- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Outcome of simultaneous thulium laser enucleation of bladder tumor and prostate in patients with non-muscle invasive bladder tumor and benign prostatic hyperplasia: a matched-pair comparison with a long-term follow-up
摘要： Objective To access the surgical and oncological outcomes of simultaneous thulium laser enucleation of bladder tumor (ThuLEBT) and thulium laser enucleation of prostate (ThuLEP) in patients with non-muscle invasive bladder tumor (NMIBC) and benign prostatic hyperplasia (BPH). Patients and methods Between June 2009 and June 2017, 118 men with NMIBC who underwent simultaneous ThuLEBT and ThuLEP and fulfilled the inclusion criteria were matched with 118 patients who received ThuLEBT alone. Clinico-pathological parameters, surgical outcome data and oncological outcomes were retrospectively analyzed and compared. Results The patients who underwent simultaneous ThuLEBT and ThuLEP experienced a longer length of operation time (70.4 vs. 25.5 min; p < 0.001), but there were no statistically significant differences in catheterization period, hospital stay and complication between the two groups. At a mean follow-up of 58.7 and 55.8 months in ThuLEBT/ThuLEP group and ThuLEBT group, no significant differences in overall recurrence rates, progression rates, recurrence in the bladder neck/prostatic fossa and mean elapsed time to recurrence were detected. The 5-year recurrence-free probability was 73.2% for ThuLEBT/ThuLEP and 69.2% for ThuLEBT (p = 0.361). Conclusions Our results indicate that simultaneous ThuLEBT and ThuLEP can be safely performed without increasing the surgical risk and the risk of tumor recurrence and progression in patients with NMIBC and BPH, and it may be preferred alternative for select patients.
关键词： Bladder tumor,Tumor recurrence,Benign prostatic hyperplasia,Laser therapy,Thulium laser enucleation of bladder tumor,Thulium laser enucleation of prostate
更新于2025-09-23 15:21:01
-
Combination of holmium and thulium laser ablation in upper tract urothelial carcinoma
摘要： Thanks to the latest technological and technical advances in endourology, the management of upper tract urothelial cancer (UTUC) has changed over the last years, with expanding indications for a conservative approach. The endourological management has been described by means of flexible ureteroscopes and of holmium:YAG fibre lasers. A systematic review showed that oncologic outcomes at 5 and 10 years of follow-up were similar by comparing cohorts of low-risk UTUC patients undertaking either nephroureterectomy or endourological ablation. Accordingly, since 2018 the European Association of Urology Guidelines on UTUC have recommended the elective conservative management of UTUC in selected patients with low-risk lesions, i.e., those 2 cm in size, solitary, low-grade, non-muscle-infiltrative and without upper urinary tract dilatation at CT scan. More recently, the use of thulium laser (TL) has been described in the context of UTUC: as far as it concerns the technical features, TL consists of a diode-pumped laser that provides a continuous wave and a lower tissue penetration, which allow for a more precise vaporization, excellent coagulation, and a lower risk of injury to normal tissue, making it the ideal laser to deal with soft tissue disease. In 2011, Defidio et al., in a series of 59 cases of UTUC, demonstrated that the thulium laser ablation was non-inferior to holmium:YAG laser ablation in terms of oncological outcomes. More recently, Musi et al. reported the outcomes of the largest published cohort of UTUC patients (n = 42) undertaking thulium laser vaporization: the authors showed oncological outcomes comparable to those available in literature, with a recurrence-free survival of 81% at a median of 44 months of follow-up, and a very low rate of complications.
关键词： UTUC,thulium laser,endourology,holmium laser,upper tract urothelial carcinoma
更新于2025-09-23 15:19:57
-
Can a second resection be avoided after initial thulium laser endoscopic en bloc resection for non-muscle invasive bladder cancer? A retrospective single-center study of 251 patients
摘要： Background: This study aimed to evaluate the efficacy of transurethral thulium laser en bloc resection of the bladder tumor (TmLRBT) in patients with non-muscle invasive bladder cancer (NMIBC) and to investigate whether a second resection can be avoided. Methods: From June 2012 to June 2018, 251 newly diagnosed patients with NMIBC were enrolled in this retrospective study; all patients received regular administration of pirarubicin after the initial resection. A second transurethral resection (TUR) was performed in patients within 2–6 weeks after the initial TmLRBT in group 1. Patients in group 2 only underwent cystoscopy at 3 months. Results: Second surgery results indicate that recurrence was detected histopathologically in 6/108 and 11/143 patients in group 1 and 2, respectively (P = 0.52); Progression was observed in 2 patients in each group (P = 0.34). The mean follow-up duration was 40.1 months, with no significant difference between the groups (P = 0.32). Recurrence was observed in 23 (21.3%) and 39 (27.3%) patients in groups 1 and 2 during the follow-up, respectively (P = 0.34); disease progression occurred in 4 (3.8%) patients in group 1 compared with 7 (4.0%) in group 2 (P = 0.20). Conclusion: Complete removal of tumors can be achieved by TmLRBT. This technique may decrease the number of second TURs.
