报道北美首例使用高功率超脉冲Thulium光纤激光治疗上尿路结石的输尿管肾镜系列病例。
机构审查委员会批准后,我们对2019年10月至2020年3月期间接受高功率超脉冲Thulium光纤激光治疗的患者进行了多中心回顾性图表回顾.基本人口统计信息,术前,并记录围手术期数据.
纳入76例患者,平均年龄为60.9±13.3岁。治疗了118颗结石,包括输尿管内的32颗,49在下极点,37在中极或上极。通常使用喷粉技术(67.1%),脉冲频率高达2400Hz。平均手术时间为59.4±31.5分钟。平均激光时间和总激光能量分别为10.8±14.1分钟和12.5±19.1KJ,分别。术中并发症仅限于7例1级,3例2级和1例3级输尿管损伤和1例肾脏收集系统出血,并通过激光凝固设置(1J-20Hz)进行了充分处理。
在北美的这种高功率超脉冲Thulium光纤激光器的初始病例系列有望用于治疗尿石症。成功利用了200μm以下的纤维和高达2400Hz的除尘设置。没有看到与使用激光相关的特定并发症。
To report the first
case series of ureterorenoscopy in North America using the High Power Super Pulse
Thulium Fiber Laser for the treatment of upper urinary tract stones.
After Institutional Review Board approval, a multicentric retrospective chart review of patients treated with the High Power Super Pulse
Thulium Fiber Laser from October 2019 to March 2020 was conducted. Basic demographic information, pre-operative, and peri-operative data were recorded.
Seventy-six patients were included with a mean age of 60.9 ± 13.3 years. 118 stones were treated including 32 within the ureter, 49 in the lower pole, 37 in mid or upper poles. Dusting technique was commonly used (67.1%) with pulse frequencies up to 2400 Hz. Mean operative time was 59.4 ± 31.5 minutes. Mean laser time and total laser energy were 10.8 ± 14.1 minutes and 12.5 ± 19.1 KJ, respectively. Intraoperative complications were limited to 7 grade 1, 3 grade 2, and 1 grade 3 ureteral injuries and one
case of renal collecting system bleeding that was adequately managed with laser coagulation settings (1J-20Hz).
This initial
case series in North America of the High Power Super Pulse
Thulium Fiber Laser is promising for the treatment of urolithiasis. Sub-200 μm fibers and dusting settings up to 2400 Hz were utilized successfully. No specific complications related to use of the laser were seen.