Department of Urology, Vocabulary School of Health Sciences, Surgical Technician Department, Acıbadem Healthcare Group, Kozyatagi Hospital, Acıbadem Mehmet Ali Aydinlar University, İçerenköy, Kayışdağı Cd. No: 32, 34684, Ataşehir/Istanbul, Turkey.
Department of Urology, School of Medicine, Department of Urology, Acıbadem Healthcare Group, Kozyatagi Hospital, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Urolithiasis. 2022 Feb;50(1):95-102. doi: 10.1007/s00240-021-01285-z. Epub 2021 Oct 11.
Better endoscopic vision is mandatory for successful ureteroscopic stone operations to achieve shorter operating time. However, an important impairing factor for a good endoscopic view is the cloudiness of vision which was formed during laser fragmentation. Holmium laser fragmentation of calcium oxalate stones produces calcium carbonate solubility of which is dependent on pH, citrate, and phosphate. In this ex vivo research, the solubility of calcium carbonate has been investigated in solutions composed of various concentrations of citrate and phosphate buffered at different pH levels after laser fragmentation of calcium oxalate stones. Calcium oxalate stones were placed into the laboratory tubes filled with various concentrations of citrate-phosphate buffers with different pH values. Laser energy in dusting mode was applied to the stones and spectrophotometric measurement for optical density (OD) was calculated for each buffered solution for clarity comparison. In the first phase, solutions composed of four different molar concentrations of citrate-phosphate buffer (0.2, 0.3, 0.4 and 0.5 molars) at various pH levels were used. Then, the next phase of the study was designed to compare solutions demonstrating the lowest OD values with an isotonic saline solution. The results were most convenient at 0.5 molarity (pH = 6) followed by 0.4 molarity (pH = 7) in the first phase (OD values of 0.054 and 0.065, respectively). In the next phase, OD values of both buffered solutions were significantly lower than those of isotonic saline solution (p = 0). Two specific buffers have provided better optic visibility values after laser fragmentation supporting their use as an irrigation solution for the favor of less cloudiness.
更好的内镜视觉对于成功进行输尿管镜碎石术至关重要，可以缩短手术时间。然而，良好的内镜视野的一个重要障碍是激光碎石过程中形成的视觉混浊。钬激光碎石草酸钙结石会产生碳酸钙，其溶解度取决于 pH 值、柠檬酸盐和磷酸盐。在这项离体研究中，研究了在激光碎石后，用不同 pH 值的不同浓度柠檬酸盐-磷酸盐缓冲液组成的溶液中碳酸钙的溶解度。将草酸钙结石放入装有不同 pH 值不同浓度柠檬酸盐-磷酸盐缓冲液的实验室管中。用喷雾模式的激光能量作用于结石，并对每种缓冲溶液进行分光光度测量以计算光密度 (OD)，以进行清晰度比较。在第一阶段，使用了四种不同摩尔浓度的柠檬酸盐-磷酸盐缓冲液（0.2、0.3、0.4 和 0.5 毫摩尔）组成的溶液，研究的下一阶段旨在比较显示最低 OD 值的溶液与等渗盐水溶液。结果在第一阶段最方便，在 0.5 摩尔浓度（pH=6）和 0.4 摩尔浓度（pH=7）下（OD 值分别为 0.054 和 0.065）。在下一阶段，两种缓冲溶液的 OD 值均明显低于等渗盐水溶液（p=0）。两种特定的缓冲液在激光碎石后提供了更好的光学可见度值，支持将其用作冲洗液，以减少混浊度。
