平均パワーとパルス幅が78 W，250 μsおよび100 W，600 μsの2機種によるホルミウムレーザー前立腺核出術（HoLEP）の治療成績と核出効果の比較検討
前立腺肥大症に対する外科的治療として，波長2,100 nmのHo:YAGレーザーを用いたホルミウムレーザー前立腺核出術（HoLEP）は，標準術式である経尿道的前立腺切除術（TURP）の代替治療として普及しつつある．本術式は低侵襲的で，TUR症候群の発症率や周術期の出血が少なく，また術後のカテーテル留置期間が短いため，入院期間の短縮が期待できる．今回78 W（パルス幅250 μs）と100 W（パルス幅600 μs）の平均パワーの違いによる治療成績を検討した．...
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| Published in | 日本レーザー医学会誌 Vol. 38; no. 4; pp. 421 - 430 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
特定非営利活動法人 日本レーザー医学会
2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0288-6200 1881-1639 |
| DOI | 10.2530/jslsm.jslsm-38_0033 |
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| Abstract | 前立腺肥大症に対する外科的治療として，波長2,100 nmのHo:YAGレーザーを用いたホルミウムレーザー前立腺核出術（HoLEP）は，標準術式である経尿道的前立腺切除術（TURP）の代替治療として普及しつつある．本術式は低侵襲的で，TUR症候群の発症率や周術期の出血が少なく，また術後のカテーテル留置期間が短いため，入院期間の短縮が期待できる．今回78 W（パルス幅250 μs）と100 W（パルス幅600 μs）の平均パワーの違いによる治療成績を検討した． |
|---|---|
| AbstractList | 前立腺肥大症に対する外科的治療として，波長2,100 nmのHo:YAGレーザーを用いたホルミウムレーザー前立腺核出術（HoLEP）は，標準術式である経尿道的前立腺切除術（TURP）の代替治療として普及しつつある．本術式は低侵襲的で，TUR症候群の発症率や周術期の出血が少なく，また術後のカテーテル留置期間が短いため，入院期間の短縮が期待できる．今回78 W（パルス幅250 μs）と100 W（パルス幅600 μs）の平均パワーの違いによる治療成績を検討した． |
| Author | 宍戸, 俊英 林, 建二郎 相澤, 卓 |
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| Copyright | 2018 特定非営利活動法人 日本レーザー医学会 |
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| References | 25) G.M. Hale, M.R. Querry: Optical constants of water in the 200 nm to 200 μm wavelength region. Appl. Opt., 12: 555-563, 1973. 3) J.N. Cornu, S. Ahyai, A. Bachmann: A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur. Urol., Available online 25 June, 2014. 4) P.J. Gilling, K. Kennett, A.K. Das, D. Thompson, M.R. Fraundorfer: Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J. Endourol., 12: 457-459, 1998. 22) F. Endo, Y. Shiga, S. Minagawa, T. Iwabuchi, A. Fujisaki, M. Yashi, K. Hattori, O. Muraishi: Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology, 76: 1451-1455, 2010. 8) R. Naspro, A. Bachmann, P. Gilling, R. Kuntz, S. Madersbacher, F. Montorsi, O. Reich, C. Stief, I. Vavssori: A review of the recent evidence (2006-2008) for 532-nm photoselective laser vaporization and holmium laser enucleation of the prostate. Eur. Urol., 55(6): 1345-1357, 2009. 5) L.C.Wilson, P.J. Gilling, A. Williams, K.M. Kennet, C.M. Frampton, A.M. Westenberg, M.R. Fraundorfer: A randomized trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years. Eur. Urol., 50: 569-573, 2006. 15) 日本レーザー医学会安全教育委員会編：レーザー医療の基礎と安全，12-19，2016，アトムス 12) M. Khalil: Management of impacted proximal ureteral stone: extracorporeal shock wave lithotripsy versus ureteroscopy with holmium: YAG laser lithotripsy. Urol. Ann., 5: 88-92, 2013. 23) 部谷学，内園岳志，粟津邦男：基礎 レーザーと生体硬組織の相互作用．日レ医誌（JJSLSM），25: 323-331, 2005. 7) M.H. Elmansy, A. Kotb, M.M. Elhilali: Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of follow up. J. Urol., 186(5): 1972-1976, 2011. 26) T.R.W. Herrmann, T. Bach, F. Imkamp, A. Georgiou, M. Burchardt, M. Oelke, A.J. Gross: Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. GrossWorld J. Urol., 28:45-51, 2010. 20) J.C. Hwang, S.M. Park, J.B. Lee: Holmium Laser enucleation of the prostate for benign prostatic hyperplasia: effectiveness, safety, and overcoming of the learning curve. Korean J. Urol., 51: 619-624, 2010. 