Τίτλος:
Comparing the efficacy and safety of 365- and 550-μm laser fibers in semirigid ureteroscopic Ho:YAG lithotripsy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Sfoungaristos, S.
Gofrit, O.N.
Katafigiotis, I.
Pode, D.
Landau, E.H.
Yutkin, V.
Constantinides, C.A.
Duvdevani, M.
Περιοδικό:
International Urology and Nephrology
Εκδότης:
SPRINGER NETHERLANDS
Λέξεις-κλειδιά:
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
DOI:
10.1007/s11255-015-1130-x
