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中華民國泌尿科醫學會雜誌

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篇名 Application of the Holmium:YAG Laser for Ureteral and urethral Disease-Experience in Minimally Invasive Endourology in Chang Gung Memorial Hospital
卷期 11:2
並列篇名 使用鈥亞鉻雷射於輸尿管和尿道疾病:長庚醫院微創手術之經驗
作者 張英勛陳志碩
頁次 051-054
關鍵字 鈥亞鉻雷射結石狹窄息肉內視鏡泌尿學YAG laserstonestricturepolypendourologyTSCI
出刊日期 200006

中文摘要

本篇是報告使用鈥亞鉻雷射在治療輸尿管和尿道疾病所獲得之經驗。從1998年4月到1999年10月,總共27位有輸尿管和尿道疾病之病患接受鈥亞鉻雷射。其中17位共有21顆輸尿管結石(上段10顆,中段1顆,下段10顆)。其餘10位之中,1個結石合併輸尿管狹窄,5個結石合併輸尿管息肉,3個輸尿管窄,1個尿道狹窄。我們使用6.0/7.5Fr. 半硬式輸尿管鏡與550-μm微細雷射光纖來處輸尿管病灶。對於尿道病灶則是使用19Fr.膀胱鏡與相同雷射光纖處理。雷射能量設定在5-15焦爾,頻率則是設定在5-15赫茲。結果顯示,所有結石成功被擊碎並且術後結石排空率為100%。輸尿管息肉完全被切除,輸尿管狹窄與尿道狹窄則完全被切開。在回朔分析中,並沒有手術併發症之發生。結論,對於輸尿管和尿道疾病來說,鈥亞鉻雷射提拱一個有效且安全的治療方式。它提供泌尿科醫師在輸尿管和尿道內視鏡手術上另外一種選擇。由於微細雷射光纖之應,它讓我們在結石擊碎或病灶之切除上並不會有太大的困難。

英文摘要

We report our experience in the treatment of ureteral and urethral disease using a holmium: yttrium-aluminum-garnet (Ho:YAG) laser. From April 1998 to October 1999, 27 patients with ureteral and urethral lesions underwent Ho:YAG laser operations. Seventeen patients had a total of 21 ureteral stones (10 upper, 1middle, and 10 lower ureter). Among the remaining patients, 1 had stones combined with ureteral stricture, 5 had ureteral ployp, and 3 had ureteral stricture. One other had urethral stricture only. We used a 6.0/7.5 Fr.semi-rigid tapered ureteroscope with a 550-μm SlimLine laser fiber for the energy was set at a power of 0.5 to 1.0 J, and a frequency from 5 to 15 Hz. All stones were successfully fragmented, and the post-operative stone-free rate was 100%. The ureteral polyps were completely ablated. The ureteral and urethral strictures were successfully incised. There were no intraoperative complications in this retrospective analysis. The Ho: YAG laser is an effective and safe treatment modality for ureteral and urethral lesions, and provides the urologist with another choice for ureteral and urethral endourology. With its thin laser fiber, this laser technique provides exellent results in either fragmentation or ablation, without difficulty.

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