a sub-diffuse reflectance spectroscopy combined with a machine learning method for oral mucosal disease identification. This method provides a noninvasive cost-effective identification option for early signs of malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sub-diffuse spectra of three oral sites (hypoglottis, buccal, and gingiva) from healthy subjects and three types of mucosal lesions (oral lichen planus, OLP, oral leukoplakia, OLK, and OSCC) from patients were collected by using a home-made sub-diffuse reflectance spectroscopy prototype system, and three features including spectra ratio (SR), first-order derivative(DE) of the spectra and optical parameters (OP) were derived from the original spectra to enhance the insights into the optical properties of the oral mucosal tissues. To accurately classify the spectral features, a support vector machine (SVM) and probabilistic neural network (PNN) were employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Most of the statistical distributions of the spectral features demonstrated obvious differences and the two classification methods exhibited comparable performances. For the classification in the oral sites of healthy subjects, the OP-based classification results were unsatisfactory, while the classification results utilizing DR, SR, and DE achieved a least accuracy of 0.8289, sensitivity of 0.8495, sensitivity of 0.9311, and Matthews correlation coefficient of 0.8085. Comparatively, the classification results between OLP, OLK, OSCC, and normal tissue obtained achieved high indexes even using the OP feature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating sub-diffuse reflectance spectroscopy measurement and suitable machine learning methods can obtain remarkable precision in differentiating different sites of oral mucosa and identifying different types of oral mucosal diseases, especially based on DE features. It is of great help in detecting OSCC and is expected to be a highly sensitive, time-sensitive, and accurate method for oral disease detection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 4","pages":"339-351"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Efficacy and Safety of Erbium-Doped Yttrium Aluminum Garnet Laser Therapy for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-04-06 DOI: 10.1002/lsm.70012

Huilei Yan, Jialei Wang, Yefei Ding, Guanli Huang, Hao Ding, Wei Zhao, Yunbo Ma

Objectives

The erbium-doped yttrium aluminum garnet(Er:YAG) laser therapy has recently emerged as a novel treatment for stress urinary incontinence (SUI) in women. The purpose of this meta-analysis was to evaluate the efficacy and safety of Er:YAG laser therapy in the management of SUI.

Materials and Methods

We conducted a search in the databases MEDLINE, EMBASE, and the Cochrane Library, up to December 2024, to identify randomized controlled trials (RCTs) that mentioned the use of Er:YAG laser therapy for the treatment of SUI. A systematic review and meta-analysis was conducted.

Results

The meta-analysis included four publications with a total of 390 patients diagnosed with SUI. Posttreatment analysis revealed statistically significant improvements in the Er:YAG laser therapy group for the 1-h pad test (mean difference [MD]: −10.42; 95% confidence interval [CI], −17.32 to −3.53; p = 0.003) and the number of subjective cures as assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) (odds ratio [OR]; 6.21, 95% CI; 1.55–24.84, p = 0.01). However, no significant differences were observed in the change of ICIQ-SF scores (MD: −0.15; 95% CI, −0.77 to 1.07; p = 0.75) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores (MD: 0.81; 95% CI, −0.24 to 1.85; p = 0.13). In terms of comfort, pain visual analog score (VAS) was higher in the laser therapy versus sham therapy following both treatment sessions (The pain VAS after session one (MD; 3.72, 95% CI; 3.24–419, p < 0.00001). The pain VAS after session two(MD; 2.64, 95% CI; 2.12–3.15, p < 0.00001). Regarding adverse events, there were no statistically significant differences between the Er:YAG laser group and the sham group in terms of increased vaginal discharge (OR; 4.64, 95% CI; 0.27–78.30, p = 0.29), vaginal discomfort (OR; 1.31, 95% CI; 0.62–2.73, p = 0.48), and suspected urinary tract infection (UTI) (OR; 3.44, 95% CI; 0.57–20.58, p = 0.18).

Conclusions

Our meta-analysis indicates that the Er:YAG laser appears to be a safe and effective treatment option for SUI.

