Tokas Theodoros, Rice Patrick, Seitz Christian, Gauhar Vineet, Somani Bhaskar
Department of Urology and Andrology, General Hospital Hall in Tirol, Hall in Tirol.
Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Austria.
Curr Opin Urol. 2023 Mar 1;33(2):108-115. doi: 10.1097/MOU.0000000000001048. Epub 2022 Oct 13.
PURPOSE OF REVIEW: To examine the most recent data on temperatures produced during laser lithotripsy and to provide several strategies for maintaining lower values and reducing the risk of complications during endourological treatment. RECENT FINDINGS: Endourologists have access to a wide range of alternatives with the help of the holmium: yttrium-aluminum-garnet (Ho:YAG), thulium: yttrium-aluminum-garnet (TM:YAG), and thulium fiber laser (TFL) that compose a robust and adaptable laser lithotripsy armamentarium. Nevertheless, the threat of thermal damage increases as the local temperature rises with high total power. Most endourologists are not familiar with normal and pathological temperature ranges, how elevated temperatures affect perioperative problems, or how to avoid them. SUMMARY: Increased temperatures experienced during laser lithotripsy may affect the course of the healing process. All lasers display a safe temperature profile at energies below 40 W. At equal power settings, Ho:YAG, Tm:YAG, and TFL lasers change the temperature comparably. Shorter on/off laser activation intervals, chilled irrigation, open irrigation systems, and UASs all aid in maintaining acceptable temperatures.
综述目的：研究激光碎石术期间产生的温度的最新数据，并提供几种在腔内泌尿外科治疗期间维持较低温度值并降低并发症风险的策略。 最新发现：在钬：钇铝石榴石（Ho:YAG）、铥：钇铝石榴石（TM:YAG）和铥光纤激光（TFL）的帮助下，腔内泌尿外科医生可以使用多种替代方法，这些构成了一个强大且适应性强的激光碎石术设备库。然而，随着局部温度随着高总功率而升高，热损伤的威胁也在增加。大多数腔内泌尿外科医生不熟悉正常和病理温度范围、温度升高如何影响围手术期问题，或者如何避免这些问题。 总结：激光碎石术期间经历的温度升高可能会影响愈合过程。所有激光在能量低于40瓦时都显示出安全的温度曲线。在相同功率设置下，Ho:YAG、Tm:YAG和TFL激光对温度的影响相当。较短的激光开/关激活间隔、冷冻冲洗、开放式冲洗系统和输尿管通路鞘都有助于维持可接受的温度。
Curr Opin Urol. 2023-7-1
Zotero 插件