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首页> 外文会议>Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII >Hypospadias repair using laser tissue soldering (LTS): preliminary results of a prospective randomized study
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Hypospadias repair using laser tissue soldering (LTS): preliminary results of a prospective randomized study

机译：使用激光组织焊接（LTS）进行下丘脑修复：一项前瞻性随机研究的初步结果

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Abstract: Purpose: The purpose of this study was to evaluate laser tissue soldering using an 808 nm diode laser and wavelength- matched human albumin solder for urethral surgery in children. Methods: Currently, 30 boys, ages 3 months to 8 years were randomized to standard suturing (n equals 22) or 'sutureless' laser hypospadias repair (n equals 18). Laser soldering was performed with a human albumin solder doped with indocyanine green dye (2.5 mg/ml) using a laser power output of 0.5 W, pulse duration of 0.5 sec, and interval of 0.1 sec. Power density was approximately 16 W/cm$+2$/. In the laser group, sutures were used for tissue alignment only. At the time of surgery, neourethral and penile lengths, operative time for urethral repair, and number of sutures/throws were measured. Postoperatively, patients were examined for complications of wound healing, stricture, or fistula formation. Results: Mean age, severity of urethral defect, type of repair, and neourethra length were equivalent between the two groups. Operative time was significantly faster for laser soldering in both simple (1.6 plus or minus 0.21 min, p less than 0.001) and complex (5.4 plus or minus 0.28 min, p less than 0.0001) hypospadias repairs compared to controls (10.6 plus or minus 1.4 min and 27.8 plus or minus 2.9 min, respectively). The mean number of sutures used in the laser group for simple and complex repairs (3.3 plus or minus 0.3 and 8.1 plus or minus 0.64, respectively) were significantly (p less than 0.0001) less than for controls (8.2 plus or minus 0.84 and 20 plus or minus 2.3, respectively). Followup was between 3 months and 14 months. The overall complication rate in the laser group (11%) was lower than the controls (23%). However, statistical significance (p less than 0.05) was achieved only for the subgroup of patients undergoing simple repairs (LTS, 100% success versus suturing, 69% success). Conclusions: These preliminary results indicate that laser tissue soldering for hypospadias repair may be performed in a nearly sutureless fashion and in a more rapid manner than for conventional suturing. The trend towards a decreased rate of complications in the laser group at this time indicates that laser soldering may be an improved method of tissue closure for hypospadias repair. We continue to accrue patients to this study. !8
机译：摘要：目的：本研究的目的是评估使用808 nm二极管激光器和波长匹配的人白蛋白焊料对儿童进行尿道手术的激光组织焊接。方法：目前，将30名年龄在3个月至8岁的男孩随机分组进行标准缝合（n等于22）或“无缝线”激光尿道下裂修补术（n等于18）。使用掺杂有吲哚菁绿色染料（2.5 mg / ml）的人白蛋白焊料进行激光焊接，使用的激光功率输出为0.5 W，脉冲持续时间为0.5秒，间隔为0.1秒。功率密度约为16 W / cm $ + 2 $ /。在激光组中，缝合线仅用于组织对准。在手术时，测量新尿道和阴茎的长度，尿道修复的手术时间以及缝合线/投掷的次数。术后检查患者伤口愈合，狭窄或瘘管形成的并发症。结果：两组的平均年龄，尿道缺损的严重程度，修复类型和新尿道长度相等。与对照（10.6 +/- 1.4）相比，简单（1.6 +/- 0.21 min，p小于0.001）和复杂（5.4 +/- 0.28 min，p小于0.0001）的尿道下裂修复的手术时间明显更快。分钟和27.8正负2.9分钟）。激光组用于简单和复杂修复的平均缝合线数量（分别为3.3正负0.3和8.1正负0.64）比对照组（8.2正负0.84和20）显着减少（p小于0.0001）。加号或减号2.3）。随访时间为3个月至14个月。激光组的总并发症发生率（11％）低于对照组（23％）。然而，仅进行简单修复的患者亚组（LTS，成功率100％vs缝合，成功率69％）才达到统计学显着性（p小于0.05）。结论：这些初步结果表明，与常规缝合相比，激光组织焊接可用于缝合尿道下裂的修复几乎以无缝合的方式进行，且速度更快。此时，激光组的并发症发生率降低的趋势表明，激光焊接可能是改善尿道下裂修复的组织闭合方法。我们继续使患者参与这项研究。 ！8

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