{"title":"The Efficacy and Safety of Erbium-Doped Yttrium Aluminum Garnet Laser Therapy for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis","authors":"Huilei Yan, Jialei Wang, Yefei Ding, Guanli Huang, Hao Ding, Wei Zhao, Yunbo Ma","doi":"10.1002/lsm.70012","DOIUrl":"10.1002/lsm.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The erbium-doped yttrium aluminum garnet(Er:YAG) laser therapy has recently emerged as a novel treatment for stress urinary incontinence (SUI) in women. The purpose of this meta-analysis was to evaluate the efficacy and safety of Er:YAG laser therapy in the management of SUI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a search in the databases MEDLINE, EMBASE, and the Cochrane Library, up to December 2024, to identify randomized controlled trials (RCTs) that mentioned the use of Er:YAG laser therapy for the treatment of SUI. A systematic review and meta-analysis was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The meta-analysis included four publications with a total of 390 patients diagnosed with SUI. Posttreatment analysis revealed statistically significant improvements in the Er:YAG laser therapy group for the 1-h pad test (mean difference [MD]: −10.42; 95% confidence interval [CI], −17.32 to −3.53; <i>p</i> = 0.003) and the number of subjective cures as assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) (odds ratio [OR]; 6.21, 95% CI; 1.55–24.84, <i>p</i> = 0.01). However, no significant differences were observed in the change of ICIQ-SF scores (MD: −0.15; 95% CI, −0.77 to 1.07; <i>p</i> = 0.75) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores (MD: 0.81; 95% CI, −0.24 to 1.85; <i>p</i> = 0.13). In terms of comfort, pain visual analog score (VAS) was higher in the laser therapy versus sham therapy following both treatment sessions (The pain VAS after session one (MD; 3.72, 95% CI; 3.24–419, <i>p</i> < 0.00001). The pain VAS after session two(MD; 2.64, 95% CI; 2.12–3.15, <i>p</i> < 0.00001). Regarding adverse events, there were no statistically significant differences between the Er:YAG laser group and the sham group in terms of increased vaginal discharge (OR; 4.64, 95% CI; 0.27–78.30, <i>p</i> = 0.29), vaginal discomfort (OR; 1.31, 95% CI; 0.62–2.73, <i>p</i> = 0.48), and suspected urinary tract infection (UTI) (OR; 3.44, 95% CI; 0.57–20.58, <i>p</i> = 0.18).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our meta-analysis indicates that the Er:YAG laser appears to be a safe and effective treatment option for SUI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 4","pages":"297-305"},"PeriodicalIF":2.2,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combination Laser Treatment in Procedural Management of Congenital Melanocytic Nevi

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-04-03 DOI: 10.1002/lsm.70007

Serena Y. Tsai, Martin R. Buta, Branko Bojovic, Mia A. Mologousis, R. Rox Anderson, Elena B. Hawryluk, Yakir S. Levin

Background

Congenital melanocytic nevi (CMN) are benign melanocytic proliferations present at birth. Surgical excision has traditionally been the first-line management for CMN removal; however, it may result in scars and potential disfigurement. Multiple clinical studies have demonstrated the effects of laser treatment for CMN, but data on fair-skinned subjects remain limited.

Objectives

To report the outcomes of combination laser therapy for CMN in pediatric patients.

Methods

A retrospective review was conducted on the electronic medical records of patients under 18 years of age with CMN of any size who underwent an operating room procedure at Massachusetts General Hospital between January 1, 2010, and December 31, 2022. Laser types and settings were determined by the treating physician. The age, gender, race, Fitzpatrick skin type, size of nevus, treated area, number of treatments, interval between sessions, laser device, treatment response, complication, and follow-up duration were collected.

Results

Of 158 children with CMN, 13 were treated with laser therapy alone. Most patients had Fitzpatrick skin type I–III and large-to-giant CMN with facial involvement. They were typically treated with a combination of a long-pulsed laser and a Q-switched laser, followed by a resurfacing laser. The median number of total treatments was 7. The laser treatment achieved pigment reduction in all patients as expected, with no disfiguring scarring, unsatisfactory dyspigmentation, or adverse events observed during follow-up visits.

Conclusions

We conclude that CMN in children with lighter skin types can be effectively treated using a strategic combination of different laser devices over multiple sessions for cosmetic purposes.

