Heinrich Elmar, Wendt-Nordahl Gunnar, Honeck Patrick, Alken Peter, Knoll Thomas, Michel Maurice Stephan, Häcker Axel
Department of Urology, University Hospital Mannheim, Mannheim, Germany.
J Endourol. 2010 Jan;24(1):75-9. doi: 10.1089/end.2009.0051.
To evaluate the ablative and hemostatic properties of the recently introduced 120 W lithium triborate (LBO) 532 nm laser and compare the results against the conventional 80 W potassium-titanyl-phosphate (KTP) laser.
The ex-vivo model of the isolated blood-perfused porcine kidney was used to determine the ablation capacity, hemostatic properties, and coagulation depth of the GreenLight HPS laser system (American Medical System, Minnetonka, MN) that used an output power of 120 W. The results were compared with the KTP laser that used output power levels of 30 W, 50 W, and 80 W. Unperfused kidneys were weighed before and after 10 minutes of laser ablation in an area of 3 x 3 cm; the weight difference marked the amount of removed tissue. Bleeding was determined by the weight difference of a swab before and after it was placed on the bleeding surface for 60 seconds after ablating a surface area of 9 cm(2) on blood-perfused kidneys.
With a tissue removal of 7.01 +/- 1.83 g after 10 minutes of laser ablation at 120 W, the LBO laser offered a significantly higher ablation capacity compared with 3.99 +/- 0.48 g reached with the conventional KTP laser at 80 W in the same time interval (P < 0.05). The bleeding rate was also significantly increased using the LBO at 120 W compared with the conventional device at 80 W (0.65 +/- 0.26 g/min vs 0.21 +/- 0.07 g/min; P < 0.05). The corresponding depths of the coagulation zones were 835 +/- 73 microm and 667 +/- 64 microm (P < 0.05), respectively.
The 120 W LBO laser offers a significantly higher tissue ablation capacity compared with the conventional 80 W KTP laser. Because the increased efficacy of the device is accompanied by a higher bleeding rate and a slightly deeper coagulation zone, the user has to select the appropriate output power levels carefully for a safe and efficient treatment. Nevertheless, the bleeding rate compared with previous studies of transurethral resection of the prostate is significantly reduced.
评估最近推出的120W硼酸锂（LBO）532nm激光的消融和止血性能，并将结果与传统的80W磷酸钛钾（KTP）激光进行比较。
使用离体血液灌注猪肾的体外模型，以确定使用120W输出功率的GreenLight HPS激光系统（美国医疗系统公司，明尼通卡，明尼苏达州）的消融能力、止血性能和凝固深度。将结果与使用30W、50W和80W输出功率水平的KTP激光进行比较。在3×3cm区域进行10分钟激光消融前后，对未灌注的肾脏进行称重；重量差即为去除组织的量。在血液灌注肾脏上消融9cm²表面积后，将拭子置于出血表面60秒，通过拭子前后重量差确定出血量。
在120W功率下进行10分钟激光消融后，LBO激光去除组织7.01±1.83g，与传统80W KTP激光在相同时间间隔内达到的3.99±0.48g相比，其消融能力显著更高（P<0.05）。与80W的传统设备相比，使用120W的LBO时出血率也显著增加（0.65±0.26g/分钟对0.21±0.07g/分钟；P<0.05）。相应的凝固区深度分别为835±73微米和667±64微米（P<0.05）。
与传统的80W KTP激光相比，120W LBO激光具有显著更高的组织消融能力。由于该设备功效的提高伴随着更高的出血率和稍深的凝固区，使用者必须仔细选择合适的输出功率水平以进行安全有效的治疗。然而，与先前前列腺经尿道切除术的研究相比，出血率显著降低。
