经尿道激光前列腺切除术200例报告

１９８８年８月至１９９３年５月，对２００例前列腺增生症经尿道行Ｎｄ：ＹＡＧ激光手术切除术。术后１６５例随访６个月～４年６个月，显效１２８例占７７．６％，改善３２例占１９．４％，总有效率９７％。该法是治疗前列腺增生症的有效术式，具有适应证宽、安全、可靠之优点。前列腺癌不宜接受此项治疗。     

前列腺组织间质内激光凝固治疗前列腺增生症76例报告

１９９３年１１月～１９９５年７月对７６例良性前列腺增生（ＢＰＨ）病人进行间质组织内激光凝固治疗，随访６～１８个月，症状和ＭＦＲ改善达７０％，效果满意。结果认为：本方法简单、安全，尤其适合于高危的病人，治疗效果与手术者的经验和插入前列腺侧叶的点数有关。     

经尿道绿激光瘢痕汽化术治疗良性前列腺增生术后后尿道狭窄

目的研究采用绿激光在膀胱尿道软镜配合下治疗前列腺增生术后后尿道狭窄的临床疗效。方法使用绿激光对前列腺增生术后后尿道狭窄的患者18例进行经尿道绿激光瘢痕汽化术,所有患者术前经膀胱尿道软镜检查确诊。其中前列腺摘除术后10例,经尿道前列腺电切术后8例。术后留置尿管1周至1个月。结果 18例患者手术均一次性成功,手术时间25～90min,平均67min,随访2～8个月,15例患者术后即治愈,其余3例患者经多次定期尿道扩张后4～8个月内治愈,无尿失禁患者出现。结论绿激光治疗前列腺增生术后后尿道狭窄安全有效。     

经尿道前列腺激光切除术后的随访观察

经尿道前列腺激光切除术后的随访观察符庆吉刘洪礼刘悦郑洪柱王越为观察经尿道前列腺激光切除术（ＴＵＬＰ）的治疗效果，我们对１９９３年４～１２月ＴＵＬＰ术后的５８例病人进行了随访观察，平均随访时间２年６个月，效果满意者５６例，占９６６％。临床资料本组５８...     

经尿道接触式激光治疗前列腺增生216例报告

目的：探讨接触式激光治疗前列腺增生症（ＢＰＨ）的有效性。方法：１９９５年７月～１９９８年７月采用ＮＤ：ＹＡＧ接触式激光治疗ＢＰＨ２１６例。激光输出功率５０Ｗ,治疗时间５～１５ｍｉｎ。结果：随访３个月～３年,２０１例一次治疗成功,１３全钎２次激光治疗,２例改行开放性手术治愈。结论：激光手术虽然不能取代开放性手术,但其具有适应证宽、安全性高、易于掌握、患者痛苦小等优点,近期疗效肯定,易被老年患者接受。     

射频治疗前列腺增生症并发晕厥5例报告

１９９３年３月至１９９６年１月，我院经尿道射频热疗治疗老年前列腺增生５１２例，其中并发晕厥５例，报告如下。临床资料本组５例，年龄６１～７８岁，平均６７岁。病程３～２０年，平均７．２年。５例均有排尿困难，夜尿次数增多等症状，其中４例伴有较重的紧张、恐惧...     

原发性前列腺移行细胞癌五例报告

自１９８９～１９９４年共收治原发性前列腺移行上皮细胞癌（ＰＴＣＣ）５例，占同期前列腺恶性肿瘤的７％（５／７２），报告如下。临床资料本组５例。年龄６４～８０岁，平均７０岁。病程：４例为３个月～１年，平均７个月；１例４年，入院时已有肺及全身骨转移。临床表...     

Nd：YAG非接触式激光治疗前列腺增生：附32例报告

Ｎｄ：ＹＡＧ非接触式激光治疗前列腺增生（附３２例报告）孙颖浩，钱松溪，许传亮，马永江自１９９４年１１月～１９９５年４月应用Ｎｄ：ＹＡＧ非接触式激光机经尿道治疗前列腺增生症（ＢＰＨ）３２例，对经治病人术后尿流动力学改善、激光作用前列腺组织的病理改变、激...     