{"title":"Combination Laser Treatment in Procedural Management of Congenital Melanocytic Nevi","authors":"Serena Y. Tsai, Martin R. Buta, Branko Bojovic, Mia A. Mologousis, R. Rox Anderson, Elena B. Hawryluk, Yakir S. Levin","doi":"10.1002/lsm.70007","DOIUrl":"10.1002/lsm.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Congenital melanocytic nevi (CMN) are benign melanocytic proliferations present at birth. Surgical excision has traditionally been the first-line management for CMN removal; however, it may result in scars and potential disfigurement. Multiple clinical studies have demonstrated the effects of laser treatment for CMN, but data on fair-skinned subjects remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To report the outcomes of combination laser therapy for CMN in pediatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted on the electronic medical records of patients under 18 years of age with CMN of any size who underwent an operating room procedure at Massachusetts General Hospital between January 1, 2010, and December 31, 2022. Laser types and settings were determined by the treating physician. The age, gender, race, Fitzpatrick skin type, size of nevus, treated area, number of treatments, interval between sessions, laser device, treatment response, complication, and follow-up duration were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 158 children with CMN, 13 were treated with laser therapy alone. Most patients had Fitzpatrick skin type I–III and large-to-giant CMN with facial involvement. They were typically treated with a combination of a long-pulsed laser and a Q-switched laser, followed by a resurfacing laser. The median number of total treatments was 7. The laser treatment achieved pigment reduction in all patients as expected, with no disfiguring scarring, unsatisfactory dyspigmentation, or adverse events observed during follow-up visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We conclude that CMN in children with lighter skin types can be effectively treated using a strategic combination of different laser devices over multiple sessions for cosmetic purposes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 4","pages":"306-311"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Comparitive Study Between Early Outcomes of Laser and Lay-Open Technique in Management of Simple Pilonidal Sinus

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-03-19 DOI: 10.1002/lsm.70008

Mostafa Seif El Deen, Youssef Mohamed Hassan, Magdy Akel Sorour, Hany El Hadad, Mohamed Wael

Background

Pilonidal sinus (PS) predominantly impacts adolescent and young adult males. This condition may be asymptomatically or escalate to painful acute abscesses and recurrent discharge.

Objective

To evaluate the early postoperative outcomes of laser therapy compared to the lay-open technique in the treatment of chronic pilonidal sinus disease.

Methods

Prospective randomized comparative study including 40 patients, divided into two equal groups: (a) The SiLaT group: PS treated with diode laser therapy (SiLaT) and (b) the lay-open group: PS treated with lay-open (sinotomy). Postoperative outcomes such as operative time, hospital stay, pain scores, healing time, complications, and recurrence rates were analyzed.

Results

Operative time was significantly shorter in the SiLaT group (18.4 ± 2.1 min vs. 26.2 ± 3.7 min, p = 0.022). Hospital stay was shorter in the SiLaT group (6.60 ± 1.47 h vs. 15.10 ± 5.52 h, p < 0.001). Pain scores were lower in the SiLaT group (2.30 ± 0.92 vs. 4.80 ± 1.01, p < 0.001). Wound healing was significantly faster in the SiLaT group (10.1 ± 2.7 days vs. 34.1 ± 15.1 days, p < 0.0001). Recurrence rates (p = 0.998) and surgical site infection (p = 1.00) were comparable among both groups.

Conclusion

Sinus laser therapy (SiLaT) demonstrated superior early outcomes, including faster recovery, reduced pain, and fewer complications with earlier resumption of daily activities compared to the lay-open technique. However, recurrence rates remain similar, necessitating long-term studies to evaluate its effectiveness as a first-line treatment. These findings support the use of SiLaT as a day-case surgical procedure, for treating simple PS disease, particularly in young active patients seeking rapid recovery with minimal morbidity.

