Clinical observation of blue laser in the treatment of benign prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To evaluate the clinical efficacy of 200 W blue laser vaporization of prostate and the possibility of developing such surgery into day surgery. 【Methods】 The clinical data of 30 patients treated during Aug. and Sep.2022 were retrospectively reviewed. The residual urine volume, urine flow rate, International Prostate Symptom Score (IPSS) and Quality of Life Scale(QoL) score before and after surgery were compared. The operation time and postoperative routine urinary red blood cell count were recorded. 【Results】 All surgeries were successful and the catheter was moved 1 day after surgery. The operation time was (12.2±5.1) min, postoperative bladder irrigation time (20.0±4.2) h, and urinary red blood cell count (806.2±16.3)/μL. Recatheter was needed in 1 patient. The urinary flow rate before surgery, immediately and 1-month after surgery were (10.6±3.5) mL/s, (24.2±5.6) mL/s, and (27.2±3.1) mL/s, respectively. The residual urine was (57.3±3.2) mL before surgery and (5.6±3.1) mL 1-month after surgery. The average preoperative IPSS and QoL scores were (25.1±1.6) and (5.4±0.7), and were (9.5±1.4) and (2.9±0.6), respectively, 3-months after surgery. 【Conclusion】 Transurethral 200 W blue laser vaporization of the prostate is a practical and feasible surgical technique for the treatment of benign prostatic hyperplasia. It is effective, rapid and safe, and can greatly shorten the length of hospital stay and improve perioperative safety. With the improvement of clinical application technology, it can be a choice of prostatic day surgery.

Effect of transurethral low power green laser vapor-resection-enucleation after transrectal prostate biopsy / 国际生物医学工程杂志

Objective:To investigate the effectiveness and safety of transurethral low power green laser enucleation of prostate (VREP) after transrectal prostate puncture.Methods:The clinical data of 96 patients with VERP in the First Affiliated Hospital of Xinxiang Medical College from October 2020 to October 2021 were retrospectively analyzed. They were randomly divided into the control group ( n=41) and the observation group ( n=55). The control group did not undergo prostate biopsy before operation, and the observation group underwent transrectal prostate biopsy within 1 week before operation. The general data, perioperative indexes, maximum urinary flow rate ( Qmax), international prostate symptom score (IPSS), quality of life score (QOL) and complications of the two groups were compared before and 3, 6 and 12 months after surgery. Results:Preoperatively, the PSA was higher in the observation group compared with the control group ( P<0.05), and the differences in other general information were not statistically significant (all P>0.05). Compared with the control group, the observation group had longer operation times and heavier resected specimens, and the differences were statistically significant (all P<0.05), but there were no statistically significant differences between the two groups in the comparison of enucleation efficiency, crushing efficiency, postoperative hemoglobin (HGB) decline value, postoperative hospitalization time, and postoperative ureter removal time (all P>0.05). At 3, 6 and 12 months postoperatively, Qmax, IPSS and QOL were significantly improved in the observation group compared with the control group (all P<0.05). However, there was no statistically significant difference between the two groups in the comparison of the above-mentioned indexes in the same period after surgery (all P>0.05). There was no statistically significant difference in the complication rate comparison between the two groups ( P>0.05). Conclusions:Transurethral low-power green laser prostate enucleation after transrectal prostate puncture is efficacious and has a certain degree of safety.

High power lateral green laser assisted non-blocking laparoscopic partial nephrectomy for T 1a renal tumors / 中华泌尿外科杂志

