脉冲铥：YAG 激光、钬：YAG 激光和铥光纤激光的体外比较。

IF 2.9 2区医学 Q1 UROLOGY & NEPHROLOGY Journal of endourology Pub Date : 2024-10-01 DOI:10.1089/end.2024.0424

Marie Chicaud, Stessy Kutchukian, Laurent Berthe, Mariela Corrales, Catalina Solano, Luigi Candela, Steeve Doizi, Daron Smith, Olivier Traxer, Frédéric Panthier

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引用次数: 0

摘要

目的描述脉冲铥：YAG（p-Tm：YAG）激光器的脉冲特性和光纤断裂风险（ROF），并将其烧蚀体积（AV）与钬：YAG（Ho：YAG）和铥光纤激光器（TFL）进行比较。材料和方法：p-Tm:YAG（100W-Thulio，DornierMedtech©，德国）使用一次性使用的 272μm 芯径光纤（CDF）进行表征。在 5 分钟连续激光激活（CLA）后，在五个递减光纤弯曲半径（1、0.9、0.75、0.6 和 0.45 厘米）下对 ROF 进行了评估。比较了 p-Tm:YAG、Ho:YAG（120W-Cyber-Ho,Quanta®,美国）和 TFL（60W-TFLDrive(Coloplast®, 丹麦)）AV，使用的是 20 毫米线性 CLA，速度为 2 毫米/秒，与完全浸没在生理盐水中的 20 毫米立方体硬石和软石模型（HSP 和 SSP，水粉比为 15:3 和 15:5）接触，频率为 0.5J-20Hz 或 1J-10Hz。CLA后，使用3DSlicer©对假体进行三维（3D）显微扫描（计算机断层扫描）和随后的三维分割，以估算AV。结果：在所有可用的预设模式中，p-Tm:YAG 呈现出均匀的脉冲曲线。根据脉冲模式的不同，峰值功率（PP）在 564 到 2199W 之间。对于 HSP（8.96±3.1 vs 9.78±1.1 vs 8.8±2.8mm3，p=0.67），p-Tm:YAG 与 TFL 和 Ho:YAG 获得了相似的平均 AVs（12.86±1.85 vs 10.12±1.89 vs 7.56±2.21mm3，p=0.002），但对于 SSP，TFL 与 p-Tm:YAG 和 Ho:YAG 相比具有更高的 AVs（12.86±1.85 vs 10.12±1.89 vs 7.56±2.21mm3，p=0.002）。随着脉冲能量的增加，p-Tm:YAG 和 Ho:YAG 的 HSP AVs 增加（11.56±1.8 vs 6.36±0.84 mm3 和 11.27±1.98 vs 6.34±0.55mm3，p=0,03 和 p=0,02），而所有激光源在不同激光设置下的 SSP AVs 相似。结论：p-Tm:YAG 具有介于 Ho:YAG 和 TFL 之间的峰值功率、均匀的脉冲轮廓、随着偏转的增加不会出现纤维断裂的风险以及有效的消融率。需要进一步的临床研究来证实这些体外结果。

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In Vitro Comparison of Pulsed-Thulium:YAG, Holmium:YAG, and Thulium Fiber Laser.

Objective: To characterize the pulse characteristics and risk of fiber fracture (ROF) of the pulsed-Thulium:YAG (p-Tm:YAG) laser and to compare its ablation volumes (AVs) against Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) laser and Thulium fiber laser (TFL). Materials and Methods: p-Tm:YAG (100 W-Thulio, Dornier-Medtech^©, Germany) was characterized using single-use 272 μm core-diameter-fibers. p-Tm:YAG characterization included pulse shape, duration, and peak power (PP) studies. ROF was assessed after 5 minutes of continuous laser activation (CLA) at five decreasing fiber bend radii (1, 0.9, 0.75, 0.6, and 0.45 cm). p-Tm:YAG, Ho:YAG (120 W-Cyber-Ho, Quanta^®, USA), and TFL (60 W-TFLDrive, Coloplast^®, Denmark) AVs were compared using a 20-mm linear CLA at 2 mm/second velocity in contact with 20 mm³ hard stone phantoms (HSP) and soft stone phantoms (SSP) (15:3 and 15:5 water to powder ratio, respectively) fully submerged in saline at 0.5 J-20 Hz or 1 J-10 Hz. After CLA, phantoms underwent three-dimensional (3D) micro-scanning (CT) and subsequent 3D segmentation to estimate the AVs, using 3DSlicer^©. Each experiment was performed in triplicate. Results: p-Tm:YAG presents a uniform pulse profile in all of the available preset modes. PP ranged from 564 to 2199 W depending on pulse mode. No laser fiber fracture occurred at any bend radius. p-Tm:YAG achieved similar mean AVs to TFL and Ho:YAG for HSP (8.96 ± 3.1 vs 9.78 ± 1.1 vs 8.8 ± 2.8 mm³, p = 0.67) but TFL was associated with higher AVs compared with p-Tm:YAG and Ho:YAG (12.86 ± 1.85 vs 10.12 ± 1.89 vs 7.56 ± 2.21 mm³, p = 0.002) against SSP. AVs for HSP increased with pulse energy for p-Tm:YAG and Ho:YAG and (11.56 ± 1.8 vs 6.36 ± 0.84 mm³ and 11.27 ± 1.98 vs 6.34 ± 0.55 mm³, p = 0.03 and p = 0.02), whereas AVs for SSP were similar across laser settings for all laser sources. AVs with TFL were similar across laser settings for both phantom types. Conclusion: p-Tm:YAG combines intermediate PP between Ho:YAG and TFL, a uniform pulse profile, no ROF with increasing deflection and effective ablation rates. Further clinical studies are needed to confirm these in vitro results.

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来源期刊

Journal of endourology 医学-泌尿学与肾脏学

CiteScore

5.50

自引率

14.80%

发文量

254

审稿时长

1 months

期刊介绍： Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes. The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation. Journal of Endourology coverage includes: The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions Pioneering research articles Controversial cases in endourology Techniques in endourology with accompanying videos Reviews and epochs in endourology Endourology survey section of endourology relevant manuscripts published in other journals.