The holmium:YAG laser lithotripsy-a non-invasive tool for removal of midsize stones of major salivary glands.
Holmium:YAG-laser
Incorporeal laser-assisted lithotripsy
Lithotripsy
Sialoendoscopy
Sialolithiasis
Journal
Lasers in medical science
ISSN: 1435-604X
Titre abrégé: Lasers Med Sci
Pays: England
ID NLM: 8611515
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
11
12
2019
accepted:
17
11
2020
pubmed:
22
11
2020
medline:
3
2
2022
entrez:
21
11
2020
Statut:
ppublish
Résumé
Incorporeal lithotripsy by using holmium:YAG laser has been recently successfully spread and used in the treatment of urolithiasis. Although this method is not as common in salivary gland surgery, it is also recommended for endoscopic treatment of sialolithiasis. In this study, we decided to analyse effectiveness of holmium:YAG laser method among patients with midsize stones as the treatment in this particular population is still not determined and remains in dispute. Thus, the primary aim of the study is a prospective, complex analysis of incorporeal holmium:YAG laser lithotripsy effectiveness and safety in patients suffering from sialolithiasis. The examined group consisted of 32 consecutive patients, 17 female (53%) and 15 male (47%). The average age was 42 (age range 22-70). In our series, sialoendoscopy with intraductal lithotripsy was performed in patients with wide range of stone's diameter (3 to 10 mm). The calculi were removed with foreign body forceps or retrieval basket, after stone fragmentation with holmium:YAG laser. The power of the laser during surgery was set at 2.5 to 3.5 W. One shot energy equalled 0.5-0.7 J with frequency of 5 Hz. The bivariate Pearson Correlation and a point-biserial correlation were used to analyse the data. Total success rate of holmium:YAG laser lithotripsy in this consecutive group was equal to 90% and efficacy in the group with excluded cases when endoscopic approach difficulties were experienced (stone not visible) reached 93%. The long-term follow-up revealed that in 26 patients (84%), complete recovery was achieved. Two patients developed Wharton's duct stenosis and one Stensen's duct orifice stenosis (9.5%), of whom one required reoperation. Two patients eventually underwent total excision of submandibular gland. Sialoendoscopy combined with incorporeal laser-assisted lithotripsy proved to be effective and safe method for treatment of sialothiasis with midsize stones (4-8 mm) in population of clinic. Even taking into account the prevalence of complications associated with holmium:YAG laser, it is still safer alternative compared to open surgery where there is a significant risk of the bleeding, wound infection or injury of the facial nerve.
Identifiants
pubmed: 33219871
doi: 10.1007/s10103-020-03201-0
pii: 10.1007/s10103-020-03201-0
doi:
Substances chimiques
Holmium
W1XX32SQN1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
163-169Informations de copyright
© 2020. Springer-Verlag London Ltd., part of Springer Nature.
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