Abstract：
OBJECTIVE: To compare the efficacy of conventional low power and high power holmium: yttrium aluminum-garnet (Ho: YAG) laser lithotripsy settings during retrograde intrarenal surgery (RIRS). METHODS: The prospective study was conducted in patients undergoing RIRS for renal stones less than 2 cm diameter. Pulsed Ho:YAG laser (Lumenis® Pulse TM P120 H) was used for laser lithotripsy and the patients were randomized into low power (LP) and high power (HP) laser lithotripsy settings groups. The lasing duration, total laser energy used (Joules), laser energy used to ablate 1 mm3 of stone (Joules/mm3), operative duration, stone ablation speed (mm3/s) and stone free rate were compared.
RESULTS: A total of 120 underwent RIRS with 63 and 57 patients in LP and HP group, respectively. Median stone volume and stone density were comparable between the groups. The total energy used and laser energy used to ablate 1mm3 of stone (Joules/mm3) were significantly higher in the HP group than in LP group (27.9 (16.4-46.2) J/ mm3 vs 9.7 (5.3-17.7) J/ mm3) (p < 0.01). Median (IQR) ablation speed were 0.8 (0.5-1.3) mm3/s and 0.6 (0.4-1) mm3/s in the LP and HP groups, respectively. The median lasing time, operative time and stone free rate were similar in both the groups.
CONCLUSIONS: The total energy used and J/mm3 were lower in the LP group than in HP group with similar lasing duration, operative duration, ablation speed and stone free rate for renal stones less than 2 cm.
RESULTS: A total of 120 underwent RIRS with 63 and 57 patients in LP and HP group, respectively. Median stone volume and stone density were comparable between the groups. The total energy used and laser energy used to ablate 1mm3 of stone (Joules/mm3) were significantly higher in the HP group than in LP group (27.9 (16.4-46.2) J/ mm3 vs 9.7 (5.3-17.7) J/ mm3) (p < 0.01). Median (IQR) ablation speed were 0.8 (0.5-1.3) mm3/s and 0.6 (0.4-1) mm3/s in the LP and HP groups, respectively. The median lasing time, operative time and stone free rate were similar in both the groups.
CONCLUSIONS: The total energy used and J/mm3 were lower in the LP group than in HP group with similar lasing duration, operative duration, ablation speed and stone free rate for renal stones less than 2 cm.
摘要：
目的：比较常规低功率和高功率钬：钇铝石榴石（Ho：YAG）激光碎石术在逆行肾内手术（RIRS）中的疗效。方法：前瞻性研究是在接受RIRS治疗直径小于2cm的肾结石的患者中进行的。脉冲Ho：YAG激光（Lumenis®PulseTMP120H）用于激光碎石术，患者被随机分为低功率（LP）和高功率（HP）激光碎石组。激射持续时间，使用的总激光能量（焦耳），激光能量用于烧蚀1mm3的石头（焦耳/mm3），手术持续时间,比较结石消融速度(mm3/s)和无结石率。
结果：LP和HP组分别有63和57例患者，共120例接受了RIRS，分别。两组之间的中值结石体积和结石密度相当。HP组用于烧蚀1mm3结石的总能量和激光能量（焦耳/mm3）明显高于LP组（27.9（16.4-46.2）J/mm3vs9.7（5.3-17.7）J/mm3）（p<0.01）。LP组和HP组的消融速度中位数(IQR)分别为0.8(0.5-1.3)mm3/s和0.6(0.4-1)mm3/s,分别。中值激射时间，两组的手术时间和结石发生率相似。
结论：LP组的总能量使用和J/mm3低于HP组，激光持续时间相似，手术持续时间,2cm以下肾结石的消融速度和结石游离率。
结果：LP和HP组分别有63和57例患者，共120例接受了RIRS，分别。两组之间的中值结石体积和结石密度相当。HP组用于烧蚀1mm3结石的总能量和激光能量（焦耳/mm3）明显高于LP组（27.9（16.4-46.2）J/mm3vs9.7（5.3-17.7）J/mm3）（p<0.01）。LP组和HP组的消融速度中位数(IQR)分别为0.8(0.5-1.3)mm3/s和0.6(0.4-1)mm3/s,分别。中值激射时间，两组的手术时间和结石发生率相似。
结论：LP组的总能量使用和J/mm3低于HP组，激光持续时间相似，手术持续时间,2cm以下肾结石的消融速度和结石游离率。
