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

被引：6

作者：

Candela, Luigi ^{[1
,2
,11
]}

Solano, Catalina ^{[2
]}

Castellani, Daniele ^{[3
]}

Teoh, Jeremy Y. ^{[4
]}

Tanidir, Yiloren ^{[5
]}

Fong, Khi Y. ^{[6
]}

Vaddi, Chandramohan ^{[7
]}

Sinha, Mriganka Mani ^{[8
]}

Ragoori, Deepak ^{[9
]}

Somani, Bhaskar K. ^{[8
]}

Traxer, Olivier ^{[2
]}

Gauhar, Vineet ^{[10
]}

机构：

[1] IRCCS San Raffaele Hosp, Urol Res Inst URI, Div Expt Oncol, Unit Urol, Milan, Italy

[2] Sorbonne Univ, Hop Tenon, AP HP, Paris, France

[3] Marche Polytech Univ, Azienda Osped Univ Marche, Azienda Ospedaliero Universitaria Marche, Ancona, Italy

[4] Chinese Univ Hong Kong CUHK, SH Ho Urol Ctr, Hong Kong, Peoples R China

[5] Marmara Univ, Pendik Res & Educ Hosp, Unit Urol, Istanbul, Turkiye

[6] Natl Univ Hosp NUH, Singapore, Singapore

[7] Preeti Urol & Kidney Hosp, Hyderabad, Telangana, India

[8] Univ Hosp Southampton NHS Fdn Trust, Southampton, England

[9] Asian Inst Nephrourol, Hyderabad, India

[10] Natl Univ Hlth Syst, Ng Teng Fong Gen Hosp, Div Urol, Singapore, Singapore

[11] Univ Vita Salute San Raffaele, IRCCS San Raffaele Hosp, Urol Res Inst URI, Div Expt Oncol,Unit Urol, Via Olgettina 60, I-20132 Milan, Italy

来源：

MINERVA PEDIATRICS | 2023年

关键词：

Lithotripsy; laser; Urology; Pediatrics; FLEXIBLE URETEROSCOPY; URETERORENOSCOPY; CHILDREN; RATES;

D O I：

10.23736/S2724-5276.23.07392-5

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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 chi 2 and Fisher's Exact Test for categorical variables were used to compare outcomes be-tween 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 corrobo-rate our findings.(Cite this article as: Candela L, Solano C, Castellani D, Teoh JY, Tanidir Y, Fong KY, et al. 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. Minerva Pediatr 2023 Oct 31. DOI: 10.23736/S2724-5276.23.07392-5)

引用

页数：8

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