Ibrahim Ahmed, Badaan Shadi, Elhilali Mostafa M, Andonian Sero
Department of Urology, Royal Victoria Hospital, McGill University Health Centre, Montreal, QC, Canada.
Department of Urology, Alhussain University Hospital, Al-Azhar University, Cairo, Egypt.
Can Urol Assoc J. 2018 Apr;12(4):127-130. doi: 10.5489/cuaj.4797. Epub 2017 Dec 22.
The objective of this study was to compare fragmentation efficiency of the conventional regular mode of holmium laser to the Moses contact mode on a stone simulator.
The Lumenis Pulse P120 H holmium laser system, together with Moses D/F/L fibers were used to compare regular mode with Moses contact mode in a stone simulator model using flexible ureteroscopy with artificial stones. Efficiency of laser lithotripsy was measured by procedural time. Degree of stone retropulsion was also compared between regular and Moses modes using a Likert scale from 0 (no retropulsion) to 3 (maximum retropulsion).
Using the stone simulator model, a significant reduction in stone retropulsion was noticed when comparing regular mode to the Moses contact mode (mean Grade 2.5 vs. Grade 1; p<0.01). When compared with the regular mode, the Moses contact mode was associated with significantly shorter procedural time during fragmentation (13.9 vs. 9.1 minutes; p≤0.01) and dusting (9.3 vs. 7.1 minutes; p≤0.01). In addition, when compared with the regular mode, the laser pedal was pressed significantly less often with the Moses mode during fragmentation (86 vs. 43 times; p<0.01) and dusting (50 vs. 26 times; p<0.01). Moses contact mode was associated with significantly higher percentage of lasing vs. pausing when compared with the regular mode for both fragmentation (0.8 J/10 Hz) and pulverization (0.4 J/50 Hz) settings (both p<0.05).
Using the stone simulator setup, Moses technology was associated with more efficient laser lithotripsy (shorter operative time) due to significantly reduced stone retropulsion.
本研究的目的是在结石模拟器上比较钬激光传统常规模式与摩西接触模式的碎石效率。
使用科医人脉冲P120 H钬激光系统以及摩西D/F/L光纤，在使用柔性输尿管镜和人工结石的结石模拟器模型中比较常规模式与摩西接触模式。通过手术时间来衡量激光碎石的效率。还使用从0（无后推）到3（最大后推）的李克特量表比较常规模式和摩西模式下的结石后推程度。
在结石模拟器模型中，与常规模式相比，摩西接触模式下结石后推明显减少（平均等级2.5 vs. 等级1；p<0.01）。与常规模式相比，摩西接触模式在碎石过程中（13.9 vs. 9.1分钟；p≤0.01）和粉末化过程中（9.3 vs. 7.1分钟；p≤0.01）的手术时间明显更短。此外，与常规模式相比，在碎石过程中（86 vs. 43次；p<0.01）和粉末化过程中（50 vs. 26次；p<0.01），使用摩西模式时激光踏板的按压次数明显更少。与常规模式相比，在碎石（0.8 J/10 Hz）和粉碎（0.4 J/50 Hz）设置下，摩西接触模式下的激光发射与暂停的百分比明显更高（p均<0.05）。
在结石模拟器设置中，由于结石后推明显减少，摩西技术与更高效的激光碎石术（手术时间更短）相关。