Objective:To explore the safety and efficacy of laparoscopic non-blocking partial nephrectomy assisted by high power lateral green laser in the treatment of T 1a renal tumor. Methods:The clinical data of 10 patients with T1a stage renal tumor from February 2021 to April 2021 in department of urology, Gongli hospital affiliated to Naval Military Medical University were retrospectively analyzed. There were 7 males and 3 females, aged 47.0-74.0 years, with average of(58.8±9.7)years old. The diameter of the tumor ranged from 2.0 cm to 3.8 cm, with an average of (3.1±0.6)cm. There were 6 cases on the left side and 4 cases on the right side, locate on lumbar side in 9 cases and ventral sied in 1 case. The R. E.N.A.L score was 4.0-6.0, with an average of (5.0±0.8). The preoperative creatinine was 66.9-90.1μmol/L, with an average of (75.1±9.0)μmol/L, preoperative GFR of 44. 6- 67. 3 ml /min, with an average of(56.7±7.7)ml/min, preoperative hemoglobin level of 119.0-156.0g/L, with an average of (135.8±11.4)g/L. All patients underwent laparoscopic non-blocking partial nephrectomy assisted by 180w lateral green laser, free the surrounding area of the tumor fully and completely expose the renal tumor. The laser fiber was placed through the green laser hand piece, and the fiber was connected with normal saline to wash the strip. The initial green laser vaporization power was set at 80W, and the hemostasis power at 35W.About 3mm away from the edge of the tumor, and one optical fiber away from the renal parenchyma, the renal parenchyma was cut with 80W power. In order to reduce the interference by smoke, high-pressure flushing was used through the optical fiber while vaporizing, and an attractor was used to push and peel the tumor. In case of bleeding during operation, hemostatic power can be used to close the bleeding point and gradually advance until the tumor was completely removed. The wounds of renal inner medulla and renal outer cortex were continuously sutured in 1-3 layers with barbed suture. It involved 9 cases via retroperitoneal approach and 1 case via abdominal approach. The operation time, postoperative hemoglobin decrease, extraction time of negative pressure drainage, postoperative hospital stay, postoperative pathology and postoperative complications were recorded, and the serum creatinine level and GFR level of the affected side were followed up 1 month after operation.Results:All the operations were successfully completed, and there was no conversion to open surgery or radical nephrectomy. One case changed to scissors fast resection and sutured hemostasis due to severe intraoperative bleeding. The operation time was 90.0-120.0 min, with the average of (104.5±9.0)min. The postoperative hemoglobin level was 96.0-132.0g/L, with an average of (115.2±11.8)g/L, and the difference was statistically significant ( P<0.05). The postoperative hemoglobin decreased from 12.0g/L to 25.0g/L, with an average of (20.6±4.6)g/L. The time of vacuum drainage was 5.0-7.0 days, with an average of (5.7±0.7)d. Postoperative hospital stay was 6.0-8.0 days, with an average of (6.7±0.7)d. No bleeding, urinary leakage and other complications occurred in all patients. There were 7 cases of clear cell carcinoma, 2 cases of papillary renal cell carcinoma and 1 case of angiomyolipoma. All margins were negative. One month after operation, creatinine ranged from 66.0 to 90.4μmol/L, with an average of (76.8±8.3)μmol/L, which was not significantly different compared with that before operation ( P>0.05). One month after operation, GFR was 45.1-60.8 ml/min, and with an average of (55.5±4.7)ml/min, and there was no significant difference compared with preoperative data( P>0.05). Conclusions:For T 1aN 0M 0 stage and exophytic renal tumors, laparoscopic non-blocking partial nephrectomy assisted by lateral green laser is safe and effective.

Safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser photocoagulation for treatment of retinopathy of prematurity

