TY - JOUR
TI - Comparing the efficacy and safety of 365- and 550-μm laser fibers in semirigid ureteroscopic Ho:YAG lithotripsy
AU - Sfoungaristos, S.
AU - Gofrit, O.N.
AU - Katafigiotis, I.
AU - Pode, D.
AU - Landau, E.H.
AU - Yutkin, V.
AU - Constantinides, C.A.
AU - Duvdevani, M.
JO - International Urology and Nephrology
PY - 2015
VL - 47
TODO - 12
SP - 1947-1952
PB - SPRINGER NETHERLANDS
SN - 0301-1623
TODO - 10.1007/s11255-015-1130-x
TODO - adult;  Article;  clinical effectiveness;  cohort analysis;  female;  holmium laser;  human;  intraoperative period;  laser lithotripsy;  major clinical study;  male;  operation duration;  postoperative complication;  postoperative period;  preoperative period;  radiation energy;  safety;  semirigid ureteroscopy;  surgical technique;  ureter stone;  ureteroscope;  ureteroscopy;  vascular guide wire;  adverse effects;  aged;  comparative study;  devices;  laser lithotripsy;  middle aged;  pathology;  retrospective study;  solid state laser;  therapeutic use;  Ureteral Calculi, glass fiber, Adult;  Aged;  Female;  Humans;  Lasers, Solid-State;  Lithotripsy, Laser;  Male;  Middle Aged;  Operative Time;  Optical Fibers;  Retrospective Studies;  Ureteral Calculi;  Ureteroscopes
TODO - Purpose: To compare the efficacy and safety of 365- and 550-μm Ho:YAG laser fiber in semirigid ureteroscopic lithotripsy and to identify parameters that may affect laser energy and time during the procedure. Methods: A database of 111 patients who undergone a semirigid ureteroscopy (SRURS) for ureteral stone lithotripsy was analyzed. A 365-μm core fiber was used in 56 cases, and a multiple-uses 550-μm laser fiber was used in 55 cases. A standard 6.4 W protocol (8 Hz, 0.8 J/pulse) was used in all cases. The association between laser fiber diameter and several preoperative, intraoperative and postoperative parameters was evaluated. Results: Mean stone burden was 54.1 ± 39.1 mm2, and postoperative stone-free and complication rate was 100.0 and 16.2 %, respectively. The 550-μm laser fiber diameter was significantly associated with lower laser energy (p = 0.01), energy/mm3 (p = 0.031), number of pulses (p = 0.012), laser time (p = 0.012) and laser time/mm3 (p = 0.043), while it did not affect postoperative outcomes. The multivariate analysis showed that shorter procedure duration, smaller stone burden and the 550-μm laser fiber were all significant independent predictors for decreased laser energy consumption. Conclusion: The 550-μm laser fiber may decrease laser energy and time during SRURS lithotripsy with Ho:YAG laser compared to the 365 μm. Given its lower cost, it may represent the optimal choice for semirigid procedures. © 2015, Springer Science+Business Media Dordrecht.
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