{"title":"A Comparitive Study Between Early Outcomes of Laser and Lay-Open Technique in Management of Simple Pilonidal Sinus","authors":"Mostafa Seif El Deen, Youssef Mohamed Hassan, Magdy Akel Sorour, Hany El Hadad, Mohamed Wael","doi":"10.1002/lsm.70008","DOIUrl":"10.1002/lsm.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pilonidal sinus (PS) predominantly impacts adolescent and young adult males. This condition may be asymptomatically or escalate to painful acute abscesses and recurrent discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the early postoperative outcomes of laser therapy compared to the lay-open technique in the treatment of chronic pilonidal sinus disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective randomized comparative study including 40 patients, divided into two equal groups: (a) The SiLaT group: PS treated with diode laser therapy (SiLaT) and (b) the lay-open group: PS treated with lay-open (sinotomy). Postoperative outcomes such as operative time, hospital stay, pain scores, healing time, complications, and recurrence rates were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Operative time was significantly shorter in the SiLaT group (18.4 ± 2.1 min vs. 26.2 ± 3.7 min, <i>p</i> = 0.022). Hospital stay was shorter in the SiLaT group (6.60 ± 1.47 h vs. 15.10 ± 5.52 h, <i>p</i> < 0.001). Pain scores were lower in the SiLaT group (2.30 ± 0.92 vs. 4.80 ± 1.01, <i>p</i> < 0.001). Wound healing was significantly faster in the SiLaT group (10.1 ± 2.7 days vs. 34.1 ± 15.1 days, <i>p</i> < 0.0001). Recurrence rates (<i>p</i> = 0.998) and surgical site infection (<i>p</i> = 1.00) were comparable among both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sinus laser therapy (SiLaT) demonstrated superior early outcomes, including faster recovery, reduced pain, and fewer complications with earlier resumption of daily activities compared to the lay-open technique. However, recurrence rates remain similar, necessitating long-term studies to evaluate its effectiveness as a first-line treatment. These findings support the use of SiLaT as a day-case surgical procedure, for treating simple PS disease, particularly in young active patients seeking rapid recovery with minimal morbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 4","pages":"321-328"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Possible Number of Recommended Sessions and Influential Factors of Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Pulsed Dye Laser-Resistant Facial Port-Wine Stain

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-03-17 DOI: 10.1002/lsm.70003

Yating Lv, Luan Yang, Shufang Wei, Xiaoying Xiangli, Xiaorong Yang, Xianjun Zhang, Hua Zhong

Objectives

Some patients with port-wine stain (PWS) who have undergone several sessions of pulsed dye laser (PDL) treatment desire further improvement through hematoporphyrin monomethyl ether (HMME) photodynamic therapy (PDT). We attempted to analyse a possible number of recommended sessions and factors influencing the efficacy of multiple sessions of HMME-PDT for facial PDL-resistant PWSs.

Methods

Forty-eight patients with facial PDL-resistant PWSs who underwent at least three HMME-PDT sessions were included in this study. All patients received an intravenous injection of HMME (5 mg/kg) followed by 532-nm light-emitting diode green light therapy. Cumulative improvement scores and single improvement scores were obtained after each session to evaluate the degree of improvement.

Results

The excellent improvement rates of patients were 0% (0/48), 8.3% (4/48), 29.2% (14/48), 38.5% (10/26), and 50.0% (8/16) after 1–5 HMME-PDT sessions, respectively. A significant difference was observed in the cumulative improvement scores (p < 0.0001). Moreover, there were significant differences between any two sessions in the first four HMME-PDT sessions (p = 0.003). The improvement after the first HMME-PDT session was more obvious than that after each subsequent session (p = 0.004). A PWS less than or equal to 1% of the body surface area (OR = 9.05; 95% CI, 1.42–57.57; p = 0.020) and 5–10 sessions of previous PDL treatment (OR = 8.06; 95% CI, 2.01–32.33; p = 0.003) were positive influential factors for PDL-resistant PWS.

Conclusions

We propose that at least 4 HMME-PDT sessions could be recommended for patients with PDL-resistant PWSs, and the improvement after the first HMME-PDT session was the most evident compared with that after each subsequent treatment. Moreover, greater erythema and a greater number of previous PDL session were associated with poor HMME-PDT efficacy.