11) 石川隆太，設楽敏也，若田部陽司，久保星一，平山貴博，藤田哲夫，岩村正嗣，馬場志郎．HoLEP：エネルギーの違いにおける臨床成績の比較（78W vs 100W）. Jpn. J. Endourol. ESWL., 22: 136-141, 2011. 16) S.L. Jacques, G. Gofstein, R.S. Dingus: Laser-flash photography of laser-induced spallation in liquid media. Proc. SPIE., 1646: 284-294, 1992. 24) B. Choi, A.J. Welch: Analysis of thermal relaxation during laser irradiation of tissue. Lasers Surg. Med., 29: 351-359, 2001. 9) H.N. Shah, A.P. Mahajan, H.S. Sodha, S. Hegde, P.D. Mohile, M.B. Bansal: Prospective evaluation of the learning curve for holmium laser enucleation of the prostate. J. Urol., 177: 1468-1474, 2007. 1) W.K. Mebust, H.L. Holtgrewe, A.T. Cockett, P.C. Peters: Writing Committee, the American Urological Association. Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3,885 patients. J. Urol., 141: 243-247, 1989. 10) 設楽敏也，石川隆太，若田部陽司，久保星一，平山貴博，藤田哲夫，岩村正嗣，馬場志郎．ホルミウムレーザ前立腺核出術；使用エネルギー量からの検討．日レ医誌，32: 120-124, 2011. 13) H.P. Berlien, J. Gerhard: Applied Laser Medicine, 2003, Springer, Berlin. 2) S.W. Lee, J.B. Choi, K.S. Lee: Transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement: A quality and meta-analysis. Int. Neurourol. J., 17: 59-66, 2013. 17) 粟津邦男：赤外レーザーの医療応用最前線 レーザー研究，28: 291-297, 2000. 14) 荒井恒憲：生体におけるレーザー応用 Ⅲ．赤外レーザー照射による生体軟組織の蒸散機構．電学論C, 114: 522-528, 1994. 21) 若田部陽司，設楽敏也，石川隆太，久保星一，平山貴博，藤田哲夫，岩村定嗣，馬場志郎（Holmium Laser Enucleation of the Prostate）：術後尿道狭窄に対する手術手技の検討．Jpn. J. Endourol., 24: 147-151, 2011. 6) P.J. Gilling, L.C. Wilson, C.J. King, A.M. Westenberg, C.M. Frampton, M.R. Fraundorfer: Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int., 109: 408-411, 2011. 19) J. Bae, S.J. Oh, J.S. Paick: The learning curve for holmium laser enucleation of the prostate: a single-center experience. Korean J. Urol., 51: 688-693, 2010. 18) N. Seki, O. Mochida, N. Kinukawa, K. Sagiyama, S. Naito: Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J. Urol., 170: 1847-1850, 2003. |
| References_xml | – reference: 14) 荒井恒憲：生体におけるレーザー応用 Ⅲ．赤外レーザー照射による生体軟組織の蒸散機構．電学論C, 114: 522-528, 1994. – reference: 8) R. Naspro, A. Bachmann, P. Gilling, R. Kuntz, S. Madersbacher, F. Montorsi, O. Reich, C. Stief, I. Vavssori: A review of the recent evidence (2006-2008) for 532-nm photoselective laser vaporization and holmium laser enucleation of the prostate. Eur. Urol., 55(6): 1345-1357, 2009. – reference: 13) H.P. Berlien, J. Gerhard: Applied Laser Medicine, 2003, Springer, Berlin. – reference: 9) H.N. Shah, A.P. Mahajan, H.S. Sodha, S. Hegde, P.D. Mohile, M.B. Bansal: Prospective evaluation of the learning curve for holmium laser enucleation of the prostate. J. Urol., 177: 1468-1474, 2007. – reference: 15) 日本レーザー医学会安全教育委員会編：レーザー医療の基礎と安全，12-19，2016，アトムス． – reference: 10) 設楽敏也，石川隆太，若田部陽司，久保星一，平山貴博，藤田哲夫，岩村正嗣，馬場志郎．ホルミウムレーザ前立腺核出術；使用エネルギー量からの検討．日レ医誌，32: 120-124, 2011. – reference: 18) N. Seki, O. Mochida, N. Kinukawa, K. Sagiyama, S. Naito: Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J. Urol., 170: 1847-1850, 2003. – reference: 21) 若田部陽司，設楽敏也，石川隆太，久保星一，平山貴博，藤田哲夫，岩村定嗣，馬場志郎（Holmium Laser Enucleation of the Prostate）：術後尿道狭窄に対する手術手技の検討．