电化学治疗前列腺增生症的体外实验及临床研究

目的探讨经尿道电化学治疗前列腺增生的作用机制及临床疗效。方法自１９９７年１０月～１９９８年５月,应用前列腺电解治疗仪对离体前列腺组织行体外实验,临床治疗前列腺增生患者１９例。结果体外研究显示,经尿道电解治疗可使尿道周围０．７～０．９ｃｍ范围内组织发生不可逆性坏死、变性;１９例前列腺增生伴尿潴留患者接受了３００～４００库仑电量的治疗,总有效率７４％。结论经尿道电化学治疗前列腺增生操作简单,无需麻醉,耐受性好,安全有效,尤其适合于不宜手术治疗的患者。     

耻骨上经膀胱前列腺摘除术后尿失禁

１９８８年８月～１９９２年８月行耻骨上经膀胱前列腺摘除术２２０例，其中２０例（９．１％）术后早期出现尿失禁症状，１４例随访半年后症状消失，６例（２．７％）仍有持续性尿失禁。前列腺术后尿失禁的发生与术前合并尿路感染、膀胱结石、合并有神经系统疾病以及前列腺过大或过小有关。通过２０例患者的尿流动力学检查，认为尿流动力学对前列腺术后尿失禁的诊断、分型、预测预后和治疗方案的制定有很大帮助。     

The contact Nd:YAG laser system in the treatment of bladder cancer: a preliminary report in 48 patients

A synthetic contact sapphire endoprobe attached to the quartz fiber of a neodymium:yttrium aluminum garnet (Nd:YAG) laser had been used in the transurethral treatment of bladder tumors. A total of 68 operations have been carried out in 48 patients. The contact probe was placed directly into the tumor under direct vision. Using 15-20 watts of laser energy, the tumor blanched and underwent necrosis. The technique was easy to apply, and bleeding was minimal. Damage to the ureteral orifice and ureter in the bladder wall at repeat cystoscopy appeared less than with conventional electrocautery or noncontact laser treatment. The technique of contact Nd:YAG laser surgery will have an important role in the transurethral treatment of bladder tumors.     

Laser recanalization of pyloric stenosis: a guidewire-directed contact probe technique

A variety of techniques has been used to relieve the obstructive symptoms of pyloric stenosis. Endoscopic dilatation using hydrostatic balloon dilators, multiple-diameter bougies, and electrocautery with a sphincterotome have been described. The neodymium yttrium aluminum garnet laser also has been used, with both noncontact and contact probes. We describe a new technique using a guidewire-directed contact probe for laser recanalization of pyloric stenosis in a patient with radiation-induced gastric outlet obstruction.     

The contact neodymium-yttrium aluminum garnet laser. A new approach to arthroscopic laser surgery

Arthroscopic treatment of meniscal lesions has been modified as technological advances have occurred. However, alternatives to conventional arthroscopic cutting tools, including electrocautery and CO2 lasers, have thus far met with limited success. The recent development of a sapphire tip has enabled the use of the neodymium-yttrium aluminum garnet (Nd-YAG) laser in a contact mode in a saline medium. This study compares the biology of the Nd-YAG laser to that of electrocautery and scalpel techniques with respect to its effects on articular cartilage and the meniscus. The contact Nd-YAG laser has advantages over both scalpel and electrocautery with regard to its effects on articular cartilage. It also has significant biologic advantages over electrocautery for meniscal lesions. Although in its infancy in the clinical setting, the contact Nd-YAG laser represents the possible beginning of a new era for application of laser energy in arthroscopy.     

Lasers in the treatment of benign prostatic hyperplasia: an update

PURPOSE OF REVIEW: Few of the original laser-based procedures from the early 1990s have withstood the test of time while some, such as holmium laser prostatectomy, have been significantly modified. New additions to the fold, such as the high-powered potassium-titanyl-phosphate (KTP) laser, use old techniques and disposables but a higher level of energy than previously. In the 12 months since September 2003, a number of important articles have appeared concerning laser prostatectomy, the subject of this review. RECENT FINDINGS: Holmium laser enucleation of the prostate has been shown to result in greater relief of bladder outflow obstruction than transurethral resection of the prostate, which is a first for an endoscopic procedure. Durability beyond 4 years has also been confirmed. Concerns regarding the histology of the retrieved tissue and the learning curve have been clarified. Early results for 'photoselective' (KTP) vaporization of the prostate have been published confirming the lack of short-term morbidity. Its use on an outpatient basis has been tested in a small number of patients, and canine studies have confirmed less bleeding than with transurethral resection but inferior efficiency. Interstitial laser coagulation has been reviewed unfavourably and the results with contact laser vaporization have been variable. SUMMARY: New studies of holmium laser enucleation have confirmed its efficacy and durability, though training and company support remain problematic and its acceptance has been slow. The KTP laser is beginning to accumulate some support in the literature though its 'honeymoon phase' is still in evidence. Randomized studies are needed. Interstitial laser coagulation and contact laser vaporization appear to be in decline.     

