2000 年代初期柔性光纤技术的引入重新激发了人们对 CO2 激光器在神经外科应用中的兴趣，使其适用于显微外科手术。尽管 CO2 激光应用广泛，但其在神经外科手术中的具体适应症仍不明确。本研究评估了 CO2 激光在脑肿瘤手术中的功效和局限性。这项回顾性观察性单中心研究分析了 2011 年至 2021 年 CO2 激光在颅内肿瘤手术中的使用情况。总共评估了 94 名患者，重点关注人口统计数据、肿瘤特征、手术持续时间、并发症和激光特定问题。我们使用五级评分系统来评估激光在减瘤和解剖任务中的有效性；根据既定指南评估切除范围。CO2 激光在实体瘤减灭方面非常有效，总切除率达到 76.5%，但对于较软、高度血管化的肿瘤效果较差。解剖的平均有效性得分（2.6±0.8）显着低于减灭术（3.2±1.2）。两个主要并发症与激光的使用直接相关。随着时间的推移，效果不断提高，特别是在研究的后半段，并且不同肿瘤类型的效果有所不同，在脑膜瘤和前庭神经鞘瘤中效果显着，但在神经胶质瘤中得分较低。CO2 激光是神经外科的一种有价值的工具，特别是对于实体瘤具体的解剖位置。仔细选择患者至关重要，激光是对传统手术工具的补充而不是取代。持续的技术进步表明未来在神经外科领域的应用将更加广泛。

The introduction of flexible fiber technology in the early 2000s revitalized the interest in the CO2 laser for neurosurgical applications, making it suitable for microsurgical procedures. Despite its widespread use, specific indications for the CO2 laser in neurosurgery remains undefined. This study evaluates the efficacy and limitations of the CO2 laser in brain tumor surgery.This retrospective observational single-center study analyzed the use of the CO2 laser in intracranial neoplasm surgeries from 2011 to 2021. A total of 94 patients were assessed, focusing on demographics, tumor characteristics, surgical duration, complications, and laser-specific issues. We used a five-tiered scoring system to assess laser effectiveness in both debulking and dissection tasks; with resection extent assessed following established guidelines.The CO2 laser was highly effective in debulking solid tumors, achieving a 76.5% gross total resection rate, while being less effective in softer, highly vascularized tumors. The average effectiveness scores for dissection (2.6±0.8) were significantly lower than for debulking (3.2±1.2). Two major complications were directly associated with laser use. Effectiveness improved over time, particularly in the latter half of the study, and varied across tumor types, with notable utility in meningiomas and vestibular schwannomas but lower scores in glial tumors.The CO2 laser is a valuable tool in neurosurgery, especially for solid tumors in specific anatomical locations. Careful patient selection is crucial, and the laser complements rather than replaces conventional surgical tools. Ongoing technological advancements suggest broader future applications in neurosurgery.