Jpn. J. Endourol., 24: 147-151, 2011. – reference: 12) M. Khalil: Management of impacted proximal ureteral stone: extracorporeal shock wave lithotripsy versus ureteroscopy with holmium: YAG laser lithotripsy. Urol. Ann., 5: 88-92, 2013. – reference: 25) G.M. Hale, M.R. Querry: Optical constants of water in the 200 nm to 200 μm wavelength region. Appl. Opt., 12: 555-563, 1973. – reference: 4) P.J. Gilling, K. Kennett, A.K. Das, D. Thompson, M.R. Fraundorfer: Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J. Endourol., 12: 457-459, 1998. – reference: 22) F. Endo, Y. Shiga, S. Minagawa, T. Iwabuchi, A. Fujisaki, M. Yashi, K. Hattori, O. Muraishi: Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology, 76: 1451-1455, 2010. – reference: 1) W.K. Mebust, H.L. Holtgrewe, A.T. Cockett, P.C. Peters: Writing Committee, the American Urological Association. Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3,885 patients. J. Urol., 141: 243-247, 1989. – reference: 24) B. Choi, A.J. Welch: Analysis of thermal relaxation during laser irradiation of tissue. Lasers Surg. Med., 29: 351-359, 2001. – reference: 5) L.C.Wilson, P.J. Gilling, A. Williams, K.M. Kennet, C.M. Frampton, A.M. Westenberg, M.R. Fraundorfer: A randomized trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years. Eur. Urol., 50: 569-573, 2006. – reference: 20) J.C. Hwang, S.M. Park, J.B. Lee: Holmium Laser enucleation of the prostate for benign prostatic hyperplasia: effectiveness, safety, and overcoming of the learning curve. Korean J. Urol., 51: 619-624, 2010. – reference: 2) S.W. Lee, J.B. Choi, K.S. Lee: Transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement: A quality and meta-analysis. Int. Neurourol. J., 17: 59-66, 2013. – reference: 7) M.H. Elmansy, A. Kotb, M.M. Elhilali: Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of follow up. J. Urol., 186(5): 1972-1976, 2011. – reference: 19) J. Bae, S.J. Oh, J.S. Paick: The learning curve for holmium laser enucleation of the prostate: a single-center experience. Korean J. Urol., 51: 688-693, 2010. – reference: 23) 部谷学，内園岳志，粟津邦男：基礎 レーザーと生体硬組織の相互作用．日レ医誌（JJSLSM），25: 323-331, 2005. – reference: 6) P.J. Gilling, L.C. Wilson, C.J. King, A.M. Westenberg, C.M. Frampton, M.R. Fraundorfer: Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int., 109: 408-411, 2011. – reference: 11) 石川隆太，設楽敏也，若田部陽司，久保星一，平山貴博，藤田哲夫，岩村正嗣，馬場志郎．HoLEP：エネルギーの違いにおける臨床成績の比較（78W vs 100W）. Jpn. J. Endourol. ESWL., 22: 136-141, 2011. – reference: 3) J.N. Cornu, S. Ahyai, A. Bachmann: A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur. Urol., Available online 25 June, 2014. – reference: 17) 粟津邦男：赤外レーザーの医療応用最前線 レーザー研究，28: 291-297, 2000. – reference: 26) T.R.W. Herrmann, T. Bach, F. Imkamp, A. Georgiou, M. Burchardt, M. Oelke, A.J. Gross: Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. GrossWorld J. Urol., 28:45-51, 2010. – reference: 16) S.L. Jacques, G. Gofstein, R.S. Dingus: Laser-flash photography of laser-induced spallation in liquid media. Proc. SPIE., 1646: 284-294, 1992. |
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| SubjectTerms | Ho:YAGレーザー HoLEP パルス幅 前立腺肥大症 核出 |
| Title | 平均パワーとパルス幅が78 W，250 μsおよび100 W，600 μsの2機種によるホルミウムレーザー前立腺核出術（HoLEP）の治療成績と核出効果の比較検討 |
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