EXPERIMENTAL SUBSTANTIATION OF THE METHOD OF PHOTODYNAMIC STIMULATION OF ADHESIONS IN THE PLEURAL CAVITY IN LABORATORY ANIMALS

Khmara Artyom Dmitrievich, Polidanov Maxim Andreevich, Kapralov Sergey Vladimirovich, Petrunkin Rodion Pavlovich, Chupakhin Nikolay Vladimirovich, Gorbunova Elena Sergeevna

The aim of the study is experimental substantiation of the method of stimulation of adhesion process in the pleural cavity in laboratory animals. Materials and methods. The research was carried out on 80 female laboratory rats of «standard» breed weighing 200±50 g. All experimental animals were divided into two groups: 40 rats in each group. The first group included experimental animals that underwent pleurodesis of visceral and parietal pleural laminae by solid-state laser radiation (laser device Lasermed 1-10, near-infrared range), the second group included experimental animals that underwent pleurodesis of visceral and parietal pleural laminae by laser radiation of semiconductor device with simultaneous treatment with photosensitizer 5-aminolevulinic acid. General anesthesia of laboratory animals was performed according to the standard technique. Under aseptic conditions, a thoracotomy was performed through 5-6 intercostal spaces from periorbital to midclavicular line. Atypical resection of the lung was performed. Subsequently, the resection site and healthy (unchanged) lung area of the animals of the first group were exposed to the solid-state laser radiation with the wavelength of 1064 nm, power 7-8 W. Exposure to pleural sheets was performed with the help of quartz light guide by non-contact method, but not more than 2 cm from the pleura and visual assessment of the appearance of coagulation signs (as at direct contact with pleura its destruction occurs, and more than 2 cm - there will be no coagulation, this is due to the power density of the laser beam). Animals of the second group were exposed to laser radiation of semiconductor device «Atkus-2», wavelength 662 nm, output power 1 W, energy density 80-100 J/cm2 in continuous mode for 15 minutes with simultaneous treatment of areas with photosensitizer 5-aminolevulinic acid. Exposure was carried out under visual control and stopped when signs of coagulation appeared. After that the chest wall wound was sutured. Results. Due to this method in experimental animals of the second group in comparison with the first group there was observed an earlier, more pronounced and voluminous adhesion process, which was confirmed by the results of histologic study. Conclusions. Thus, the conducted experiment proved that the use of 5-aminolevulinic acid as a photosensitizer and irradiation by the semiconductor device in a continuous mode for 15 minutes, allows to provide better adhesion after the completion of the formation of coarse-fiber connective tissue and to achieve denser and more extensive sclerosing when exposed to both pleural sheets, reducing the treatment period by 2 days.

Keywords:bullous emphysema, minimally invasive thoracoscopic surgeries, adhesion stimulation, laser surgery, photodynamic therapy