关键词： Intravesical instillation,Transurethral thulium laser en bloc resection of bladder tumor,Second resection,Bladder cancer,Pirarubicin
更新于2025-09-23 15:19:57
-
Single-step Laser Plastic Deposition (LPD) using a near-infrared Thulium fiber-laser
摘要： Additive Manufacturing of thermoplastic polymers is typically carried out using techniques such as Selective Laser Sintering (SLS) or Fused Layer Modeling (FLM), both of which require the use of support structures that have to be removed after the production process. The laser welding of thermoplastic polymers using laser sources with a wavelength of around 1 μm and thus also Direct Selective Laser Melting (SLM) in the same wavelength spectrum requires the admixing of additives such as carbon black in order to improve the absorption of laser light within the polymer and hence poses an additional process step that has to be performed. Laser sources like Thulium fiber-lasers with a wavelength of around 2 μm enable the absorber-free welding of thermoplastic polymers and therefore promise to be a new source for the SLM of thermoplastic polymers as well as a possible adaption of the known Laser Metal Deposition (LMD) to plastics, the so called ?Laser Plastic Deposition“ (LPD). In the present paper, the feasibility of a single-step LPD process using irradiation of a 1,94 μm Thulium fiber-laser is investigated through the manual deposition of unfilled and absorber-free polyamide-12 powder on polyamide-6 substrates. Powder material and the created structures are characterized by differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). In addition to that, optical microscopy and computer tomography analysis (CT) are carried out and discussed for the created LPD structures. From the experiments, it is to be concluded that a single-step LPD process can be carried out using a 2 μm Thulium fiber-laser.
关键词： Fiber laser,Thulium laser,Polymer cladding,Laser polymer deposition,Laser plastic deposition,Additive manufacturing
更新于2025-09-16 10:30:52
-
Simulation of optical fiber amplifier gain using equivalent short fibers
摘要： Electromagnetic wave propagation in optical fiber amplifiers obeys Maxwell equations. Using coupled mode theory, the full Maxwell system within an optical fiber amplifier is reduced to a simpler model. The simpler model is made more efficient through a new scale model, referred to as an equivalent short fiber, which captures some of the essential characteristics of a longer fiber. The equivalent short fiber can be viewed as a fiber made using artificial (unphysical) material properties that in some sense compensates for its reduced length. The computations can be accelerated by a factor approximately equal to the ratio of the original length to the reduced length of the equivalent fiber. Computations using models of two commercially available fibers – one doped with ytterbium, and the other with thulium – show the practical utility of the concept. Extensive numerical studies are conducted to assess when the equivalent short fiber model is useful and when it is not.
关键词： Scale model,Ytterbium,Thulium,Laser gain,Fiber amplifier
更新于2025-09-16 10:30:52
-
Fractional 1,927?nm Thulium Laser Plus Photodynamic Therapy Compared and Combined for Photodamaged Décolleté Skin: A Side‐by‐Side Randomized Controlled Trial
摘要： Background and Objectives: Décolleté photodamage is a common condition typically treated with light and energy‐based devices. This study investigated the efficacy and safety of a fractional 1,927 nm thulium laser (TL) alone and combined with photodynamic therapy (PDT). Study Design/Materials and Methods: In a 12‐week follow‐up study, participant décolletés were divided into four treatment areas and randomized to receive a single treatment with field‐directed TL, PDT, combination TL‐PDT, or lesion‐directed curettage control. All actinic keratoses (AKs) underwent lesion‐directed curettage before randomization. TL was delivered at 20 mJ/mb, 500 mJ/cm2 fluence, 5 W, and 8 (n = 6 pts.) or 16 (n = 6 pts.) passes. PDT was performed with 16% methyl aminolevulinate (MAL) creme incubated for 3 h, followed by red light‐emitting diode light at 37 J/cm2. Outcome measures included clinical assessment of overall photodamage and specific subcomponents, assisted by optical coherence tomography (OCT) imaging. Results: Twelve women with moderate to severe photodamage on the décolleté and a cumulative total of 184 thin grade I AKs were included. Field‐directed treatments TL and combination TL‐PDT equally improved the overall photodamage, mottled pigmentation, and rhytides compared with lesion‐directed control (P < 0.05). The skin texture improved by TL alone and was further improved by combining TL and PDT (P < 0.05). Median AK complete responses were similar for field‐directed interventions TL‐PDT (100%), TL (90%), PDT (82%), and lesion‐directed curettage control (52%) (P = 0.464). Patients presented with mild local skin responses, slightly more pronounced when combining TL with PDT versus individual treatments (P < 0.05). No scarring or adverse events were observed. Conclusions: The 1,927 nm fractional thulium laser is an effective, tolerable, and safe field‐directed treatment for décolleté photodamage. Provided alone, TL proved to be as effective as combined TL‐PDT for overall photodamage, while a greater improvement in skin texture was achieved using TL and PDT in combination.