{"title":"Possible Number of Recommended Sessions and Influential Factors of Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Pulsed Dye Laser-Resistant Facial Port-Wine Stain","authors":"Yating Lv, Luan Yang, Shufang Wei, Xiaoying Xiangli, Xiaorong Yang, Xianjun Zhang, Hua Zhong","doi":"10.1002/lsm.70003","DOIUrl":"10.1002/lsm.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Some patients with port-wine stain (PWS) who have undergone several sessions of pulsed dye laser (PDL) treatment desire further improvement through hematoporphyrin monomethyl ether (HMME) photodynamic therapy (PDT). We attempted to analyse a possible number of recommended sessions and factors influencing the efficacy of multiple sessions of HMME-PDT for facial PDL-resistant PWSs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-eight patients with facial PDL-resistant PWSs who underwent at least three HMME-PDT sessions were included in this study. All patients received an intravenous injection of HMME (5 mg/kg) followed by 532-nm light-emitting diode green light therapy. Cumulative improvement scores and single improvement scores were obtained after each session to evaluate the degree of improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The excellent improvement rates of patients were 0% (0/48), 8.3% (4/48), 29.2% (14/48), 38.5% (10/26), and 50.0% (8/16) after 1–5 HMME-PDT sessions, respectively. A significant difference was observed in the cumulative improvement scores (<i>p</i> < 0.0001). Moreover, there were significant differences between any two sessions in the first four HMME-PDT sessions (<i>p</i> = 0.003). The improvement after the first HMME-PDT session was more obvious than that after each subsequent session (<i>p</i> = 0.004). A PWS less than or equal to 1% of the body surface area (OR = 9.05; 95% CI, 1.42–57.57; <i>p</i> = 0.020) and 5–10 sessions of previous PDL treatment (OR = 8.06; 95% CI, 2.01–32.33; <i>p</i> = 0.003) were positive influential factors for PDL-resistant PWS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We propose that at least 4 HMME-PDT sessions could be recommended for patients with PDL-resistant PWSs, and the improvement after the first HMME-PDT session was the most evident compared with that after each subsequent treatment. Moreover, greater erythema and a greater number of previous PDL session were associated with poor HMME-PDT efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 4","pages":"312-320"},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Protocol for Dermatology Service Learning for Medical Students: Supporting Laser Tattoo Removal for Adults Impacted by the Justice-System

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-03-11 DOI: 10.1002/lsm.70005

Victoria D. Ojeda, Hong-An Nguyen, Saisha Nandamuri, Spencer Chau, Jose Luis Burgos, Laura Romero, Arisa Ortiz

<div> <section> <h3> Objective</h3> <p>Medical students are interested in participating in dermatology-based service learning programs that address social justice issues. This article describes a novel volunteer program in dermatology with a focus on laser medicine.</p> </section> <section> <h3> Methods</h3> <p>We developed a service-learning program that is embedded in a tattoo removal program that serves adults who have interacted with the criminal justice system. The program is designed to ensure that student participation is appropriate to their training while allowing volunteers to: (1) gain exposure to dermatological clinical settings, (2) strengthen communication skills with diverse patients that medical students typically do not typically interact with during their first and second years, (3) build relationships with dermatology residents and faculty and work in multi-disciplinary teams, (4) observe laser procedure and physicians' approaches to the bedside manner, and (5) support the clinical team with patient education postprocedure. Lastly, the program is designed to facilitate peer mentorship by encouraging second-year students to transition into a leadership role and co-mentor first-year students. Evaluation survey data of the first two student cohorts (<i>n</i> = 6 students, 75% response rate) were collected in January, 2025 and results are summarized.</p> </section> <section> <h3> Results</h3> <p>Student volunteers participate in the following activities: consent form preparation, patient check-in, rooming, consent form collection, shadow procedure, assist with postprocedure tasks (e.g., apply skin ointment and provide sun protection supplies) and patient education as needed. The program is in its second year and has been piloted with eight students with the number of sessions attended ranging between 1 and 13. Evaluation data indicate that all students had prior work experience in clinical settings. Motivations for working in the clinic primarily included interest in providing medical services to adults impacted by the justice system (100%) followed by interest in gaining experience in dermatology to potentially support a career in this discipline. Students felt the program would prepare them to serve underserved communities and for a career in dermatology (33% for each). All students reported being very satisfied with the program's training activities and the majority were able to partake in most activities. Most students reported being confident or very confident in their abilities to carry-out the activities assigned to volunteers and build relationships with students and clinicians. Areas for program improvement include streamlin