接触式激光治疗尿道狭窄（附23例报告）

１９９３年１２月～１９９５年８月，应用ＳＬＴ接触式激光（Ｎｂ：ＹＡＧ）治疗仪治疗尿道狭窄２３例，随访１４例排尿良好，９例狭窄复发，复发率３９．１％。接触式激光治疗尿道狭窄方法简便、安全有效、无痛苦、无出血，复发率低。     

Contact neodymium:YAG laser surgery in gastroenterology: a preliminary report

Fifty-four patients have been successfully endoscopically treated without complications using contact neodymium:YAG laser probes (endoprobes) for tumors and bleeding and, during open surgery (laser scalpel), for liver and pancreatic resections. The contact probes made from a synthetic sapphire crystal with its optical properties, geometric design, and thermal conductivity have proven to be more effective than the current conventional noncontact method of delivering laser energy through a quartz fiber. Advantages include greater precision, sterilizability, avoidance of the tip melting, and a requirement for lower neodymium:YAG laser energy with reduced tissue damage. The configuration of the probes allows coagulation, cutting, or vaporization, depending on the clinical condition being treated.     

Contact neodymium: YAG laser surgery in gastroenterology

Summary Eighty-eight patients have been successfully treated endoscopically without complications using contact neodymium yttrium aluminum garnet: (YAG) laser probes (endoprobes) for tumors and bleeding and during open surgery (laser scalpel) to perform hepatic and pancreatic resections. The contact probes, made from a synthetic sapphire crystal with its optical properties, geometric design, thermal conductivity, and high melting temperature (2030 °C), have proven to be more effective than the current conventional noncontact method of delivering laser energy through a quartz fiber. Advantages include greater precision, sterility, avoidance of the tip melting, and lower neodymium: YAG laser energy required, resulting in reduced tissue damage. The configuration of the probes allows coagulation, cutting, or vaporization, depending on the clinical condition being treated.     

接触与非接触式激光经尿道前列腺切除术(附51例报告)

为探讨并发症少、死亡率低的治疗前列腺增生症（BPH）的更有效方法，采用接触与非接触式激光联合治疗BPH51例。术中先以接触式激光将5、7点间腺体切除，再以非接触式侧射探头高功率（60W）照射树叶腺体致组织塌陷，扩大排尿通道。11例腺体较大、组织炭化重者加用经尿道前列腺切除术（TURP）。结果51例中，48例成功，3例因腺体≥80ml改行开放手术。术后随访1～12个月，平均6.6个月，平均最大尿流率17．2±4．4ml／s，IPSS平均递减8.5分。认为接触与非接触式激光联合经尿道前列腺切除术安全有效，适用于具有前列腺增生梗阻、刺激症状重的高危患者，腺体较大及中叶凸向膀胱2cm者，单独使用激光效果不佳，可在激光气化、凝固腺体基础上酌加TURP。腺体≥80ml或中叶凸向膀胱＞3cm者，不适宜腔内治疗。     

Contact neodymium: YAG laser surgery in gastroenterology

Eighty-eight patients have been successfully treated endoscopically without complications using contact neodymium yttrium aluminum garnet: (YAG) laser probes (endoprobes) for tumors and bleeding and during open surgery (laser scalpel) to perform hepatic and pancreatic resections. The contact probes, made from a synthetic sapphire crystal with its optical properties, geometric design, thermal conductivity, and high melting temperature (2030 degrees C), have proven to be more effective than the current conventional non-contact method of delivering laser energy through a quartz fiber. Advantages include greater precision, sterility, avoidance of the tip melting, and lower neodymium: YAG laser energy required, resulting in reduced tissue damage. The configuration of the probes allows coagulation, cutting, or vaporization, depending on the clinical condition being treated.     

Endovenous laser ablation of varicose veins

Readily available non-invasive diagnostic tests now allow physicians to accurately map out abnormal venous pathways and identify all sources of reflux. Minimally invasive alternatives to surgical removal of incompetent truncal veins have been developed with impressive RESULTS: Endovenous laser treatment can be performed in the office under local anesthesia and is associated with virtually no recovery period. Better understanding of the primary mechanism of energy transfer by direct contact between the laser fiber tip and vein wall has underscored the importance of vein emptying. Improved utilization of tumescent anesthesia has helped facilitate circumferential laser fiber to vein wall contact and virtually eliminated the incidence of heat-related complications. Further refinements in the technique and optimization of laser energy parameters have improved success rates of vein closure from 90% to nearly 100%. Compared to surgery, endovenous laser has also demonstrated lower rates of recurrence largely due to the absence of neovascularity. This review of endovenous laser treatment should validate this exciting technique as a scientifically acceptable option for eliminating truncal vein reflux. If measured by patient acceptance and satisfaction, endovenous laser and other minimally invasive methods have already supplanted traditional surgery as the treatment of choice for superficial venous insufficiency.