A multicentric non-randomized prospective observational study on the clinical efficiency of thulium fibre laser in large volume stones (&gt; 1000 mm3)

Singh, Abhishek; Vaddi, Chandra Mohan; Ganesan, Soundarya; Batra, Rohan; Ramakrishna, Paidakula; Swamy, Siddalinga; Anandan, Hemnath; Babu, Manas; Panda, Rakesh; Ganpule, Arvind; Sabnis, Ravindra; Desai, Mahesh

doi:10.1007/s00345-023-04476-y

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…In contrast, stone density had weak correlation with laser time and laser energy denoting the efficacy of TFL lithotripsy even in hard stones. These results were consistent with previously published studies evaluating performance of TFL in large stones [ 23 ]. Enikeev et al also noted no correlation between laser time and stone density while using TFL during PNL [ 18 ].…”

Section: Discussionsupporting

confidence: 94%

Successful treatment of staghorn stones with flexible ureteroscopy and thulium fiber laser (TFL) lithotripsy: initial experience with 32 cases

Gul,

laymon,

Alrayashi

et al. 2024

Urolithiasis

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Purpose To investigate the efficacy and safety of flexible ureteroscopy with thulium fiber laser lithotripsy for management of renal staghorn stones. Materials and Methods Thirty-two patients with staghorn stones were recruited. Stone characteristics including: width, length, volume and density were analyzed. Ablation speed, laser efficacy and laser activity were recorded. The primary outcome was to assess stone free rate after the procedure using spiral CT scan. Results The median stone volume was 7339 (3183–53838) mm3. Median operative and lasing time were 135 (70–200) and 117 (50–180) minutes, respectively. The mean total energy delivered was 63.9 ± 30 KJ with a median ablation speed of 1.3 (0.5–4.9) mm3/sec. Mean laser efficacy was 7.5 ± 3.6 Joules/mm3. A total of 12 complications occurred in 8 patients (25%). The median hospital stay was 7 (3.5–48) hours and 30 patients (93.7%) were discharged on the same day of surgery. After the first session, seventeen patients (53%) were stone free with no residual fragments while six (19%) patients had residuals £ 2 mm. Nine patients (28%) had residuals > 2 mm with median residual size of 4 (3–9) mm. A second intervention was required in 4 cases.The overall stone free rate after completion of treatment was 65.6%. Conclusion Flexible ureteroscopy with thulium fiber laser lithotripsy is a safe and effective treatment option for staghorn stones with stone free rate comparable to standard PCNL with advantages of minimal morbidity, minimal blood loss and shorter hospital stay.

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Section: Discussionsupporting

confidence: 94%

Successful treatment of staghorn stones with flexible ureteroscopy and thulium fiber laser (TFL) lithotripsy: initial experience with 32 cases

Gul,

laymon,

Alrayashi

et al. 2024

Urolithiasis

View full text Add to dashboard Cite

show abstract

“…In contrast, stone density had weak correlation with laser time and laser energy denoting the e cacy of TFL lithotripsy even in hard stones. These results were consistent with previously published studies evaluating performance of TFL in large stones [23]. Enikeev et al also noted no correlation between laser time and stone density while using TFL during PCNL [18].…”

Section: Discussionsupporting

confidence: 93%

Successful treatment of renal staghorn stones with flexible ureteroscopy and Thulium Fiber Laser (TFL) lithotripsy: a prospective study.

Gul,

laymon,

Alrayashi

et al. 2024

Preprint

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Purpose To investigate the efficacy and safety of flexible ureteroscopy with thulium fiber laser lithotripsy for management of renal staghorn stones. Materials and Methods Thirty-two patients with staghorn stones were recruited. Stone characteristics including: width, length, volume and density were analyzed. Ablation speed, laser efficacy and laser activity were recorded. The primary outcome was to assess stone free rate after the procedure using spiral CT scan. Results The median stone volume was 7339 (3183-53838) mm3. Median operative and lasing time were 135 (70-200) and 117 (50-180) minutes, respectively. The mean total energy delivered was 63.9±30 KJ with a median ablation speed of 1.3 (0.5-4.9) mm3/sec. Mean laser efficacy was 7.5 ±3.6 Joules/mm3. A total of 12 complications occurred in 8 patients (25%). The median hospital stay was 7 (3.5-48) hours and 30 patients (93.7%) were discharged on the same day of surgery. After the first session, seventeen patients (53%) were stone free with no residual fragments while six (19%) patients had residuals £ 2 mm. Nine patients (28%) had residuals > 2 mm with median residual size of 4 (3-9) mm. A second intervention was required in 4 cases.The overall stone free rate after completion of treatment was 65.6%. Conclusion Flexible ureteroscopy with thulium fiber laser lithotripsy is a safe and effective treatment option for staghorn stones with stone free rate comparable to standard PCNL with advantages of minimal morbidity, minimal blood loss and shorter hospital stay.

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Comment to: Dusting efficacy between the regular setting of holmium laser (Ho:YAG) versus vapor tunnel pulse modality for non-complex kidney stones

Panthier,

Chicaud,

Candela

et al. 2024

Lasers Med Sci

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A multicentric non-randomized prospective observational study on the clinical efficiency of thulium fibre laser in large volume stones (> 1000 mm3)

Cited by 5 publications

References 20 publications

Successful treatment of staghorn stones with flexible ureteroscopy and thulium fiber laser (TFL) lithotripsy: initial experience with 32 cases

Successful treatment of staghorn stones with flexible ureteroscopy and thulium fiber laser (TFL) lithotripsy: initial experience with 32 cases

Successful treatment of renal staghorn stones with flexible ureteroscopy and Thulium Fiber Laser (TFL) lithotripsy: a prospective study.

Comment to: Dusting efficacy between the regular setting of holmium laser (Ho:YAG) versus vapor tunnel pulse modality for non-complex kidney stones

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