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The effect of focus size and intensity on stone fragmentation in SWL on a piezoelectric lithotripter.
World Journal of Urology ( IF 2.8 ) Pub Date : 2020-01-10 , DOI: 10.1007/s00345-019-03069-y
Julian Veser 1 , Victoria Jahrreiss 1 , Christian Seitz 1 , Mehmet Özsoy 1, 2
Affiliation  

PURPOSE We aim to analyze the efficacy of different focus sizes and the influence of pulse pressure (intensity) during shock wave lithotripsy (SWL) in terms of stone fragmentation. METHODS Combination of three focal sizes (F1 = 2 mm, F2 = 4 mm, F3 = 8 mm) and 11 output pressure settings (intensity 10-20) of a piezoelectric lithotripter (Wolf PiezoLith 3000) were tested on artificial stones (n = 99). The stones were placed within a 2 mm mesh cage. The needed number of shockwaves (SW) to first visible crack, 50% and 100% stone disintegration were recorded. RESULTS Similar number of SW's were observed until the first crack 10, 11 and 11 SW's for F1, F2, and F3, respectively (p > 0,05). The median number of SW needed for 50% stone disintegration was 245 for F1 group, 242 for F2 group and 656 for F3 group. F1 vs F2 p = 0.7, F1 vs F3 and F2 vs F3 p < 0.05. Similarly, with larger focus size a higher number of shockwaves were necessary for 100% stone disintegration. 894, 877 and 1708 SW's for F1, F2 and F3, respectively. Only for F1 vs F3 and F2 vs F3 (all p < 0.05) a statistical difference was observed. These findings were consistent in all different power settings, with an increased difference in lower power levels (≤ 14). CONCLUSIONS A smaller focus size, as well as a higher peak pressure results in a more effective stone fragmentation. However, these results need to be confirmed in an in vivo setting with multiple parameters interfering the efficacy, like BMI, respiration or stone migration.

中文翻译:

聚焦大小和强度对压电碎石机SWL结石碎裂的影响。

目的我们旨在从结石碎裂角度分析冲击波碎石术(SWL)期间不同焦点尺寸的功效以及脉冲压力(强度)的影响。方法在人造石上测试了压电碎石机(Wolf PiezoLith 3000)的三种焦距大小(F1 = 2 mm,F2 = 4 mm,F3 = 8 mm)和11种输出压力设置(强度10-20)的组合(n = 99)。将结石放置在2毫米网孔笼中。记录到第一个可见裂纹,50%和100%的石材崩解所需的冲击波(SW)数量。结果观察到类似的SW数量,直到第一个裂纹F1,F2和F3的第10、11和11个SW为止(p> 0.05)。F1组崩解50%所需的SW的中位数是F1组245,F2组242和F3组656。F1 vs F2 p = 0.7,F1 vs F3和F2 vs F3 p <0.05。同样,对于较大的焦点,要使石头100%崩解,就需要更多数量的冲击波。F1,F2和F3分别为894、877和1708 SW。仅对于F1 vs F3和F2 vs F3(所有p <0.05),观察到统计学差异。这些发现在所有不同的功率设置下都是一致的,但较低功率水平的差异却越来越大(≤14)。结论较小的焦点尺寸以及较高的峰值压力会导致更有效的碎石。但是,这些结果需要在体内设置多个参数,这些参数会影响功效,例如BMI,呼吸作用或结石迁移。F2和F3分别。仅对于F1 vs F3和F2 vs F3(所有p <0.05),观察到统计学差异。这些发现在所有不同的功率设置下都是一致的,但较低功率水平的差异却越来越大(≤14)。结论较小的焦点尺寸以及较高的峰值压力会导致更有效的碎石。但是,这些结果需要在体内设置多个参数,这些参数会影响功效,例如BMI,呼吸作用或结石迁移。F2和F3分别。仅对于F1 vs F3和F2 vs F3(所有p <0.05),观察到统计学差异。这些发现在所有不同的功率设置下都是一致的,但较低功率水平的差异却越来越大(≤14)。结论较小的焦点尺寸以及较高的峰值压力会导致更有效的碎石。但是,这些结果需要在体内设置多个参数,这些参数会影响功效,例如BMI,呼吸作用或结石迁移。峰值压力越高,碎石效果越好。但是,这些结果需要在体内设置多个参数,这些参数会影响功效,例如BMI,呼吸作用或结石迁移。峰值压力越高,碎石效果越好。但是,这些结果需要在体内设置多个参数,这些参数会影响功效,例如BMI,呼吸作用或结石迁移。
更新日期:2020-01-11
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