Chen Yu, Wang Rongjiang, Shen Xufeng, Tang Jianer, Shen Junwen, Fang Zhihai, Shi Zhanqin, Jin Xiaodong
Department of Urology, The First Affiliated Hospital of Zhejiang University School of Medicine, Huzhou, Zhejiang 313100, P.R. China.
Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China.
Exp Ther Med. 2021 Feb;21(2):172. doi: 10.3892/etm.2020.9603. Epub 2020 Dec 27.
The present study aimed to compare the efficacy and safety of a flexible ureteroscopic holmium laser incision with flexible ureteroscopic 1470-nm diode laser incision for the treatment of parapelvic renal cysts. The current study collected and analysing the clinical data of 90 independent renal cysts cases retrospectively, including 43 renal cysts cases that received holmium laser surgery (holmium laser group) and 47 renal cysts cases that received 1470-nm diode laser surgery (1470-nm diode laser group). Each group was divided into a thin-walled cyst subgroup and thick-walled cyst subgroup according to cyst wall thickness. Intracapsular hematoma was significantly lower in the 1470-nm diode laser group compared with the holmium laser group (0/47 vs. 4/43; P=0.048). The incision diameter in the 1470-nm diode laser group was significantly larger than the holmium laser group in the thick-walled parapelvic renal cysts subgroup [1.70(1.50,1.90) vs. 1.30(1.25,1.70) cm; P=0.007]. The renal cystic diameter of the two groups was markedly reduced one and six months after surgery. The difference was non-significant in the diameter of the renal cyst in the thin-walled cysts subgroups between the two laser groups 6 months after surgery (1.01±0.38 vs. 1.03±0.53 cm; P=0.454). However, the diameter of the renal cyst in the thick-walled cysts subgroup treated with the 1470-nm diode laser was significantly lower compared with the thick-walled cysts subgroup treated with the holmium laser 6 months after surgery (1.21±0.57 vs. 1.88±0.94 cm; P=0.002). The results demonstrated that the use of a 1470-nm diode laser or holmium laser surgery under a flexible ureteroscope is a safe and effective treatment for parapelvic renal cysts. For thick-walled parapelvic renal cysts, the 1470-nm diode laser appears to exhibit a lower postoperative recurrence rate and better long-term postoperative effects due to its improved haemostatic effect and larger intraoperative incision diameter.
本研究旨在比较软性输尿管镜钬激光切开术与软性输尿管镜1470纳米二极管激光切开术治疗肾盂旁肾囊肿的疗效和安全性。本研究回顾性收集并分析了90例独立肾囊肿病例的临床资料，其中43例肾囊肿病例接受了钬激光手术（钬激光组），47例肾囊肿病例接受了1470纳米二极管激光手术（1470纳米二极管激光组）。根据囊肿壁厚度，每组又分为薄壁囊肿亚组和厚壁囊肿亚组。1470纳米二极管激光组的囊内血肿明显低于钬激光组（0/47比4/43；P=0.048）。在厚壁肾盂旁肾囊肿亚组中，1470纳米二极管激光组的切口直径明显大于钬激光组[1.70(1.50,1.90)比1.30(1.25,1.70)厘米；P=0.007]。两组肾囊肿直径在术后1个月和6个月时均明显缩小。术后6个月，两个激光组薄壁囊肿亚组的肾囊肿直径差异无统计学意义（1.01±0.38比1.03±0.53厘米；P=0.454）。然而，术后6个月，1470纳米二极管激光治疗的厚壁囊肿亚组的肾囊肿直径明显低于钬激光治疗的厚壁囊肿亚组（1.21±0.57比1.88±0.94厘米；P=0.002）。结果表明，在软性输尿管镜下使用1470纳米二极管激光或钬激光手术治疗肾盂旁肾囊肿是一种安全有效的方法。对于厚壁肾盂旁肾囊肿，1470纳米二极管激光由于其止血效果更好和术中切口直径更大，似乎术后复发率更低，长期术后效果更好。
