Comparing outcomes of thulium fiber laser versus high-power Holmium:YAG laser lithotripsy in pediatric patients managed with RIRS for kidney stones. A multicenter retrospective study.
Autor: | Candela L; Unit of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Hospital, Milan, Italy - candela.luigi@hsr.it.; Hôpital Tenon AP-HP, Sorbonne University, Paris, France - candela.luigi@hsr.it., Solano C; Hôpital Tenon AP-HP, Sorbonne University, Paris, France., Castellani D; Unit of Urology, Azienda Ospedaliero Universitaria delle Marche, Marche Polytechnic University, Ancona, Italy., Teoh JY; S.H. Ho Urology Center, The Chinese University of Hong Kong (CUHK), Hong Kong, China., Tanidir Y; Unit of Urology, Marmara University Pendik Research and Education Hospital, Istanbul, Türkiye., Fong KY; National University Hospital (NUH), Singapore, Singapore., Vaddi C; Preeti Urology and Kidney Hospital, Telangana, India., Mani Sinha M; University Hospital Southampton NHS Foundation Trust, Southampton, UK., Ragoori D; Asian Institute of NephroUrology, Hyderabad, India., Somani BK; University Hospital Southampton NHS Foundation Trust, Southampton, UK., Traxer O; Hôpital Tenon AP-HP, Sorbonne University, Paris, France., Gauhar V; Division of Urology, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore. |
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Jazyk: | angličtina |
Zdroj: | Minerva pediatrics [Minerva Pediatr (Torino)] 2023 Oct 31. Date of Electronic Publication: 2023 Oct 31. |
DOI: | 10.23736/S2724-5276.23.07392-5 |
Abstrakt: | Background: The aim of this study was to evaluate thulium fiber laser (TFL) safety and efficacy compared to high-power (HP) Holmium:YAG laser in pediatric patients who have undergone retrograde intrarenal surgery (RIRS) for kidney stones. Methods: We retrospectively reviewed data from pediatric patients who underwent RIRS for kidney stones between 2018 and 2020. Complications were assessed 4-6 weeks postoperatively. Stone-free (SF) was defined as the absence of visible fragments or as the presence of a single residual fragment ≤2 mm at 3 months postoperative imaging. Student's t-test for continuous variables, and χ 2 and Fisher's Exact Test for categorical variables were used to compare outcomes between patients treated with HP Holmium:YAG (group 1) and TFL (group 2). Univariate (UVA) and multivariate (MVA) logistic regression analyses were performed to predict SF-associated factors. Results: Data from 126 pediatric patients were analyzed, 97 in group 1 and 29 in group 2. Preoperative characteristics were similar between cohorts. No major complication occurred in both groups. Group 2 had a shorter operative time (mean time 49.5 vs. 64.3 min, P=0.024). SF rate was 81.4% and 89.7% (P=0.45) and reintervention rate was 14.4% and 6.89% (P=0.046) in group 1 and 2, respectively. At UVA and MVA, the type of laser did not influence SF rate. However, prestenting and single stones were positively associated with SR rate. Conclusions: Both laser technologies are safe and effective and showed similar SF rates. TFL showed less operative time and lower re-intervention rate compared to HP Holmium:YAG. Further prospective studies are needed to corroborate our findings. |
Databáze: | MEDLINE |
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