Navigating urolithiasis treatment: assessing the practicality and performance of thulium fiber laser, holmium YAG, and thulium YAG in real-world scenarios

被引:2
|
作者
Solano, Catalina [1 ,2 ]
Corrales, Mariela [1 ]
Panthier, Frederic [1 ]
Candela, Luigi [1 ,3 ]
Doizi, Steeve [1 ]
Traxer, Olivier [1 ,4 ]
机构
[1] Sorbonne Univ, Hop Tenon, Grp Rech Clin Lithiase Urinaire, GRC n20, F-75020 Paris, France
[2] Uroclin SAS, Dept Endourol, Medellin, Colombia
[3] IRCCS Osped San Raffaele, Div Expt Oncol, Unit Urol, URI Urol Res Inst, Milan, Italy
[4] Sorbonne Univ, Hop Tenon, Assistance Publ Hop Paris, Serv Urol, 4 Rue Chine, F-75020 Paris, France
关键词
Thulium fiber laser; Holmium laser; Thulium YAG; Laser; Kidney stones; Ureteral stones; Lithotripsy; PERCUTANEOUS NEPHROLITHOTOMY; MOSES TECHNOLOGY; LITHOTRIPSY; STONES;
D O I
10.1007/s00345-023-04487-9
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
BackgroundThe management of urolithiasis has undergone significant advancements with the introduction of pulsed lasers, particularly the holmium:yttrium-aluminum-garnet (Ho:YAG) laser, which is currently considered the gold standard in endourology. However, the Ho:YAG laser has certain limitations, such as the inability to support small laser fibers (150 & mu;m) and the requirement of a heavy water cooling system, making it challenging to transfer between operating rooms. These limitations have led to the emergence of new laser technologies, including the thulium fiber laser (TFL) and the thulium:yttrium-aluminum-garnet laser (Tm:YAG), as potential alternatives to the Ho:YAG laser.MethodsIn this review, we aimed to evaluate the effectiveness and safety of TFL, Ho:YAG, and Tm:YAG lasers in real-life scenarios by comparing clinical trial data with laboratory findings. A literature review was conducted, and relevant in vitro studies and clinical trials until March 2023 were analyzed.ResultsThe findings indicate that TFL has demonstrated high ablation efficiency for stones of any composition, size, and location, superior the capabilities of Ho:YAG lasers. TFL has shown superior dusting and fragmentation abilities, lower retropulsion, and increased patient safety. The laser parameters, such as ablation efficiency, speed, operative time, dust quality, retropulsion, visibility, temperature safety, and stone-free rate, were compared between laboratory studies and clinical outcomes.ConclusionAlthough the number of studies on TFL is limited, the available evidence suggests that TFL represents a significant advancement in laser technology for lithotripsy. However, further research is needed to fully explore the implications and limitations of TFL and Tm:YAG lasers.
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页码:2627 / 2636
页数:10
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