{"title":"A Protocol for Dermatology Service Learning for Medical Students: Supporting Laser Tattoo Removal for Adults Impacted by the Justice-System","authors":"Victoria D. Ojeda, Hong-An Nguyen, Saisha Nandamuri, Spencer Chau, Jose Luis Burgos, Laura Romero, Arisa Ortiz","doi":"10.1002/lsm.70005","DOIUrl":"10.1002/lsm.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Medical students are interested in participating in dermatology-based service learning programs that address social justice issues. This article describes a novel volunteer program in dermatology with a focus on laser medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a service-learning program that is embedded in a tattoo removal program that serves adults who have interacted with the criminal justice system. The program is designed to ensure that student participation is appropriate to their training while allowing volunteers to: (1) gain exposure to dermatological clinical settings, (2) strengthen communication skills with diverse patients that medical students typically do not typically interact with during their first and second years, (3) build relationships with dermatology residents and faculty and work in multi-disciplinary teams, (4) observe laser procedure and physicians' approaches to the bedside manner, and (5) support the clinical team with patient education postprocedure. Lastly, the program is designed to facilitate peer mentorship by encouraging second-year students to transition into a leadership role and co-mentor first-year students. Evaluation survey data of the first two student cohorts (<i>n</i> = 6 students, 75% response rate) were collected in January, 2025 and results are summarized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Student volunteers participate in the following activities: consent form preparation, patient check-in, rooming, consent form collection, shadow procedure, assist with postprocedure tasks (e.g., apply skin ointment and provide sun protection supplies) and patient education as needed. The program is in its second year and has been piloted with eight students with the number of sessions attended ranging between 1 and 13. Evaluation data indicate that all students had prior work experience in clinical settings. Motivations for working in the clinic primarily included interest in providing medical services to adults impacted by the justice system (100%) followed by interest in gaining experience in dermatology to potentially support a career in this discipline. Students felt the program would prepare them to serve underserved communities and for a career in dermatology (33% for each). All students reported being very satisfied with the program's training activities and the majority were able to partake in most activities. Most students reported being confident or very confident in their abilities to carry-out the activities assigned to volunteers and build relationships with students and clinicians. Areas for program improvement include streamlin","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 3","pages":"284-290"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inaugural Editorial by the New Editor-in-Chief 新主编的就职社论。

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-03-11 DOI: 10.1002/lsm.70006

Bahman Anvari PhD

引用次数: 0

Comparison of Topical 5-Aminolevulinic Acid Photodynamic Therapy With the Loop Electrosurgical Excision Procedure for Patients With Cervical High-Grade Squamous Intraepithelial Neoplasia: A Prospective and Propensity-Matched Analysis

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-03-03 DOI: 10.1002/lsm.70004

Yao Yang, Bingying Sun, Dan Cao, Ying Xu, Yi Chen, Dan Wu

Objective

To evaluate the efficacy of 5-aminolevulinic acid photodynamic therapy (PDT) for high-grade squamous intraepithelial lesions of the cervix associated with high-risk human papillomavirus (HPV) infection.

Methods

In this study, 120 patients who received treatment for high-grade squamous intraepithelial lesions of the cervix from March 2023 to March 2024 were followed up prospectively, which were categorized into the PDT and loop electrosurgical excision procedure (LEEP) groups and matched 1:1 using a propensity score. The regression rate of the lesions and the HPV clearance rate were compared between the groups at 6 and 12 months. Factors affecting the clearance rate were analyzed.

Results

At the 6- and 12-month follow-ups, no significant difference was observed in the rate of lesion regression between the PDT (86.7%, 91.7%) and LEEP groups (85.0%, 93.3%) (p > 0.05), nor the HPV clearance rate (55.0%, 76.7% vs. 65.0%, 78.3%) (p > 0.05). Neither group had any lesions that progressed to Grade 3 or invasive cervical carcinoma at follow-up. According to regression analysis, thinprep cytology test (TCT) results influenced lesion regression in the PDT group.

Conclusion

Compared to the LEEP, 5-aminolevulinic acid PDT had a similar rate of lesion regression and HPV clearance for the treatment of high-grade squamous intraepithelial lesions of the cervix; thus, PDT offers an alternative and effective minimally invasive approach.

