Thulium fiber laser: ready to dust all urinary stone composition types?
Thulium fiber laser: ready to dust all urinary stone composition types?
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DOI：
10.1007/s00345-020-03217-9
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发表时间：
2020-05-03
影响因子：
3.4
通讯作者：
Traxer, Olivier
中科院分区：
文献类型：
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作者：
Keller, Etienne Xavier;De Coninck, Vincent;Traxer, Olivier
目的：评价使用稀土光纤激光碎石技术(TFL)能否从各种常见的结石成分中获得碎石粉尘。在适用的情况下，通过形态成分分析进一步表征了石尘。方法采用FiberLase U2TFL碎石机和150目硅胶纤维(IPG Photonics(R)，IPG Medical(TM)，Marlborough，MA，USA)对人尿路结石进行体外碎石。激光设置为0.05J、320赫兹、200MU S。每种结石成分总共发射2400J。所有被评估的结石的纯度都达到了90%(一水草酸钙、二水草酸钙、尿酸、碳磷灰石、鸟粪石、刷石和半胱氨酸)。将自发漂浮的石材颗粒视为石粉，采集后进行扫描电子显微镜和傅立叶变换红外光谱分析。结果经TFL碎石后，所有评价的尿路结石均可回收结石粉尘。除了一水草酸钙和碳磷灰石外，大多数石粉样品的结晶结构都发生了变化，它们保留了最初的特征。石尘颗粒平均最大宽度不超过254µm。结论TFL能产生各种类型的石尘。在石屑中发现的形态成分变化表明，在TFL碎石过程中，激光能量与结石基质发生了光热相互作用。
Purpose To evaluate whether stone dust can be obtained from all prevailing stone composition types using the thulium fiber laser (TFL) for lithotripsy. Where applicable, stone dust was further characterized by morpho-constitutional analysis. Methods Human urinary stones were submitted to in vitro lithotripsy using a FiberLase U2 TFL generator with 150 mu m silica core fibers (IPG Photonics(R), IPG Medical (TM), Marlborough, MA, USA). Laser settings were 0.05 J, 320 Hz and 200 mu s. A total of 2400 J were delivered to each stone composition type. All evaluated stones had a > 90% degree of purity (calcium oxalate monohydrate, calcium oxalate dihydrate, uric acid, carbapatite, struvite, brushite and cystine). Spontaneously floating stone particles were considered as stone dust and collected for analysis by scanning electron microscopy and Fourier transform infrared spectroscopy. Results Stone dust could be retrieved from all evaluated urinary stones after TFL lithotripsy. Most stone dust samples revealed changes in crystalline organization, except for calcium oxalate monohydrate and carbapatite, which conserved their initial characteristics. Mean maximal width of stone dust particles did not exceed 254 mu m. Conclusions The TFL is capable to produce stone dust from all prevailing stone types. Morpho-constitutional changes found in stone dust suggest a photothermal interaction of laser energy with the stone matrix during TFL lithotripsy.