Pagonis Konstantinos, Katsakiori Paraskevi, Peteinaris Angelis, Tatanis Vasileios, Tsaturyan Arman, Faria Costa Gabriel, Faitatziadis Solon, Vagionis Athanasios, Natsos Anastasios, Gkeka Kristiana, Obaidat Mohammed, Spinos Theodoros, Vrettos Theofanis, Liatsikos Evangelos, Kallidonis Panagiotis
Department of Urology, University of Patras, Patras, Greece.
Department of Urology, Erebouni Medical Center, Yerevan, Armenia.
Arab J Urol. 2024 Jan 21;22(3):145-151. doi: 10.1080/20905998.2024.2304516. eCollection 2024.
To evaluate the efficacy and safety of Holmium: Yttrium-Aluminum-Garnet (Ho:YAG) laser in bladder lithotripsy using high-power settings > 100 W.
A combined experimental and clinical study was conducted. The Quanta Cyber: Ho 150 with a 550 μm Quanta optical fiber was utilized in all set-ups. Ablation rates for soft and hard artificial stones were tested in vitro using 100 W and 20 W power settings. In the experiment, a porcine bladder was used. The optical fiber was inserted through a rigid cystoscope, whilst a K-type thermocouple was inserted in the bladder dome. The tested high-power settings were 152 W, 120 W and 105 W. In every trial, the lasing time was over 60 s. In the clinical study, 35 patients underwent transurethral high-power bladder lithotripsy. Laser settings were set between 100 W and 150 W.
Stone mass (stone weight) was significantly lower after stone ablation independently of the stone type or the laser settings. Significantly higher mass decrease and ablation rate were detected in high-power compared to low-power settings. In the experiment, the highest temperature recorded was 32°C at 152 W. At 120 W and 105 W, the peak temperatures didn't reach 30°C. In the clinical study, a stone-free rate of 100% and a mean operative time of 43 ± 18 min were reported. All patients stayed in the hospital for one day except for one who presented minor hematuria. Additional complications did not occur.
Ho:YAG laser lithotripsy > 100 W is an effective, fast and safe modality for the treatment of bladder calculi.
评估钬激光（Ho:YAG）在功率设置大于100W的高功率模式下用于膀胱碎石术的疗效和安全性。
进行了一项实验与临床相结合的研究。所有设置均使用配备550μm量子光纤的Quanta Cyber: Ho 150。在体外使用100W和20W功率设置测试软质和硬质人工结石的消融率。实验中使用猪膀胱。光纤通过硬性膀胱镜插入，同时将K型热电偶插入膀胱顶部。测试的高功率设置为152W、120W和105W。每次试验的激光照射时间超过60秒。临床研究中，35例患者接受了经尿道高功率膀胱碎石术。激光设置在100W至150W之间。
无论结石类型或激光设置如何，结石消融后结石质量（结石重量）均显著降低。与低功率设置相比，高功率设置下检测到的质量减少和消融率显著更高。实验中，152W时记录的最高温度为32°C。在120W和105W时，峰值温度未达到30°C。临床研究中，报告结石清除率为100%，平均手术时间为43±18分钟。除1例出现轻微血尿外，所有患者均住院1天。未发生其他并发症。
功率大于100W的Ho:YAG激光碎石术是治疗膀胱结石的一种有效、快速且安全的方式。
