Dental Enamel ; surgery ; Dentin ; surgery ; Dentistry, Operative ; methods ; Humans ; In Vitro Techniques ; Laser Therapy ; methods

Retrograde intrarenal surgery (RIRS) is being performed for the surgical management of upper urinary tract pathology. With the development of surgical instruments with improved deflection mechanisms, visuality, and durability, the role of RIRS has expanded to the treatment of urinary calculi located in the upper urinary tract, which compensates for the shortcomings of shock wave lithotripsy and percutaneous nephrolithotomy. RIRS can be considered a conservative treatment of upper urinary tract urothelial cancer (UTUC) or for postoperative surveillance after radical treatment of UTUC under an intensive surveillance program. RIRS has a steep learning curve and various surgical techniques can be used. The choice of instruments during RIRS should be based on increased surgical efficiency, decreased complications, and improved cost-benefit ratio.
Carcinoma, Transitional Cell/surgery ; Humans ; Lithotripsy, Laser/methods ; Perioperative Care/methods ; Ureteroscopy/*methods/trends ; Urolithiasis/surgery ; Urologic Neoplasms/surgery

The search for a minimally invasive approach to the treatment of Lower Urinary Tract Symptoms (LUTS) suggestive of Benign Prostatic Hyperplasia (BPH) is probably as old as Transurethral Resection of the Prostate (TURP). In an effort to overcome the limitations and morbidities of TURP, and in light of evidence suggesting that medical treatment for BPH has a limited life-span, laser-based treatments have emerged during the last decade. Photoselective Vaporization of the Prostate (PVP) by the "GreenLight" KTP laser is considered one of the most promising options, one that is constantly evolving new technologies in prostate surgery. In this overview of KTP laser usage in BPH treatment, we will briefly discuss the evolution of this modality since it was first introduced and focus on the available evidence regarding safety, efficacy and cost parameters of its application.
Humans ; Laser Therapy/*methods/trends ; Male ; Prostate/pathology/*surgery ; Prostatic Hyperplasia/*surgery

Female ; Humans ; Laser Therapy ; methods ; Middle Aged ; Semicircular Canals ; surgery ; Vertigo ; etiology ; surgery

BACKGROUNDEndoscopic treatment for urethral stricture, including cold knife and laser, poses a major challenge to clinical practice. Both the benefits and drawbacks of these two treatments remain controversial. This article aimed to compare the efficacy and safety of laser and cold knife urethrotomy for urethral stricture.

METHODSWe searched PubMed (1966 - 2009), Embase (1980 - 2009), Cochrane Central Register of Controlled Trials (CCRCT, 2009 No.1) and Chinese Biomedical Literature Database (CBM) for laser and cold knife urethrotomy as treatment for male urethral stenosis, looking in the English literatures. Two reviewers independently screened the literatures and extracted information. Chi-square test was used for statistical analysis with SPSS15.0.

RESULTSA total of 44 articles, including of 3230 cases was retrieved. Success rate of patients treated with laser was 74.9% compared with 68.5% for cold knife, with very similar clinical results despite a statistically significant difference (P = 0.004). The trend in success rate at a different follow-up time was similar between the two groups. No significant difference in success rate was found between the groups of repeat operation for recurrence cases, first P = 0.090 and second P = 0.459. The shorter the stricture length was (< 1 cm), the higher the success rate was (P < 0.0001). No significant difference in success rate between the laser and cold knife groups was found in neither bulbar nor membranous urethra, bulbar P = 0.660 and membranous P = 0.477. The rates of urinary incontinence, urinary extravasation, and urinary tract infection showed no significant difference (P = 0.259, P = 0.938, P = 0.653, respectively).

CONCLUSIONSSuccess rates for laser and cold knife were very similar despite being statistically different, with the groups having a similar trend in success rates at different follow-up time. Stricture location and history of endoscopic intervention did impact treatment outcome but was not significantly different. The two groups showed no significant difference in major complications.

