Klaver Paul, de Boorder Tjeerd, Rem Alex I, Lock Tycho M T W, Noordmans Herke Jan
Department of Medical Technology and Clinical Physics, University Medical Center Utrecht, Utrecht, Netherlands.
Department of Urology, University Medical Center Utrecht, Netherlands.
Lasers Surg Med. 2017 Sep;49(7):698-704. doi: 10.1002/lsm.22671. Epub 2017 Apr 27.
To study the effectiveness of two laser techniques clinically used to fragment renal stones: fragmenting technique (FT) and popcorn technique (PT).
Phantom stones were placed in a test tube filled with water, mimicking a renal calyx model. A Holmium:YAG laser was used for fragmentation using both techniques. Four series of experiments were performed with two parameters: the technique (FT or PT) and the number of stones in the test tube (one or four). The mass decrease of the phantom stones was measured before, during, and after the experiment to quantify the effect of both techniques.
Visualization of PT showed that the main effect of PT takes place, when the stone moves in front of the laser fiber and is subject to direct radiant exposure. Both FT and PT resulted in a decrease in stone weight; the mass decrease of the stones subjected to FT exceeded that of the stones subjected to PT, even with less laser energy applied. This difference in mass decrease was evident in both the experiments with one and four stones.
PT was less effective in decreasing stone weight compared with FT. The FT is more effective regarding the applied energy than PT, even in a shorter time period and regardless of the number of stones. This study suggests that FT is to be preferred over PT, when stones are accessible by the laser fiber. Lasers Surg. Med. 49:698-704, 2017. © 2017 Wiley Periodicals, Inc.
研究临床上用于粉碎肾结石的两种激光技术的有效性：粉碎技术（FT）和爆米花样技术（PT）。
将模拟结石置于装满水的试管中，模拟肾盏模型。使用钬激光通过两种技术进行结石粉碎。采用技术（FT或PT）和试管中结石数量（一个或四个）这两个参数进行了四组实验。在实验前、实验过程中和实验后测量模拟结石的质量减少情况，以量化两种技术的效果。
PT的可视化显示，PT的主要作用发生在结石在激光光纤前移动并受到直接辐射暴露时。FT和PT均导致结石重量减轻；即使施加的激光能量较少，接受FT的结石的质量减少量也超过了接受PT的结石。在一个结石和四个结石的实验中，这种质量减少的差异均很明显。
与FT相比，PT在减轻结石重量方面效果较差。即使在更短的时间内且无论结石数量多少，FT在应用能量方面比PT更有效。本研究表明，当激光光纤可触及结石时，FT比PT更可取。《激光外科与医学》2017年第49卷：698 - 704页。©2017威利期刊公司。
