Editorial Comment from Dr Taguchi to Endoscopic lithotripsy with a SuperPulsed thulium‐fiber laser for ureteral stones: A single‐center experience

Abstract

and pulse rate. The authors concluded that SP TFL provided effective and safe lithotripsy during rigid ureteroscopy regardless of stone density, and that there were no intraoperative complications, postoperative ureteral stenosis, or hydronephrosis. Optimal laser settings were 0.5 J 9 30 Hz for fragmentation and 0.15 J 9 100 Hz for dusting. The study by Enikeev et al. had several limitations. Its prospective single-center design did not allow the comparison of SP TFL with Ho:YAG laser for ureteral lithotripsy. Furthermore, the optimal settings for SP TFL were previously established in a series of in vitro tests. 3 However, the study showed the real profile data on SP TFL for ureteral lithotripsy, demonstrating its efficacy and safety during ureteroscopy based on the need for low energy and short laser time. The SP TFL operates at 1940 nm, which is closer to the water absorption peak than the wavelength of the Ho:YAG laser (2120 nm). SP TFL treatment, with an optimal wavelength and long pulse duration, resulted in faster stone ablation and lower retropulsion compared with Ho:YAG laser treatment. Additionally, there was no substantial difference in the maximum water temperature elevation around the stones between the SP TFL and the Ho: YAG laser. 4 The SP TFL surpasses the Ho:YAG laser in several aspects: (i) a laser fiber diameter as small as 50 lm; (ii) pulse energy as low as 0.025 J; (iii) a pulse rate range up to 2000 Hz; and (iv) a markedly smaller laser device compared to the Ho:YAG laser. Furthermore, the ablation rate was three times higher, the retropulsion effect was three times lower, and the fiber burnback was more than two times lower with the SP TFL than with the Ho:YAG laser. 4,5 However, further randomized prospective studies including larger cohorts in clinical practice settings are warranted to compare SP TFL with Ho:YAG laser treatment.

Physical, but not laboratory, treatment-related adverse events are associated with favorable outcomes of enfortumab vedotin for advanced urothelial carcinoma: A landmark analysis

“…Meanwhile, mild trAEs such as alopecia are likely to be underreported in the realworld setting. Alopecia is not life-threatening (highest grade = 2) but is cosmetically impactful, especially for female patients, which should thus be taken into account in clinical practice [27]. The present study also found that other physical trAEs such as peripheral neuropathy were associated with better prognosis.…”

“…Despite many reports on EV in real-world patients [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], few studies have investigated the prognostic impact of trAEs on outcomes of EV [20]. This might be partly because trAEs are likely to be underreported in the real-world setting compared to the clinical trial setting [27]. This study aimed to assess the prognostic signi cance of trAEs in advanced UC treated with EV by conducting a detailed evaluation of trAEs and using landmark analysis.…”