Endoscopy ; Humans ; Laser Therapy ; methods ; Male ; Treatment Outcome ; Urethra ; surgery ; Urethral Stricture ; surgery

Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.
*Catheter Ablation/methods ; Humans ; *Laser Therapy/methods ; Thyroid Nodule/*surgery/ultrasonography

BACKGROUNDIt is unclear whether a laser epithelial keratomileusis (LASEK) has any significant advantage over a photorefractive keratectomy (PRK) for correcting myopia. We undertook this meta-analysis of randomized controlled trials to examine possible differences in efficacy, accuracy, safety and side-effects between two methods, LASEK and PRK, for correcting myopia.

METHODSA systematic literature retrieval was conducted in the PubMed, EMBASE, Chinese Bio-medicine Database, and Cochrane Controlled Trials Register to identify potentially relevant randomized controlled trials. The statistical analysis was performed using a RevMan 4.2 software. The results included efficacy outcomes (proportion of eyes with uncorrected visual acuity (UCVA) > or = 20/20 at 1 month and 12 months post-treatment), accuracy outcomes (proportion of eyes within +/-0.50 diopters (D) of target refraction at 1 month and 12 months post-treatment), safety outcomes (loss of > or = 2 lines of best spectacle-corrected visual acuity (BSCVA) at > or = 6 months post-treatment), mean pain scores on day 1 post-treatment, and mean corneal haze scores at 6 and 12 months post-treatment.

RESULTSSeven articles describing a total of 604 eyes with myopia from 0 to -9.0 D were identified in this meta-analysis. The combined results showed that the efficacy and accuracy outcomes between the two groups at 1 month and 12 months post-treatment were comparable. No patient lost > or = 2 lines of BSCVA at > or = 6 months post-treatment in four relevant trials. Compared with PRK, LASEK did not relieve discomfort on day 1 post-treatment or reduce corneal haze intensity at 6 and 12 months post-treatment.

CONCLUSIONSAccording to the available data, LASEK does not appear to have any advantage over PRK for correcting myopia from 0 to -9.0 D. This meta-analysis focuses mainly on the comparison of the early, mid-term and mid-long term results of the two methods. Additional studies to compare the long-term (> one year) results should be considered.

Humans ; Keratomileusis, Laser In Situ ; methods ; Myopia ; surgery ; Photorefractive Keratectomy ; methods ; Randomized Controlled Trials as Topic

OBJECTIVE: To explore the effective method to treat the glottic carcinoma invading the anterior commissure, we observed the difference of three kinds of operation to the anterior commissure of dogs by semiconductor laser. METHOD: Twelve dogs were divided into 3 groups at random, A: to cauterize to the thyroid cartilage's inner membrane of the anterior commissure, the right ventricular bands and vocal cord, the anterior and 1/3 of the left vocal cord; B: to cauterize part of the thyroid cartilage of the anterior commissure besides A; C: to open a window about 5 mm x 5 mm on the thyroid cartilage of the anterior commissure besides B. To take photos to observe the dogs' laryngeal wound with digital camera or electrolaryngoscope immediately, 1 week and 4 weeks, then to record the hoarseness, body weight and complications etc. RESULT: All the dogs' laser surgery were completed successfully. To observe the gross specimen, it was identical between the extent of excising and the design preoperation. One week later, the neonatal membrane covered the wound incomplete. Edematization, inflammatory reaction, pseudomembrane and the hoarseness were not heavy too. No obvious complication in group A. The neonatal membrane covered the wound incomplete. Edema, inflammatory reaction, pseudomembrane and granulation can be seen in group B. Exudation was heavy in local, erosion and infected, the hoarseness was severe. No other obvious complications in C. Different extent of adhesion could be seen at the anterior commissure in group A, B and C after 4 weeks, the laryngeal web formed, and the length of vocal cord was shorter than before. The color and luster of anterior commissure membrane was normal basically, the inflammatory reaction was not heavy in A and B groups. The anterior commissural membrane appeared the dark red chronic inflammatory reaction; the window was closed by neonatal membrane completely and had no infection in group C. To observe the gross specimen: the wound of anterior commissure was covered by prosthetic epithelia completely in three groups. The window was closed by complete membrane at the anterior commissure. The No. 1- 3 dog's conditions of hoarseness in three groups after 4 weeks: slight in A group, little severe in B and C group. The change of weight was not obvious at the pre or postoperative in group A and B. No obvious complication happened in each group postoperation. CONCLUSION The three operative methods have satisfied effects,the recovery of wound can cure well finally and no severe complications happened. It is valuable in clinic.
Animals ; Arytenoid Cartilage ; surgery ; Dogs ; Larynx ; surgery ; Laser Therapy ; methods ; Lasers, Semiconductor ; Thyroid Cartilage ; surgery ; Vocal Cords ; surgery