关键词： décolleté,optical coherence tomography,skin photodamage,thulium laser,non‐ablative laser,actinic keratosis,skin rejuvenation,photodynamic therapy
更新于2025-09-12 10:27:22
-
Acousto-optic mode-locked Tm:LuAG laser with nearly diffraction-limited beam
摘要： We reported an acousto-optic mode-locked Tm:LuAG laser pumped by a 786? nm laser diode and realized continuous-wave mode-locked operation. At the pump power of 8.2?W, the output average power was 335 mW with the wavelength of 2023.2?nm. The pulse width was 240?ps at the pulse repetition frequency of 81.60?MHz, and the beam quality factor M2 was 1.04. The output wavelength was tuned from 2022.6 to 2025.3?nm, corresponding to the output average power of 310 to 353 mW. In addition, the self-mode-locking phenomenon was found.
关键词： Solid-state lasers,Actively mode-locked,Thulium laser,Infrared laser
更新于2025-09-12 10:27:22
-
Transoral Robot-Assisted Surgery in Supraglottic and Oropharyngeal Squamous Cell Carcinoma: Laser Versus Monopolar Electrocautery
摘要： Background: Monopolar electrocautery (EC) is the surgical cutting and haemostatic tool most commonly used for transoral robotic surgery (TORS). The aim of this study was to retrospectively compare EC e?cacy in the treatment of patients a?ected by T1 or T2 oropharyngeal and supraglottic squamous cell carcinomas with the more recently introduced laser ?bres. Methods: We considered all TORS patients admitted to our department from January 2010 to June 2019. The outcomes of patients treated with Thulium: yttrium aluminium garnet (YAG) laser (TY-TORS), CO2 laser (CO2-TORS) and EC (EC-TORS) were analysed in order to assess surgical performances, functional outcomes and postoperative complications. Results: Twenty patients satis?ed the enrolling criteria, of which nine underwent laser-TORS, and the remaining 11 underwent EC-TORS. In all candidates, TORS procedures were completed without the need for microscopic/open conversion. Close or positive margins were signi?cantly more frequent in EC-TORS (p = 0.028). A considerable di?erence was found in overall functional parameters: times of nasogastric tube and tracheostomy removal and time of hospital discharge were signi?cantly shorter in laser-TORS (p = 0.04, p = 0.05, p = 0.04, respectively). Conclusions: Laser-TORS showed better results in comparison with EC-TORS in term of tumour resection margins and patient functional outcomes. Our ?ndings can be justi?ed with the greater tissue thermal damage caused by EC-TORS, despite prospective randomized trials and increased patient numbers being needed to con?rm these preliminary conclusions.