{"title":"Comparison of Topical 5-Aminolevulinic Acid Photodynamic Therapy With the Loop Electrosurgical Excision Procedure for Patients With Cervical High-Grade Squamous Intraepithelial Neoplasia: A Prospective and Propensity-Matched Analysis","authors":"Yao Yang, Bingying Sun, Dan Cao, Ying Xu, Yi Chen, Dan Wu","doi":"10.1002/lsm.70004","DOIUrl":"10.1002/lsm.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy of 5-aminolevulinic acid photodynamic therapy (PDT) for high-grade squamous intraepithelial lesions of the cervix associated with high-risk human papillomavirus (HPV) infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, 120 patients who received treatment for high-grade squamous intraepithelial lesions of the cervix from March 2023 to March 2024 were followed up prospectively, which were categorized into the PDT and loop electrosurgical excision procedure (LEEP) groups and matched 1:1 using a propensity score. The regression rate of the lesions and the HPV clearance rate were compared between the groups at 6 and 12 months. Factors affecting the clearance rate were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the 6- and 12-month follow-ups, no significant difference was observed in the rate of lesion regression between the PDT (86.7%, 91.7%) and LEEP groups (85.0%, 93.3%) (<i>p</i> > 0.05), nor the HPV clearance rate (55.0%, 76.7% vs. 65.0%, 78.3%) (<i>p</i> > 0.05). Neither group had any lesions that progressed to Grade 3 or invasive cervical carcinoma at follow-up. According to regression analysis, thinprep cytology test (TCT) results influenced lesion regression in the PDT group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to the LEEP, 5-aminolevulinic acid PDT had a similar rate of lesion regression and HPV clearance for the treatment of high-grade squamous intraepithelial lesions of the cervix; thus, PDT offers an alternative and effective minimally invasive approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 3","pages":"276-283"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effect of Vaginal Er:YAG Laser Therapy on Pelvic Floor Symptoms in Women With Stress Urinary Incontinence: A Single-Center Cohort Study

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine

Pub Date : 2025-02-19 DOI: 10.1002/lsm.70001

Massimiliano Lia, Pavel Pilát, Laura Weydandt, Kaven Baessler, Tom Kempe, Bahriye Aktas

Objectives

To examine the effect of vaginal erbium:yttrium-aluminum-garnet (Er:YAG) laser therapy on pelvic floor symptoms in women with stress urinary incontinence (SUI).

Methods

This was a prospective, single-arm interventional study applying three Er:YAG laser treatments to patients with SUI. The German version of the validated Australian Pelvic Floor Questionnaire was used to quantify pelvic floor symptoms (bladder function, bowel function, sexual function, pelvic organ prolapse) over different time points (baseline, posttreatment, 3 months, and 6 months after treatment). Subgroups were compared to examine which factors influenced symptom development after the treatment.

Results

A total of 50 women received three Er:YAG laser treatments and had their symptoms evaluated at all time points of the study. All symptom complex scores, especially bladder function and sexual function, showed statistically significant improvements lasting for the whole study period. However, score improvements of bowel function and prolapse symptoms were likely not clinically meaningful, as they were below the minimal important difference (MID) of this questionnaire. Moreover, sexual function scores improved less when women additionally had urgency symptoms (i.e., mixed urinary incontinence [MUI]; p = 0.036).

Conclusion

Vaginal Er:YAG laser therapy has the potential to improve pelvic floor symptoms linked to bladder function and sexual function in women with SUI. However, the positive effect on sexual function was lower if the women had MUI.

{"title":"The Effect of Vaginal Er:YAG Laser Therapy on Pelvic Floor Symptoms in Women With Stress Urinary Incontinence: A Single-Center Cohort Study","authors":"Massimiliano Lia, Pavel Pilát, Laura Weydandt, Kaven Baessler, Tom Kempe, Bahriye Aktas","doi":"10.1002/lsm.70001","DOIUrl":"10.1002/lsm.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the effect of vaginal erbium:yttrium-aluminum-garnet (Er:YAG) laser therapy on pelvic floor symptoms in women with stress urinary incontinence (SUI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, single-arm interventional study applying three Er:YAG laser treatments to patients with SUI. The German version of the validated Australian Pelvic Floor Questionnaire was used to quantify pelvic floor symptoms (bladder function, bowel function, sexual function, pelvic organ prolapse) over different time points (baseline, posttreatment, 3 months, and 6 months after treatment). Subgroups were compared to examine which factors influenced symptom development after the treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 50 women received three Er:YAG laser treatments and had their symptoms evaluated at all time points of the study. All symptom complex scores, especially bladder function and sexual function, showed statistically significant improvements lasting for the whole study period. However, score improvements of bowel function and prolapse symptoms were likely not clinically meaningful, as they were below the minimal important difference (MID) of this questionnaire. Moreover, sexual function scores improved less when women additionally had urgency symptoms (i.e., mixed urinary incontinence [MUI]; <i>p</i> = 0.036).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vaginal Er:YAG laser therapy has the potential to improve pelvic floor symptoms linked to bladder function and sexual function in women with SUI. However, the positive effect on sexual function was lower if the women had MUI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 3","pages":"265-275"},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0