| Autor: |
Sánchez-Puy A; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain.; Department of Surgery, Universistat Autònoma de Barcelona, 08193 Barcelona, Spain., Bravo-Balado A; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Diana P; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Baboudjian M; Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception Academic Hospital, 13005 Marseille, France., Piana A; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Girón I; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Kanashiro AK; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Angerri O; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Contreras P; Department of Urology, Hospital Alemán de Buenos Aires, Buenos Aires C1118 AAT, Argentina., Eisner BH; Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA., Balañà J; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Sánchez-Martín FM; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Millán F; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain., Palou J; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain.; Department of Surgery, Universistat Autònoma de Barcelona, 08193 Barcelona, Spain., Emiliani E; Department of Urology, Fundació Puigvert IUNA, 08017 Barcelona, Spain. |
| Abstrakt: |
(1) Background: New pulse modulation (PM) technologies in Holmium:YAG lasers are available for urinary stone treatment, but little is known about them. We aim to systematically evaluate the published evidence in terms of their lithotripsy performance. (2) Methods: A systematic electronic search was performed (MEDLINE, Scopus, and Cochrane databases). We included all relevant publications, including randomized controlled trials, non-randomized comparative and non-comparative studies, and in-vitro studies investigating Holmium:YAG lithotripsy performance employing any new PM. (3) Results: Initial search yielded 203 studies; 24 studies were included after selection: 15 in-vitro, 9 in-vivo. 10 In-vitro compared Moses with regular PM, 1 compared Quanta's, 1 Dornier MedTech's, 2 Moses with super Thulium Fiber Laser, and 1 compared Moses with Quanta PMs. Six out of seven comparative studies found a statistically significant difference in favor of new-generation PM technologies in terms of operative time and five out of six in fragmentation time; two studies evaluated retropulsion, both in favor of new-generation PM. There were no statistically significant differences regarding stone-free rate, lasing and operative time, and complications between Moses and regular PM when data were meta-analyzed. (4) Conclusions: Moses PM seems to have better lithotripsy performance than regular modes in in-vitro studies, but there are still some doubts about its in-vivo results. Little is known about the other PMs. Although some results favor Quanta PMs, further studies are needed. |
