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Ureteroscopic holmium laser to transect the greater omentum to remove an abdominal drain:Four case reports

World Journal of Clinical Cases 2021年第31期9卷 9584-9591页

作者： Hong-Ming Liu Guang-Heng Luo Xiao-Fei Yang Zhu-Gang Chu Tian Ye Zhi-Yong Su Li Kai Xiu-Shu Yang Zhen Wang Department of Urology Guizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina Department of Urology The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550000Guizhou ProvinceChina Department of General Surgery Guizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina

BACKGROUND Drainage tube removal is difficult when the greater omentum becomes incarcerated in the drainage tube through the side ***,known removal methods are either ineffective or will cause additional damage to the patient in a secondary *** and the holmium laser have been used in various surgical techniques in urology,and in theory,they are expected to be a good strategy for solving the problem of tissue *** SUMMARY Four patients diagnosed with difficult removal of an abdominal drainage tube following abdominal surgery are *** patients underwent surgery to remove the incarcerated greater omentum in the drainage tube using a holmium laser and a ureteroscope,and a new 16-F drain was then placed in the abdominal or pelvic *** efficacy of this technique was evaluated by intraoperative conditions,success rate,and operating time;safety was evaluated by perioperative conditions and the probability of postoperative *** four operations went smoothly,and the drains were successfully removed in all *** average operating time was 24.5 ***,the average irrigation volume was 892.0 mL,the average drainage volume was 638.5 mL,and no bleeding or damage to surrounding tissues was ***,the average drainage volume was 32.8 mL and the new drains were removed within 36 *** patients were able to get out of bed and move around within 12 *** visual analogue pain scores were all below *** average follow-up duration was 12.5 mo and no complications such as fever or bleeding were *** Ureteroscopic holmium laser surgery is an effective,safe and minimally invasive technique for removing drains where the greater omentum is incarcerated in the abdominal drain.

关键词： Ureteroscope holmium laser Drainage Greater omentum Complication of abdominal surgery Case report

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A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy

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Asian Journal of Urology 2023年第1期10卷 89-95页

作者： Xiaoliang Zhu Feiping Li Xixi Hu Haiping Li Songjiang Wu Haihong Jiang Department of Urology and Andrology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouChina Department of Urology and Andrology The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina

Objective:Many studies have demonstrated the heat effect from the holmium laser lithotripsy can cause persistent thermal injury to the *** purpose of this study was to elucidate the use of a modified ureteral catheter with appropriate firing and irrigation to reduce the thermal injury to the“ureter”during the ureteroscopic holmium laser lithotripsy in ***:An in vitro lithotripsy was performed using a modified catheter(5 Fr)as the entrance for the irrigation and the holmium laser fiber while using the remaining space in the ureteroscopic channel as an *** laser power settings(10 W,20 W,and 30 W)with various firing times(3 s,5 s,and 10 s)and rates of irrigation(15 mL/min,20 mL/min,and 30 mL/min)were applied in the *** changes in the“ureter”were recorded with a thermometer during and after the ***:During the lithotripsy,the local highest mean temperature was 60.3℃ and the lowest mean temperature was 26.7℃.When the power was set to 10 w,the temperature was maintained below 43℃ regardless of laser firing time or irrigation *** of the power or firing time selected,the temperature was below 43℃ at the rate of 30 mL/*** was a significant difference in temperature decrease when continuous 3 s drainage after continuous firing(3 s,5 s,or 10 s)compared to with not drainage(pholmium laser procedure.

关键词： Modified catheter holmium laser Lithotripsy Thermal injury

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Analysis of the effect of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts

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Asian Journal of Urology 2023年第2期10卷 172-176页

作者： Yuanshen Mao Wenfeng Li Jun Da Mingxi Xu Yiwei Wang Yufei Gu Weixin Pan Zhong Wang Department of Urology Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiChina

Objective:To explore the efficacy,safety,and feasibility of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal ***:From September 2012 to February 2019,a total of 18 patients,aged from 28 to 62(meanstandard deviation[SD]:46.50±9.14)years,were diagnosed with parapelvic renal cysts and treated by holmium laser flexible ureteroscopic intrapelvic *** were 10 males and eight *** of the parapelvic renal cysts were unilateral,and two cases were complicated with *** diameters of the cysts ranged from 4.1 cm to 8.2 ***:All the patients completed the operation successfully in one stage without conversion to open surgery;in two cases,it was difficult to find the cysts during the operation,and the localization was completed by B-ultrasound and percutaneous injection of methylene *** mean operative time was 33.89(SD:9.68;range:22-54)min,and the mean hospitalization time was 2.67(SD:0.91;range:2-5)*** months and 6 months of follow-up were performed after *** cysts disappeared in 13(72%)cases,and the diameter of the cysts in five(28%)cases decreased by more than 50%.Conclusion:holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts is simple,safe,and effective,and can be used as the first choice for the treatment of parapelvic renal cysts.

关键词： Flexible ureteroscopy holmium laser Parapelvic renal cyst B-ultrasound Intrapelvic drainage

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Ureteroscopic lithotripsy using holmium laser for 187 patients with proximal ureteral stones

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Chinese Medical Journal 2012年第9期125卷 1542-1546页

作者： LIU Ding-yi HE Hong-chao WANG Jian TANG Qi ZHOU Yan-feng WANG Ming-wei CHU Cheng-long ZHANG Chong-yu ZHU Yu ZHOU Wen-long SHEN Zhou-jun Department of Urology Punan Hospital Shanghai 200125 China Department of Urology Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background Improving the success rate of ureteroscopic lithotripsy for proximal ureteral stones is the hot issue in this field. Here we reported our experience on the treatment of proximal ureteral stones.Methods From 2005 to 2010, 187 consecutive patients with proximal ureteral stones who underwent ureteroscopic lithotripsy were enrolled. The initial 52 patients treated by semi-rigid ureteroscope alone were classified as group 1. The subsequent 135 patients treated by semi-rigid ureteroscope with the aid of stone basket and flexible ureteroscope were classified as group 2.Results In group 1, the overall stone-free rate was 67.3%. By a single procedure of ureteroscopic lithotripsy using a semi-rigid instrument, patients with ureteral stones below the 4th lumbar vertebra level achieved 91.7% stone-free rate, which was only 50% in patients with stones above the 4th lumbar vertebra level. Conversion to open surgery occurred in two patients since ureteral perforation was observed. In group 2, the stone-free rate achieved 93.2% with the aid of an N-Trap basket, which was significantly higher than that of patients without the aid of the basket （51.6%）. Flexible ureteroscope was subsequently used in patients with fragment migration, thus making the overall success rate in group 2 increases to 97.0%.Conclusions Ureteroscopic lithotripsy is a safe and efficacious treatment for proximal ureteral stones. A single procedure of ureteroscopic lithotripsy using semi-rigid ureteroscope could achieve a satisfactory stone-free rate in patients with proximal ureteral stones below the 4th lumbar vertebra level. However, patients with ureteral stones above the 4th lumbar vertebra level experienced higher stone-migration rate, which would decrease the success rate. Fortunately, the stone-free state could possibly be achieved with the aid of an N-trap basket and flexible ureteroscope.

关键词： ureteroscopic lithotripsy proximal ureteral stones holmium laser stone basket

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Coagulation of a giant hemangioma in glans penis with holmium laser

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Asian Journal of Andrology 2008年第5期10卷 819-821页

作者： Emin Aydur Bulent Erol Lutfi Tahmaz Hasan Cem Irkilata Cenker Eken Ahmet Fuat Peker Department of Urology Gulhane Military Medical Academy Etlik Ankara 06018Turkey Department of Emergency Medicine Gulhane Military Medical Academy Etlik Ankara 06018 Turkey

A 21-year-old man presented with an enlarged giant hemangioma on glans penis which also causes an erectile dysfunction （ED） that partially responded to the intracavernous injection stimulation test. Although the findings in magnetic resonance imaging （MRI） indicated a glandular hemangioma, penile colored Doppler ultrasound revealed an invaded cavernausal hemangioma to the glans. Surgical excision was avoided according to the broad extension of the gland lesion. holmium laser coagulation was applied to the lesion due to the cosmetically concerns. However, the cosmetic results after holmium laser application was not impressive as expected without an improvement in intracavernous injection stimulation test. In conclusion, holmium laser application should not be used to the hemangiomas of glans penis related to the corpus cavernosum, but further studies are needed to reveal the effects of holmium laser application in small hemangiomas restricted to the glans penis.