OBJECTIVESTo observe the vaporesection efficiency of the 2 micron laser to the prostatic gland in benign prostatic hyperplasia, and investigate the method of estimating the amount of the vaporesected prostatic tissues during transurethral vaporesection of the prostate using the 2 micron laser system in the treatment of benign prostatic hyperplasia.

METHODSTotal 9 fresh prostatic gland specimens were obtained from patients with BPH under open surgical procedures, and vaporesected under a simulated transurethral environment with the 2 micron laser system immediately after weighted. Energies and time consumptions were noted, collections of vaporesected tissue specimens and the remnants of the prostatic glands were weighted after the procedures. The ratios of the vaporized tissues and the collected tissues to the whole vaporesected tissues were calculated respectively. The vaporesection efficiency of the 2 micron laser to the prostatic tissues was also calculated.

RESULTSAmong the total lost tissues, about (65.6 +/- 1.5) percent of which were that of vaporized, and nearly (34.5 +/- 1.5) percent were resected. Linear correlation between the weight of collected prostatic tissue(x) and the weight of prostatic gland specimens(y) could be defined as a formula of [y = 3.245x - 6.475 (t = 15.097, P = 0.000)].

CONCLUSIONThe amounts of the whole prostatic tissues removed by the 2 micron laser could be calculated from the collected resected prostatic specimens under a simulated transurethral surgical procedure.

Humans ; In Vitro Techniques ; Laser Therapy ; methods ; Lasers ; Male ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods

OBJECTIVETo evaluate the effect of transurethral holmium laser enucleation of the prostate (HoLEP) for prostate adenoma greater than 100 g.

METHODSSixty BPH patients with the prostate larger than 100 g were randomized to two treatment groups of HoLEP (n = 32) and open prostatectomy (n = 28). Comparisons were made between the two groups in operating time, blood loss, bladder irrigating time, catheterization time and hospital stay, as well as in the international prostate symptom score (IPSS), quality of life (QOL) score, maximum urinary flow rate (Qmax) and postvoid residual volume (PVR) before and 3 months after the surgery.

RESULTSCompared with the open prostatectomy group, the operating time was significantly longer (P < 0.01) but the blood loss, mean bladder irrigating time, catheterization time and hospital stay were significantly less in the HoLEP group (P < 0.01). Three-month follow-up revealed that HoLEP and open prostatectomy resulted in a similarly significant improvement in IPSS, QOL, Qmax and PVR (P < 0.01 ), with no statistical difference between the two groups (P > 0.05).

CONCLUSIONHoLEP and open prostatectomy are equally effective procedures for removal of large prostate adenomas, but the former is a better surgical option for prostate adenomas larger than 100 g for its greater safety, less pain and faster recovery.

Aged ; Holmium ; Humans ; Laser Therapy ; Male ; Prostate ; surgery ; Prostatectomy ; methods ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods ; Treatment Outcome