CARBON-DIOXIDE LASER VAGOTOMY - EARLY RESULTS

Carbon dioxide (CO2) laser may selectively destroy peripheral nerves a nd preserve the accompanying blood vessels within the same neurovascul ar bundle. In this study we examined the effects on acid secretion of CO2 laser irradiation on the vagal distribution of the anterior wall o f the stomach with posterior truncal vagotomy. Posterior truncal vagot omy and CO2 laser anterior seromyotomy (LV) was carried out on 10 mong rel dogs. Furthermore, five dogs received posterior truncal vagotomy a nd anterior highly selective vagotomy as controls (HSV). Basal acid pH (BpH) and maximal acid pH (MpH) in response to pentagastrin (7.5 mu g /kg) were measured pre- and post-vagotomy. The mean BpH in the carbon dioxide laser vagotomy group pre-operatively was 4.01 +/- 0.8 compared to 4.96 +/- 1.3 post-operatively (ns). The mean MpH pre-operatively w as 1.55 +/- 0.6 compared to 4.17 +/- 1.0 postoperatively (P < 0.05), s howing a significant reduction in pentagastrin-stimulated acid output following carbon dioxide laser vagotomy. In the surgical vagotomy grou p, the mean BpH pre-operatively was 4.17 +/- 0.8 compared to 4.57 +/- 1.4 post-operatively (ns). The mean MpH pre-operatively was 1.07 +/- 0 .2 compared to 3.92 +/- 0.8 post-operatively (P < 0.05). The pre- and post-operative BpH was the same in both treatment groups, although the re was no significant difference in the MApH post-vagotomy in either g roup. There was a greater than 50% increase in the MpH post-vagotomy i n LV and HSV. The application of CO2 laser vagotomy through an operati ng laparoscope should be investigated.