关键词： lasers, penis, erectile dysfunction hemangioma holmium laser

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effective treatment of post-intubation subglottic stenosis in children with holmium laser therapy and cryotherapy via flexible bronchoscopy

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Pediatric Investigation 2019年第1期3卷 9-16页

作者： Anxia Jiao Fang Liu Andrew D.Lerner Xiaochun Rao Yan Guo Chenfang Meng Yuena Pan Gan Li Zheng Li Fang Wang Jing Zhao Yuyan Ma Xicheng Liu Xin Ni Kunling Shen Interventional Pulmonology Department Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina China National Clinical Research Center for Respiratory Diseases BeijingChina Division of Pulmonary and Critical Care Medicine Johns Hopkins University School of MedicineBaltimoreMDUSA Respiratory Department Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Pediatric Intensive Care Unit Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Department of Anesthesiology Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Department of Otolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck SurgeryMOE Key Laboratory of Major Disease in ChildrenBeijing Pediatric Research InstituteBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

Importance:Post-intubation subglottic stenosis(SGS)in children can be life *** treatment varies and lacks a universally accepted ***:We performed a prospective study to assess the safety and feasibility of holmium laser combined with cryotherapy delivered via flexible bronchoscopy for the treatment of post-intubation SGS in ***:This study involved all patients with post-intubation SGS seen at the Interventional Pulmonology Department of Beijing Children's Hospital between July 2014 and December *** laser treatment and cryotherapy was then performed under flexible bronchoscopy,whose parents refused to accept the alternative standard treatment of tracheotomy and balloon dilation under direct ***:Sixteen patients with post-intubation SGS were included in this *** ranged from 2 months to 12.25 years *** to the Cotton-Myer grading system,three cases were Grade II,12 cases were Grade III,and one case was Grade *** to the McCaffrey system,eight cases were Stage 1,two cases were Stage 2,and six cases were Stage *** average number of procedures was *** of the 16 patients achieved clinical *** patient achieved clinical *** average treatment course duration was 55.31 *** severe complications were ***-treatment clinical symptoms,endoscopic findings and quality of life showed marked ***:Our study supports the conclusion that holmium laser treatment combined with cryotherapy via flexible bronchoscopy appears to be a safe and feasible treatment for post-intubation SGS in children.

关键词： Subglottic stenosis Flexible bronchoscopy holmium laser Cryotherapy Children

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A Clinical Study of Choledochoscopic holmium laser Lithotripsy for Multiple Intrahepatic Calculi Within ERAS Programs

A Clinical Study of Choledochoscopic Holmium Laser Lithotrip...

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2018年浙江省外科学学术年会

作者： Cheng Wang Shangdong Lv Aidong Wang Zheping Fang 浙江省台州医院

Objectives :Multiple intrahepatic calculi,especially calculi in both sides of the liver,cannot be completely resolved by traditional *** addition,morbidity after liver resection remains *** programs have been suggested that could relieve surgical stress and accelerate postoperative *** study aimed to evaluate the safety and efficacy of choledocholithotomy combined with holmium laser lithotripsy in the treatment of multiple intrahepatic calculi within ERAS ***:In all,109 patients with multiple intrahepatic calculi were enrolled between January 2012 and September 2016,42 of whom received choledocholithotomy combined with holmium laser *** remaining 67 patients underwent choledocholithotomy combined with choledochoscopic mechanical *** outcomes were compared and *** :Patient characteristics and preoperative details were similar between the groups(P > 0.05).The implementation of holmium laser lithotripsy could reduce the calculi residual rate(7.1% vs.22.4%,P=0.037),and even the liver resection rate(16.7% vs.35.8%,P=0.031).Additionally,holmium laser lithotripsy did not result in a higher morbidity(11.9% vs.16.4%,P=0.517),readmission rate(0% vs.6%,P=0.158),hospital stay(P=0.189),hospital cost(P=0.998),transfusion rate(P=0.576) or operative time(P=0.638).Conclusions;holmium laser lithotripsy is feasible and efficient for treating multiple intrahepatic calculi within ERAS programs,which could reduce the liver resection rate and render refractory hepatic calculi easy to *** addition,holmium laser lithotripsy could be well coupled to the ERAS program to relieve surgical stress and accelerate postoperative recovery.