Purpose: To evaluate the safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser for treatment of retinopathy of prematurity (ROP). Methods: This retrospective interventional case series included infants undergoing treatment for ROP with 532 nm green laser between January 2012 and March 2017 at a single tertiary-care referral center. Review of clinical records was done to identify baseline ROP characteristics, procedural difficulties, complications related to the laser procedure and outcome of treatment at ? 1 year of follow-up. Results: There are about 347 eyes of 182 infants were included in this present study. ROP presented in zone I in 76 eyes (21.9%) and zone II in 271 eyes (78.1%). Tunica vasculosa lentis (TVL) was present in 43.8% and pre-existing vitreous hemorrhage in 4.6% of the eyes. 532 nm green laser could be performed as a primary procedure in all eyes, including those with TVL. 322 eyes completed a minimum follow up of 1 year with a mean follow up of 22.8 months (range, 12–54 months). At the last follow-up visit, 298 (92.5%) of the 322 eyes had a favorable outcome. On logistic regression analysis, pre-existing fibrovascular proliferation (p = 0.04) and new-onset fibrovascular proliferation after treatment (p = 0.001) were the most significant independent predictors of poor outcome. Complications encountered were new-onset hemorrhage in 36 eyes (11.2%), anterior segment ischemia in two eyes (0.006%) and cataract in one eye (0.003%). Conclusion: 532 nm frequency-doubled Nd-YAG green laser appears to be safe and effective in the treatment of ROP.

"Point-line-surface" three steps method of straight light beam green laser vaporesection of the prostate for treatment of benign prostatic hyperplasia / 新乡医学院学报

Objeodve To discuss the safety and efficacy of " point-line-surface" three step method of straight light beam green laser photoselective vaporesection of the prostate(PVRP) for the treatment of benign prostatic hyperplasia(BPH).Methods The data of one hundred and twenty-six BPH patients who were treated with surgery in the First Affiliated Hospital of Xinxiang Medical University from May 2016 to August 2017 was analyzed retrospective.In all of the patients,69 cases were given "point-line-surface" three step method of straight light beam green laser PVRP(PVRP group),57 cases were given photoselective vaporization of the prostate (PVP group).Operation time,blood loss,postoperative washing time,indwelling catheter time,international prostate symptom score (IPSS),quality of life score (QOL),maximum urinary flow rate (Qmax) and postvoid residual urine (PVR) were compared between the two groups.Results The operation time in the PVRP group was shorter than that in the PVP group(P ＜ 0.05).There was no significant difference in the blood loss,postoperative washing time and indwelling catheter time between the PVRP group and PVP group(P ＜ 0.05).There was no significant difference in the IPSS,QOL,Qmax and PVR between the PVRP group and PVP group before operation (P ＜ 0.05).In the two groups,the IPSS,QOL and PVR were lower after operation than that before operation (P ＜ 0.05),while Qmax was higher after operation than that before operation(P ＜ 0.05).There was no significant difference in the IPSS,QOL,Qmax and PVR between the PVRP group and PVP group after operation(P ＜ 0.05).The rate of postoperative complications in the PVRP group and PVP group was 1.4％(1/69) and 1.8％ (1/57),respectively;there was no significant difference in the rate of postoperative complications between the PVRP group and PVP group (x2 =11.968,P ＜ 0.05).Conclusion " Point-line-surface" three steps of straight light of PVRP for treating BPH have simple steps and short operation time.It is a safe and ideal surgical method for BPH.

Comparison of the clinical effect between transurethral green laser enucleation of the prostate and transurethral resection of the prostate in the treatment of high-risk benign prostatic hyperplasia / 新乡医学院学报

