Document Detail


Holmium:YAG percutaneous nephrolithotomy: the laser incident angle matters.
MedLine Citation:
PMID:  9474126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Laser physics dictate that maximal radiant exposure occurs when the laser strikes the target at a normal incidence. Since the renal collecting system often limits nephroscope movements during percutaneous nephrolithotomy, the laser-calculus incidence angle may vary. We have observed during holmium:YAG percutaneous nephrolithotomy that the side firing fiber more easily approaches a normal incidence compared to the end firing fiber. We test the hypothesis that holmium:YAG percutaneous nephrolithotomy is faster with a side firing fiber compared to an end firing fiber. MATERIALS AND METHODS: Consecutive holmium:YAG percutaneous nephrolithotomy cases were studied retrospectively. The calculus size and composition, surgical time, fragmentation speed (size/time) and stone-free rates were compared between 11 patients treated with end and 8 treated with side firing fibers. RESULTS: When the end and side firing groups were compared, calculus sizes (mean plus or minus standard deviation) were 22 +/- 13 versus 48 +/- 17 mm. (p = 0.004), calcium oxalate monohydrate incidence was 55 versus 75% (p = 0.3), surgical times were 168 +/- 87 versus 124 +/- 51 minutes, computed fragmentation speeds were 0.15 +/- 0.09 versus 0.43 +/- 0.15 mm. per minute (p = 0.0009) and stone-free rates were 73 versus 88% (p = 0.4), respectively. CONCLUSIONS: The side firing fiber is faster than the end firing fiber for holmium:YAG percutaneous nephrolithotomy. These results are consistent with principles of laser physics.
Authors:
J M Teichman; R D Rao; R D Glickman; J M Harris
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of urology     Volume:  159     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-03-10     Completed Date:  1998-03-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  690-4     Citation Subset:  AIM; IM    
Affiliation:
Division of Urology, University of Texas Health Science Center San Antonio 78284-7845, USA.
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MeSH Terms
Descriptor/Qualifier:
Aluminum
Biophysical Phenomena
Biophysics
Holmium
Humans
Kidney Calculi / therapy*
Lasers*
Lithotripsy, Laser*
Nephrostomy, Percutaneous / methods*
Retrospective Studies
Treatment Outcome
Yttrium
Chemical
Reg. No./Substance:
7429-90-5/Aluminum; 7440-60-0/Holmium; 7440-65-5/Yttrium
Comments/Corrections
Comment In:
J Urol. 1998 Mar;159(3):696-701   [PMID:  9474128 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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