高功率激光能缩短输尿管镜手术时间吗?澳大利亚高等教育中心钬激光器的比较

IF 0.1 Q4 UROLOGY & NEPHROLOGY
R. Mondschein, Caitlin Ying Ming Louey, A. Ng, P. McCahy
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引用次数: 0

摘要

有一些基于实验室的证据表明,高功率激光系统比低功率激光系统更有效地破坏石头。然而,由于文献中没有直接的临床比较,这是否在临床上转化是未知的。本研究提供了两种激光系统的直接比较。摘要目的:钬激光是一种有效的内镜治疗肾结石的方法。虽然实验室研究已经证明高功率激光可以缩短破坏时间,但缺乏临床证据。通过比较在一般医院设置的高功率和低功率激光输尿管镜(URS)的手术时间。材料和方法:对354例在两家医院使用高功率或低功率激光接受URS治疗的患者进行了为期两年的审计审查。记录手术时间、结石特征、一次性器械的使用、并发症及结石清除率。采用线性回归方法对激光类型与作战时间之间的关系进行建模。进行单因素分析以确定与手术时间增加相关的其他因素。结果:平均手术时间61.9分钟。包括排除大结石(> ~ 20mm)后,各部位间无显著差异[0.40,p=0.88,置信区间(CI) -4.9 ~ 5.8]。单独分析的石头大小类别表明,使用高功率激光时,较大的石头减少了手术时间。使用手术篮(8.4,p=0.002, CI 3.06-13.65)和增大结石大小(6.9,p<0.005, CI 3.4-10.4)与延长手术时间相关。不同部位的并发症和无结石率没有差异。结论:在这个队列中,高功率激光与总手术时间的减少无关,尽管对于较大的肾结石有这种趋势。外科医生专业知识的进一步描述将有助于确定高功率激光在临床环境中是否普遍有利。在培训医院,任何差异都可能被其他因素所掩盖。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Do High-Power Lasers Reduce Operative Time for Ureterorenoscopy? A Comparison of Holmium Lasers in An Australian Tertiary Centre
There is some laboratory-based evidence that high-powered laser systems destroy stones more effectively than low-power laser systems. However, whether this translates clinically is unknown, as direct clinical comparisons are absent from the literature. This study provides a direct comparison of the two laser systems. Abstract Objective: Holmium lasers are an effective endoscopic treatment for renal stones. Although laboratory studies have demonstrated reduced destruction times for high-power lasers, clinical evidence is lacking. Operative times for ureterorenoscopy (URS) were investigated by comparing high- and low power lasers in a general hospital setting. Materials and Methods: An audited review was conducted of 354 patients who underwent URS over a two-year period at two hospital sites using high- or low power laser. Operative time, stone characteristics, disposable equipment, s use of dusting, complications and stone-free rates were recorded. Linear regression was used to model the relationship between laser type and theater time. Univariate analysis was performed to determine other factors associated with increased operative time. Results: Mean operative time was 61.9 minutes. No significant difference between sites [0.40, p=0.88, confidence interval (CI) -4.9-5.8] was found, including following the exclusion of large stones (>20 mm). Stone size categories analyzed separately showed reduced operative times for larger stones when using high-power laser. Basket use (8.4, p=0.002, CI 3.06-13.65) and increasing stone size (6.9, p<0.005, CI 3.4-10.4) were associated with increased operative time. Complications and stone-free rates did not vary between sites. Conclusion: High-power laser was not associated with reduced total operative time in this cohort, although there was a trend toward this for larger renal calculi. Further delineation by surgeon expertise would be useful to determine whether high power laser is generally advantageous in the clinical setting. In training hospitals, any differences may be obscured by other factors.
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来源期刊
Journal of Urological Surgery
Journal of Urological Surgery UROLOGY & NEPHROLOGY-
自引率
33.30%
发文量
42
审稿时长
16 weeks
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