Optimal stone density for ablation lithotripsy with vapor tunnel Ho:YAG pulse modality.

Autor: Rico L; Department of Urology, Hospital Aleman, Buenos Aires, Argentina. luisrico_01@hotmail.com., Blas L; Department of Urology, Hospital Aleman, Buenos Aires, Argentina., Ramos LB; Department of Urology, Hospital Aleman, Buenos Aires, Argentina., Pizzarello J; Department of Urology, Hospital Aleman, Buenos Aires, Argentina., Ameri C; Department of Urology, Hospital Aleman, Buenos Aires, Argentina., Contreras P; Department of Urology, Hospital Aleman, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: International urology and nephrology [Int Urol Nephrol] 2024 Nov 19. Date of Electronic Publication: 2024 Nov 19.
DOI: 10.1007/s11255-024-04289-x
Abstrakt: Introduction: Vapor-Tunnel™ (VT) consists of a very long pulse that uses the minimum peak power, causing the energy to pass through a previously created vapor channel or tunnel. There are studies that have shown acceptable ablation lithotripsy efficiency. Nevertheless, there are no in-vivo studies that have compared the VT performance according to the stone density.
Methods: A retrospective study of 152 patients who underwent RIRS using VT Ho:YAG laser was performed. We divided the patients according to the stone density (Group 1: < 1000UH vs. Group 2: > 1000UH). We assessed the lithotripsy efficiency (mm 3 /JJ) and the laser-energy consumption (JJ/mm 3 ). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4 weeks after the procedure.
Results: Ninety three patients were included in Group 1 and 59 in Group 2. Body mass index was higher in Group 1 and the median stone volume was higher in Group 2 (846 vs. 672 mm 3 , p = 0.03). Total energy used (11.9 vs. 24 kj, p < 0.001), the laser emission time (19 vs. 30 min, p < 0.001), and the total operative time (60 vs. 85 min, p < 0.001) were lower in the Group 1. SFR was higher in Group 1 (96.7% vs. 57.6%, p < 0.001) with a global SFR of 81.6%. The ablation lithotripsy efficiency was higher in Group 1 (0.053 mm 3 /JJ vs. 0.035 mm 3 /JJ, p < 0.001).
Conclusions: VT Ho:YAG was associated with decreased laser time, operative time and laser-energy consumption in Group 1 than Group 2. Similarly, VT Ho:YAG increased lithotripsy efficiency and the SFR compared to hard stones with the same laser settings and pulse modality.
Competing Interests: Declarations Conflict of interest Luis Rico certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: The authors have no conflicts of interest to declare.
(© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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