Objective To compare the clinical effect and safety between transurethral green laser enucleation of the prostate and transurethral resection of the prostate (TURP) in the treatment of high-risk benign prostatic hyperplasia (BPH).Methods A total of 101 patients with high-risk BPH were selected from March 2014 to January 2016 in the Central Hospital of Xinxiang City.Among the patients,52 patients were treated with transurethral green laser enucleation of the prostate (green laser group),another 49 patients underwent TURP (TURP group).The operation time,intraoperative blood loss,the mass of resected prostate,bladder irrigation time,postoperative indwelling catheter time,postoperative hospitalization time,transurethral resection syndrome (TURS) and postoperative complications were compared between the two groups.The international prostate symptom scale (IPSS) score,quality of life (QOL) score,maximum urinary flow rate (Qmax) and postvoid residual (PVR) were compared between the two groups before and three months after operation.Results The operation time,bladder irrigation time,indwelling catheter time,postoperative hospitalization time of patients in green laser group were significant shorter than those in TURP group(P ＜ 0.05),the intraoperative blood loss in green laser group was significantly less than that in TURP group (P ＜ 0.05),and the mass of resected prostate in green laser group was significantly more than that in TURP group (P ＜ 0.05).There were no significant difference in the incidence of perioperative blood transfusion,TURS,urethral stricture,temporary urinary incontinence,postoperative infection,bladder neck contracture and retrograde ejaculation between the two groups (P ＞ 0.05).There was no significant difference in IPSS score,QOL score,Qmax and PVR between the two groups before operation (P ＞ 0.05).The IPSS score,QOL score and PVR at three months after operation were significantly lower than those before operation (P ＜ 0.05).The Qmax at three months after operation was significantly higher than that before operation (P ＜0.05).There was no significant difference in IPSS score,QOL score,Qmax and PVR between the two groups at three months after operation (P ＞ 0.05).Conclusion Transurethral green laser enucleation of the prostate and TURP for treating high-risk BPH can obtain good therapeutic effect.Transurethral green laser enucleation of the prostate in the treatment of high-risk BPH has the advantages of shorter operation time,less intraoperative bleeding,faster postoperative recovery and good safety.

Variables que influyen en el pronóstico de la cirugía fotovaporización prostática mediante láser verde en el tratamiento de hiperplasia prostática benigna (HBP), en el servicio de urología del Hospital Carlos Andrade Marín / Influential variables in the prognosis of prostate photovaporization surgery through green laser in the treatment of benign prostatic hyperplasia in the Urology Department of HCAM

Introducción: Determinar los factores de riesgo preoperatorios e intraoperatorios que influyen en el resultado final de la intervención con láser verde KTP en pacientes con Hiperplasia prostática benigna. Materiales y Métodos: Se realizó un estudio retrospectivo en una cohorte de 153 pacientes con diagnóstico de Hiperplasia Benigna de Próstata (HBP), sometidos a cirugía mediante láser verde KTP y realizada desde mayo 2010 a septiembre 2013 en el Hospital Carlos Andrade Marín. Analizamos variables preoperatorias como edad, volumen prostático medido por ecografía, peso prostático por tacto rectal, PSA, antecedentes urológicos, antecedentes patológicos personales y clasificación ASA; así como variables intraoperatorias: tiempo quirúrgico y complicaciones. Resultados: Éxito quirúrgico ocurrió en el 59% de la muestra. En el análisis bivariado y multivariado, tanto el volumen prostático medido por ecografía (≥ 40 cm3) y las complicaciones intraoperatorias fueron significativas. Discusión: La fotovaporización con láser verde es una técnica implementada en nuestro medio para el tratamiento de HBP. Es preciso estudiar múltiples variables para predecir el éxito o fracaso de la intervención quirúrgica. Palabras clave: laser verde, hiperplasia prostática benigna, fotovaporización.

Introduction: To determine preoperative and operative risk factors that may influence the final outcome of prostatic surgery using KTP green laser in patients with Benign Prostatic Hyperplasia. Methods: Retrospective study performed within cohort of patients with Benign Prostatic Hyperplasia who underwent surgery using KTP greenlight laser, conducted between May 2010 to September 2013, at Carlos Andrade Marín Hospital. Several pre-operative variables were analyzed, among them: age, ultrasound, prostatic volume, prostatic weight assessed by rectal examination, PSA, urological history, medical history and ASA classification; and also intraoperative variables like surgical time and surgical complications. Results: Successful outcome was seen in 59% of treated patients. In the bivariate and multivariate analysis prostatic volume measured with ultrasound and intraoperative complications achieved significance. Discusion: Green laser photovaporization is a technique already implemented in our country for the BPH treatment. Multiple variables should be analyzed in order to predict surgical outcome.

