Comparing thulium fiber versus high power holmium laser in bilateral same sitting retrograde intrarenal surgery for kidney stones: Results from a multicenter study.

Autor:	Chai CA; Division of Urology, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. chaichuann@yahoo.com., Inoue T; Department of Urology, Hara Genitourinary Private Hospital, Kobe University, Kobe, Japan., Somani BK; Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK., Yuen SKK; SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China., Ragoori D; Department of Urology, Asian Institute of Nephrology & Urology, Irram Manzil Colony, Hyderabad, India., Gadzhiev N; Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia., Tanidir Y; Department of Urology, School of Medicine, Marmara University, İstanbul, Türkiye., Emiliani E; Department of Urology, Fundacion Puigvert, Autónomos University of Barcelona, Barcelona, Spain., Hamri SB; Division of Urology, Department of Surgery, Ministry of the National Guard Health Affairs, King Saud Bin Abdulaziz University, Jeddah, Saudi Arabia., Lakmichi MA; Department of Urology, University Hospital Mohammed the VIth of Marrakesh, Marrakesh, Morocco., Chandramohan V; Department of Urology, Preeti Urology and Kidney Hospital, Hyderabad, India., Naselli A; IRCCS San Giuseppe Hospital, Multimedica, Milan, Italy., Soebhali B; Department of Urology, Abdul Wahab Sjahranie Hospital Medical Faculty, Muliawarman University, Samarinda, Indonesia., Gokce MI; Department of Urology, Ankara University School of Medicine, Ankara, Türkiye., Tursunkulov AN; Urology Division, AkfaMedline Hospital, Tashkent, Uzbekistan., de Fata Chillón FR; Department of Urology, Clinica Universidad de Navarra, Madrid, Spain., Chew BH; Department of Urology, University of British Columbia, Vancouver, Canada., Traxer O; Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy., Castellani D; Department of Urology, Sorbonne University, Tenon Hospital, AP-HP, Paris, France., Gauhar V; Department of Urology, Ng Teng Fong General Hospital, Singapore.
Jazyk:	angličtina
Zdroj:	Investigative and clinical urology [Investig Clin Urol] 2024 Sep; Vol. 65 (5), pp. 451-458.
DOI:	10.4111/icu.20240185
Abstrakt:	Purpose: Traditionally, bilateral urolithiasis treatment involved staged interventions due to safety concerns. Recent studies have shown that same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) is effective, with acceptable complication rates. However, there's no clear data on the optimum laser for the procedure. This study aimed to assess outcomes of SSB-RIRS comparing thulium fiber laser (TFL) and high-power holmium:yttrium-aluminum-garnet (Ho:YAG) laser in a multicenter real-world practice. Materials and Methods: Retrospective analysis was conducted on patients undergoing SSB-RIRS from January 2015 to June 2022 across 21 centers worldwide. Three months perioperative and postoperative outcomes were recorded, focusing on complications and stone-free rates (SFR). Results: A total of 733 patients were included, with 415 in group 1 (Ho:YAG) and 318 in group 2 (TFL). Both groups have similar demographic and stone characteristics. Group 1 had more incidence of symptomatic pain or hematuria (26.5% vs. 10.4%). Operation and lasing times were comparable. The use of baskets was higher in group 1 (47.2% vs. 18.9%, p<0.001). Postoperative complications and length of hospital stay were similar. Group 2 had a higher overall SFR. Multivariate regression analysis indicated that age, presence of stone at the lower pole, and stone diameter were associated with lower odds of being stone-free bilaterally, while TFL was associated with higher odds. Conclusions: Our study shows that urologists use both lasers equally for SSB-RIRS. Reintervention rates are low, safety profiles are comparable, and single-stage bilateral SFR may be better in certain cases. Bilateral lower pole and large-volume stones have higher chances of residual fragments. Competing Interests: The authors have nothing to disclose. (© The Korean Urological Association.)
Databáze:	MEDLINE
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