哪个激光系统最适合用于大膀结石的囊结石?
Mohammad Hajiha1, Ala'a Farkouh2, Akin S Amasyali2
1Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.
Journal of endourology
|September 12, 2023
概括
在比较膀结石的激光治疗方法时,使用MOSES技术的120W Holmium激光器被证明是最快的. 大石头的成本效益取决于病例数量,MOSES激光是每次手术最便宜的,但初始成本更高.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗器械 医疗器械
- 激光技术 激光技术 激光技术
背景情况:
- 膀结石 (囊结石) 是一个重大的临床挑战.
- 各种激光技术,包括纤维激光器 (TFL) 和激光器 (HL),用于石材处理.
- 对大型石头使用这些激光器的时间和成本效益的比较数据有限.
研究的目的:
- 为了比较60W的纤维激光器 (TFL) 与不同功率和技术的四个holmium激光器 (HLs) 的时间和成本效益.
- 为了评估在模拟的cystolithotripsy期间的激光和总程序时间.
- 模拟不同激光系统治疗大膀结石的成本效益.
主要方法:
- 在3D打印的膀模型中使用25个相同的4厘米BegoStones进行了基板模拟.
- 60W TFL,使用 MOSES 技术的 120W HL 和传统的 120W,100W 和 30W HL 的比较.
- 标准化激光设置 (最大能量,550μm光纤) 每个激光有五次试验;收集了关于激光时间,总时间,光纤剥离和能量的数据;成本效益分析包括购买价格,光纤成本和OR时间.
主要成果:
- 在五个系统之间观察到激光和总运行时间的显著差异 (p < 0.001).
- 带有MOSES的120W HL显示最短的激光 (60.9分钟) 和程序 (68.3分钟) 时间,而30W HL是最慢的 (281.2分钟激光,297.5分钟程序).
- 更高的激光功率与更短的程序时间相关 (Rs = -0.98; p = 0.002);60W的TFL比30W的HL快,但比更高功率的HL慢. 摩西HL是最具成本效益的程序,但有最高的初始成本.
结论:
- 对于大型膀石,激光和手术时间与激光功率高度相关,TFL的总功率是限制因素.
- 采用MOSES技术的120W霍尔激光器在模拟条件下提供最有效的治疗时间.
- 对于治疗大膀结石的成本效益,最优的激光选择取决于临床病例量和初始投资考虑.
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