关键词： CO2 laser,transoral robotic surgery,cancer,thulium laser
更新于2025-09-12 10:27:22
-
Thulium laser enucleation of the prostate
摘要： Various, more minimally invasive laser-based procedures have been introduced into clinical practice for the treatment of symptomatic benign prostatic obstruction (BPO) during the past 20 years as alternatives to open prostatectomy and transurethral resection of the prostate to decrease perioperative morbidity and to achieve comparable outcomes. The most prominent role played the frequency-doubled neodymium:yttrium–aluminium–garnet (YAG) laser or GreenLight laser and the holmium:YAG laser. Since the introduction of holmium laser enucleation of the prostate (HoLEP) in 1998, this procedure has gained worldwide acceptance because of complete dissection of the prostate adenoma from the prostatic pseudocapsule. HoLEP has been proven to be a size-independent, well tolerated and efficient procedure with excellent long-term outcomes. The shallow learning curve of the HoLEP technique has, however, limited its widespread use. A learning curve of at least 25–50 cases was found acceptable using a structured mentorship programme. On the basis of HoLEP, a wide array of so-called ‘me too’ laser-based transurethral enucleation techniques have been described during the past 12 years using diode, GreenLight and thulium lasers, of whom the latter played the most prominent role. Thulium:YAG vapoenucleation of the prostate (ThuVEP) has been found to be a size-independent, well tolerated and effective procedure with low-perioperative morbidity and excellent long-term results. The durability of ThuVEP was demonstrated by a prostate-specific antigen (PSA)-reduction rate of 77.1% at 5-year follow-up. The completeness of adenoma removal by ThuVEP was currently confirmed by a retrospective matched-paired comparison between ThuVEP and thulium vaporesection of the prostate (ThuVARP): the PSA-reduction was significantly higher after ThuVEP compared with ThuVARP (78.9 vs. 23.4%) at 24-month follow-up, which may lead to a higher reoperation rate after ThuVARP during long-term follow-up.
关键词： Thulium laser enucleation,BPO,ThuVEP,prostate,HoLEP
更新于2025-09-12 10:27:22
-
The Comparison of Thermal Effects of a 1940‐nm Tm:fiber Laser and 980‐nm Diode Laser on Cortical Tissue: Stereotaxic Laser Brain Surgery
摘要： Background and Objectives: The thermal damage on adjacent healthy structures is always an unwanted consequence of continuous‐wave laser irradiation of soft tissues. To propose a laser as an effective alternative to traditional surgical tools, this photothermal damage due to heat conduction must be taken into account with a detailed laser dosimetry study. Two candidate lasers; a 980‐nm diode and 1940‐nm Tm:fiber were selected for this study. Despite the poor absorption by water, the 980‐nm diode laser has been one of the most widely used lasers in soft tissue surgeries due its good absorption by hemoglobin, which provides good homeostasis. The second laser; the Tm:fiber laser was selected due to its wavelength operating at an absorption peak of water (1,940 nm), which makes it a good candidate for ablation of biological tissues, and it is readily capable of being transmitted through flexible fiber optics to deliver energy to hard‐to‐reach regions. The underlying motivation for the research described in this paper is that with a comprehensive comparison of ablation capabilities and a detailed dose study of infrared lasers operating at different wavelengths and temperature monitoring of the tissue during laser surgery, it may be possible to specify the optimal laser parameters for laser surgery, and propose a treatment alternative to conventional surgical techniques in clinical use. The objectives of this study were to investigate and to compare the thermal effects of 980‐nm and 1940‐nm lasers on cortical tissue in vivo, to find the optimum parameters for laser‐brain‐ablation with minimum thermal damage to the surrounding healthy tissue, and finally, to analyze laser irradiated tissue thermographically and histologically to correlate thermal events and tissue damage with laser irradiation parameters. Study Design/Materials and Methods: Stereotaxic laser brain surgeries were performed on 32 male Wistar rats. A t‐type thermocouple was used to measure the temperature of the nearby tissue at a distance of 1 mm above and 1 mm away from the fiber tip during laser surgery. Cresyl fast violet (CFV) staining was used to expose the thermal extent of laser surgery on cortical tissue. Eight tissue samples from each laser study group were processed for histological analysis and the mean ± standard deviation for thermal damage was reported. Thermal damage was quantified as ablation (thermally removed tissue), severe and mild coagulation (irreversible thermal damage) and edematous (reversible thermal damage) areas with regard to CFV stained slices. The Pearson correlation coefficient was calculated to test if the ablation efficiencies and total damage, and edematous areas were correlated to rates of temperature change. Results: No significant adverse effects were observed during surgeries. We found that both lasers investigated were successful in cortical tissue removal. Our results also revealed that irrespective of the mode of operation, laser wavelength and laser power, there is a strong correlation between the rates of temperature change and ablation efficiencies and a negative correlation between the rate of temperature change and total damage and edematous area. Conclusions: Both lasers investigated were successful in cortical tissue removal. We also reported that when the amount of energy delivered to the tissue was constant, the most important issue was to deliver this energy in a short time to achieve more efficient ablations with less edema around the lesion, regardless of mode of delivery (continuous or pulsed‐modulated mode), but further studies including the healing period after laser surgeries have to be performed to compare the thermal extent of damage comprehensively.
关键词： ablation efficiency,rate of temperature change,980‐nm diode laser,Thulium laser,ablation,real‐time temperature monitoring,Laser brain surgery,cortical tissue
更新于2025-09-11 14:15:04