Clinical effect of PVBT combined with intraoperative Submucosal multi-point injection of gemcitabine for treating NMIBC / 国际外科学杂志

Objective The clinical effect and prognosis of greenlight photoselective laser vaporization combined with intraoperative submucosa multi-point injection of gemcitabin for the treatment of non muscle-invasive bladder tumors(NMIBC).Methods Selected 105 cases of NMIBC Confirmed by pathology from Mar.2012 to Nov.2013 in Guangzhou General Hosptial of Guangzhou Military Command of PLA urology.Put the patients into three groups randomly.Greenlight photoselective laser vaporization for bladder tumors (PVBT) combined with intraoperative submucosal injection of gemcitabine (PVBT group) 38 cases,Transurethral resection of bladder tumor(TURBT) combined with intraoperative submucosal injection of gemcitabine 25 cases (TURBT group),TURBT combined with immediate postoperative bladder perfusion chemotherapy (Control group)42 cases.Maintain the bladder perfusion chemotherapy after surgery,follow-up of 2 years.To compare and analysis the effect and the prognosis of three ways of operation method,And evaluate the quality of life of three groups of patients after treatment.Results The operation of 105 cases were successful,a total of 31 cases of recurrence,included PVBT group 7 cases (18.4％),TURBT group 6 cases (24％),contrlol group 18 cases (42.9％).Tumor progression of time were 12、10、6 month for the first time.The body function,psychological function,social function and material life of four dimensions scores have no obvious difference Three groups (P ＞ 0.05).Conclusions PVBT combined with intraoperative submucosal multi-point injection of gemcitabine is a kind of simple operation,and reduce the complications and the recurrence of the operation,especially suitable for the lateral wall of superficial tumor and intolerance to TURBT surgery for high-risk patients.It is a new better method of expansion clinical application.

A Case of Maculopathy from Handheld Green Laser Pointer

PURPOSE: To report a case of successfully treated maculopathy after exposure to a handheld green laser pointer beam. CASE SUMMARY: A-15-year-old patient visited our clinic complaining of visual disturbance in the left eye 5 days earlier after exposure to a handheld laser pointer with 532 nm wavelength green beam for 5 seconds. His best corrected visual acuity was 20/50 in the left eye. On fundus examination, a yellowish retinal scar was observed at the foveal area. The spectral domain optical coherence tomography (SD-OCT) showed cone outer segment tip line and inner segment/outer segment line disruption, external limiting membrane line and retinal pigment epithelial complex injury related to laser pointer exposure. We started occlusion therapy, oral prednisolone and, antioxidant treatment on his left eye for 2 weeks. The best corrected visual acuity was 20/20 in the left eye at 1 month after treatment. However, spectral domain optical coherence tomography showed a scar remained in the retinal pigment epithelial complex of the macular region of his left eye while the external limiting membrane line was restored and inner segment/outer segment line was partially restored. CONCLUSIONS: Maculopathy can result from exposure to a handheld green laser pointer. Occlusion therapy, oral prednisolone and, antioxidant treatment might be helpful for recovery of visual acuity and restoration of external limiting membrane line.

Short-term clinical evaluation of photoselective vaporization of the prostate for the patients with benign hyperplasia of prostate in anti-coagulanting status / 中华泌尿外科杂志

Objective To evaluate the safety and efficacy of the photoselective prostate vaporization (PVP) for the patients of benign hyperplasia of prostate (BPH) with oral anti-coagulant.Methods From September 2008 to May 2010,7 cases of BPH with oral anti-coagulant were treated by PVP,with an average age of 74 years.The prothrombin time before the surgery was (13.14 ± 0.15) s.An 100 W Green-light laser source was applied in this study.The prostate volume,operating time,blood loss,catheter indwelling time after the surgery,hospital stay,PVR,Q IPSS score were recorded.Results The mean operating time was (65 ± 22) min without active bleeding or transfusion in this cohort.The haemoglobulin concentration was intact and catheter indwelling time was (22 ± 8) h,while the hospital stay was (2.7 ± 1.2) d.The PVR,Q IPSS score were significantly improved after follow-up of 1 month (P ＜0.01).One case complicated acute urinary retention after operation in this cohort,and the catheter was removed 4 weeks after α-blocker administration.Conclusions PVP is a safe and effective surgical strategy for BPH patients with oral anti-coagulant.However,since there were relatively limited cases enrolled in this study,more randomized controlled clinical trials are needed in the near future.

