EFFECTS OF SHIELDED OR UNSHIELDED LASER AND ELECTROHYDRAULIC LITHOTRIPSY ON RABBIT BLADDER

被引:24
作者
BHATTA, KM
ROSEN, DI
FLOTTE, TJ
DRETLER, SP
NISHIOKA, NS
机构
[1] MASSACHUSETTS GEN HOSP,DEPT UROL,BOSTON,MA 02114
[2] MASSACHUSETTS GEN HOSP,DEPT UROL,BOSTON,MA 02114
[3] HARVARD UNIV,SCH MED,BOSTON,MA 02115
[4] PHYS SCI INC,ANDOVER,MA
关键词
D O I
10.1016/S0022-5347(17)40117-0
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The pulsed dye laser and electrohydraulic lithotriptor (EHL) are both effective devices for fragmenting urinary and biliary calculi. Both fragment stones by producing a plasma-mediated shockwave. Recently, a plasma shield consisting of a hollow spring and a metal end cap has been described for use with the laser and EHL devices in an attempt to minimize tissue damage without adversely affecting stone fragmentation rates. The tissue effects produced by a pulsed dye laser and an EHL device with and without plasma shields were examined and compared using rabbit urinary bladders. If blood was present, the unshielded laser perforated the bladder wall in two pulses. However, in the absence of blood, over 100 pulses were needed for the laser to perforate the bladder. A mean of six pulses were required to perforate the bladder wall with a shielded laser. The unshielded EHL perforated the bladder wall in two pulses, whereas, the shielded EHL required a mean of 35 pulses. Microscopically, areas of exposure revealed hemorrhage and tissue ablation. We conclude that all devices examined can produce significant tissue damage when discharged directly onto bladder epithelium.
引用
收藏
页码:857 / 860
页数:4
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