关键词： holmium laser choledochoscopy ERAS programs intrahepatic calculi choledocholithotomy

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''Sandwich'' treatment for diospyrobezoar intestinal obstruction: A case report

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World Journal of Gastroenterology 2014年第48期20卷 18503-18506页

作者： Yi-Xiong Zheng Pankaj Prasoon Yan Chen Liang Hu Li Chen Department of Gastrointestinal Surgery The Second Affiliated Hospital Zhejiang University School of Medicine Department of Hepato-Biliary-Pancreatic Surgery The Second Affiliated Hospital Zhejiang University School of Medicine Department of Gastrointestinal Medicine The Second Affiliated Hospital Zhejiang University School of Medicine

Intestinal obstruction is a common clinical entity encountered in surgical *** objective of this report is to corroborate an atypical scenario of intestinal obstruction in a Chinese patient and to focus on the diagnosis and treatment.A 27-year-old male presented with a history of gastric pain combined with nausea and abdominal distension that had been present for 5 *** presence of a foreign body was detected by computed tomography and observed as an abnormal density within the stomach.A diospyrobezoar was revealed during gastroscopy,the extraction of which was preventeddue to its size and *** endoscopic holmium laser joined with a snare was used to fragment the obstruction,which was followed by management with a conservative"sandwich"treatment strategy involving intestinal decompression with an ileus tube and Coca-Cola lavage between endoscopic lithotripsy fragmentation *** strategy resulted in the successful removal of the diospyrobezoar along with multiple small bowel *** patient was discharged after abatement of *** case presented here demonstrates the implementation of a conservative,yet successful,treatment as an alternative to conventional surgical removal of intestinal obstructions.

关键词： Small bowel obstruction Diospyrobezoar Ileus tube holmium laser Endoscopy

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Thulium laser treatment for bladder cancer

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Asian Journal of Urology 2016年第3期3卷 130-133页

作者： Wei Wang Haitao Liu Shujie Xia Department of Urology Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina

Recent innovations in thulium laser techniques have allowed application in the treatment of bladder *** en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection *** conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and *** evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder ***,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second ***,large-scale multicentre studies with longer follow-up are warranted for a robust *** present review is meant as a quick reference for urologists.

关键词： Thulium laser 2-μm continuous laser Bladder cancer En bloc resection Transurethral resection of bladder tumor holmium laser

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Current laser therapy options for endoscopic treatment of upper tract urothelial carcinoma

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Current Urology 2023年第1期17卷 62-67页

作者： Benjamin W.Zollinger Ezra J.Shoen Charles F.Gresham Michael J.Whalen George Washington School of Medicine and Health Sciences WashingtonDCUSA Department of Urology Icahn School of MedicineMount Sinai HospitalNew YorkNYUSA Department of Urology George Washington University HospitalWashingtonDCUSA

Endoscopic management via retrograde ureteroscopic laser ablation of upper tract urothelial carcinoma(UTUC)has become the preferred treatment modality for low-risk *** most popular ablative lasers over the past 15-20 years have been the holmium:yttrium-aluminum-garnet(Ho∶YAG)and neodymium(Nd∶YAG)lasers,but recently the thulium(Th∶YAG)laser has emerged as a potential *** review compares the mechanism of action,physiological properties and effects,and oncologic outcomes of Ho∶YAG/Nd∶YAG lasers versus the Th∶YAG laser for UTUC *** advantages of the Th∶YAG laser over existing technologies are outlined,followed by a discussion of emerging laser technologies in UTUC management.

关键词： Endoscopic management holmium laser laser ablation Thulium laser Upper tract urothelial carcinoma

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