Eisner Brian H, Pengune Witsanu, Stoller Marshall L
Department of Urology, University of California-San Francisco, San Francisco, CA 94143, USA.
BJU Int. 2009 Sep;104(6):858-61. doi: 10.1111/j.1464-410X.2009.08540.x. Epub 2009 Mar 26.
To compare the efficiency of pneumatic lithotripsy with and without the Accordion antiretropulsion device (PercSys, Palo Alto, CA, USA).
The study comprised two in vitro experiments: in experiment 1, 10 trials were conducted using stone phantoms (6 x 6 x 10 mm), placed in a horizontal acrylic tube submerged in normal saline. Pneumatic lithotripsy was applied using a Swiss LithoClast (Boston Scientific Corporation, Natick, MA, USA). Each phantom was hit with repeated single firings of the LithoClast until it had travelled 20 cm (control group). The same experiment was then repeated with the Accordion antiretropulsion device positioned proximal to a new stone phantom. In experiment 2, stone phantoms (5 x 5 x 5 mm) were placed in a model ureter made of silicone and submerged in normal saline. Pneumatic lithotripsy was applied continuously on 10 stones for 20 s (200 strikes) without the Accordion device (control group) and on 10 stones with the Accordion device in place (experimental group). The distance of retropulsion was recorded. All stone phantoms were weighed before and after pneumatic lithotripsy.
In both experiments the Accordion group had a significantly greater percentage weight loss than the control group (experiment 1; 11% vs 3%; experiment 2, 53% vs 16%, both P < 0.001).
The Accordion device significantly increased the fragmentation efficiency in both in vitro models. Preventing retropulsion and increasing fragmentation efficiency has the potential to increase the success rate, decrease secondary procedures for migrated stones, and shorten operative times.
比较使用和不使用Accordion抗反流装置（美国加利福尼亚州帕洛阿尔托市PercSys公司）进行气压弹道碎石术的效率。
本研究包括两项体外实验：在实验1中，使用置于浸没在生理盐水中的水平丙烯酸管内的结石模型（6×6×10毫米）进行了10次试验。使用瑞士LithoClast（美国马萨诸塞州纳蒂克市波士顿科学公司）进行气压弹道碎石术。每次对每个模型重复单次发射LithoClast，直至其移动20厘米（对照组）。然后在新的结石模型近端放置Accordion抗反流装置，重复相同实验。在实验2中，将结石模型（5×5×5毫米）置于由硅胶制成并浸没在生理盐水中的输尿管模型中。在不使用Accordion装置的情况下，对10颗结石连续进行20秒（200次冲击）的气压弹道碎石术（对照组），并在使用Accordion装置的情况下对10颗结石进行同样操作（实验组）。记录反流距离。在气压弹道碎石术前和术后对所有结石模型进行称重。
在两项实验中，Accordion组的重量减轻百分比均显著高于对照组（实验1：11%对3%；实验2：53%对16%，P均<0.001）。
在两个体外模型中，Accordion装置均显著提高了碎石效率。防止反流并提高碎石效率有可能提高成功率、减少移位结石的二次手术，并缩短手术时间。
