Luis Rico, Leandro Blas, Lorena Banda Ramos, Javier Pizzarello, Carlos Ameri, Pablo Contreras
{"title":"使用蒸汽隧道 Ho:YAG 脉冲模式进行消融碎石的最佳结石密度。","authors":"Luis Rico, Leandro Blas, Lorena Banda Ramos, Javier Pizzarello, Carlos Ameri, Pablo Contreras","doi":"10.1007/s11255-024-04289-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Vapor-Tunnel™ (VT) consists of a very long pulse that uses the minimum peak power, causing the energy to pass through a previously created vapor channel or tunnel. There are studies that have shown acceptable ablation lithotripsy efficiency. Nevertheless, there are no in-vivo studies that have compared the VT performance according to the stone density.</p><p><strong>Methods: </strong>A retrospective study of 152 patients who underwent RIRS using VT Ho:YAG laser was performed. We divided the patients according to the stone density (Group 1: < 1000UH vs. Group 2: > 1000UH). We assessed the lithotripsy efficiency (mm<sup>3</sup>/JJ) and the laser-energy consumption (JJ/mm<sup>3</sup>). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4 weeks after the procedure.</p><p><strong>Results: </strong>Ninety three patients were included in Group 1 and 59 in Group 2. Body mass index was higher in Group 1 and the median stone volume was higher in Group 2 (846 vs. 672 mm<sup>3</sup>, p = 0.03). Total energy used (11.9 vs. 24 kj, p < 0.001), the laser emission time (19 vs. 30 min, p < 0.001), and the total operative time (60 vs. 85 min, p < 0.001) were lower in the Group 1. SFR was higher in Group 1 (96.7% vs. 57.6%, p < 0.001) with a global SFR of 81.6%. The ablation lithotripsy efficiency was higher in Group 1 (0.053 mm<sup>3</sup>/JJ vs. 0.035 mm<sup>3</sup>/JJ, p < 0.001).</p><p><strong>Conclusions: </strong>VT Ho:YAG was associated with decreased laser time, operative time and laser-energy consumption in Group 1 than Group 2. Similarly, VT Ho:YAG increased lithotripsy efficiency and the SFR compared to hard stones with the same laser settings and pulse modality.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimal stone density for ablation lithotripsy with vapor tunnel Ho:YAG pulse modality.\",\"authors\":\"Luis Rico, Leandro Blas, Lorena Banda Ramos, Javier Pizzarello, Carlos Ameri, Pablo Contreras\",\"doi\":\"10.1007/s11255-024-04289-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Vapor-Tunnel™ (VT) consists of a very long pulse that uses the minimum peak power, causing the energy to pass through a previously created vapor channel or tunnel. There are studies that have shown acceptable ablation lithotripsy efficiency. Nevertheless, there are no in-vivo studies that have compared the VT performance according to the stone density.</p><p><strong>Methods: </strong>A retrospective study of 152 patients who underwent RIRS using VT Ho:YAG laser was performed. We divided the patients according to the stone density (Group 1: < 1000UH vs. Group 2: > 1000UH). We assessed the lithotripsy efficiency (mm<sup>3</sup>/JJ) and the laser-energy consumption (JJ/mm<sup>3</sup>). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4 weeks after the procedure.</p><p><strong>Results: </strong>Ninety three patients were included in Group 1 and 59 in Group 2. Body mass index was higher in Group 1 and the median stone volume was higher in Group 2 (846 vs. 672 mm<sup>3</sup>, p = 0.03). Total energy used (11.9 vs. 24 kj, p < 0.001), the laser emission time (19 vs. 30 min, p < 0.001), and the total operative time (60 vs. 85 min, p < 0.001) were lower in the Group 1. SFR was higher in Group 1 (96.7% vs. 57.6%, p < 0.001) with a global SFR of 81.6%. The ablation lithotripsy efficiency was higher in Group 1 (0.053 mm<sup>3</sup>/JJ vs. 0.035 mm<sup>3</sup>/JJ, p < 0.001).</p><p><strong>Conclusions: </strong>VT Ho:YAG was associated with decreased laser time, operative time and laser-energy consumption in Group 1 than Group 2. Similarly, VT Ho:YAG increased lithotripsy efficiency and the SFR compared to hard stones with the same laser settings and pulse modality.</p>\",\"PeriodicalId\":14454,\"journal\":{\"name\":\"International Urology and Nephrology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-11-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Urology and Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11255-024-04289-x\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Urology and Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11255-024-04289-x","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Optimal stone density for ablation lithotripsy with vapor tunnel Ho:YAG pulse modality.
Introduction: Vapor-Tunnel™ (VT) consists of a very long pulse that uses the minimum peak power, causing the energy to pass through a previously created vapor channel or tunnel. There are studies that have shown acceptable ablation lithotripsy efficiency. Nevertheless, there are no in-vivo studies that have compared the VT performance according to the stone density.
Methods: A retrospective study of 152 patients who underwent RIRS using VT Ho:YAG laser was performed. We divided the patients according to the stone density (Group 1: < 1000UH vs. Group 2: > 1000UH). We assessed the lithotripsy efficiency (mm3/JJ) and the laser-energy consumption (JJ/mm3). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4 weeks after the procedure.
Results: Ninety three patients were included in Group 1 and 59 in Group 2. Body mass index was higher in Group 1 and the median stone volume was higher in Group 2 (846 vs. 672 mm3, p = 0.03). Total energy used (11.9 vs. 24 kj, p < 0.001), the laser emission time (19 vs. 30 min, p < 0.001), and the total operative time (60 vs. 85 min, p < 0.001) were lower in the Group 1. SFR was higher in Group 1 (96.7% vs. 57.6%, p < 0.001) with a global SFR of 81.6%. The ablation lithotripsy efficiency was higher in Group 1 (0.053 mm3/JJ vs. 0.035 mm3/JJ, p < 0.001).
Conclusions: VT Ho:YAG was associated with decreased laser time, operative time and laser-energy consumption in Group 1 than Group 2. Similarly, VT Ho:YAG increased lithotripsy efficiency and the SFR compared to hard stones with the same laser settings and pulse modality.
期刊介绍：
International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.
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