Efficacy analysis of green laser treatment on 80 cases of non-invasive bladder cancer / 肿瘤研究与临床

Objective To evaluate the clinical curative effect of the non-muscle invasive bladder cancer by selective green laser.Methods 80 cases of non-muscle invasive bladder cancer clinical data were retrospective analysis who received selective green laser treatment.Results All operations were successful,surgery durations were 15-120 min.Patients had basically no intraoperative bleeding,no obturator nerve reflex,without severe complication such as electricity cut syndrome.Postoperative applied of pirarubicin bladder perfusion chemotherapy.All patients were followed-up for 3 months-1 year.No recurred tumor was observed.Conclusion Transurethral selective green laser treatment of non-muscle invasive bladder cancer should be efficient and curative treatment,no serious complications are observed.

The safety of simultaneous transurethral green laser vaporization therapy in benign prostatic hyperplasia and nonmuscle-invasive bladder transitional cell carcinoma / 中国医师进修杂志

Objective To evaluate the safety of simultaneous transurethral green laser vaporization therapy in benign prostatic hyperplasia (BPH) and nonmuscle-invasive bladder transitional cell carcinoma (NMIBT).Methods The clinical data of 27 patients (observation group) who had undergone simultaneous transurethral green laser vaporization therapy in BPH and NMIBT between May 2004 and October 2010 were analyzed retrospectively.Meanwhile 27 patients(control group) only had undergone green laser vaporization therapy in NMIBT during the same period were selected.Clinicopathologic parameters,rate of recurrence and progression,rate of recurrence in the bladder neck and prostatic urethra were determined and compared.Results The time of follow-up in observation group and control group were (28.61 ± 19.53) and (30.20 ± 21.46) months.The rates of recurrence,progression and recurrence in the bladder neck and prostatic urethra between observation group and control group had no significant differences [ 18.5％ (5/27) vs.25.9％ (7/27),3.7％ (1/27) vs.0,0 vs.0] (P ＞0.05).Conclusion Simultaneous transurethral green laser vaporization of NMIBT and BPH can be safely performed without increasing the risk of tumor recurrence in the prostatic urethra.

A Case of Green Laser Pointer Injury to the Macula

PURPOSE: We report a case of macular injury by accidental exposure to a green laser pointer. CASE SUMMARY: A 25-year-old man had an acute reduction of visual acuity in his right eye two years ago after accidental exposure to a green laser pointer for a few seconds. The patient's best corrected visual acuity was counting fingers in his right eye. Fundus examination and optical coherence tomography showed a macular hole and a linear retinal scar in his right eye. CONCLUSIONS: Green laser pointers may cause macular damage after exposure of just a few seconds, which can lead to irreversible reduction of visual acuity.

Laser Photocoagulation for Macular Edema in Branch Retinal Vein Occlusion

We observed 44 eyes of 43 patients who were diagnosed as macular edema in branch retinal vein occlusion(BRVO) by fluorescein angiogram, which had been followed up over 6 months after argon-green laser photocoagulation. In our cases, sixth decade of age was most commonly affected and there were no significant difference in sexual prevalence and laterality. Eighty six percent was 0.5 or less in initial visual acuity and 59.1% was 0.5 or more in final visual acuity. Increased visual acuity of 2 lines or more was 61.4% and decrease was only 9.1%. After laser treatment, visual improvements of each comparing group were as follow: 60.7% in superotemporal and 62.5% in inferotemporal, 56.5% in hypertensive patients and 66.7% in normotensive patients, 61.5% in below 6 months from onset of symptom until entry into laser photocoagulation and 61.1% in over 7 months, and there were no significant statistical difference.