Thulium:YAG <i>Versus</i> Holmium:YAG Laser Effect on Upper Urinary Tract Soft Tissue: Evidence from an <i>Ex Vivo</i> Experimental Study

Proietti, Silvia; Rodríguez-Socarrás, Moisés; Eisner, Brian H.; Lucianò, Roberta; Martinez, Mario José Basulto; Yeow, Yuyi; Rapallo, Ilenia; Saitta, Giuseppe; Scarfò, Federico; Gaboardi, Franco; Giusti, Guido

doi:10.1089/end.2020.0222

Cited by 31 publications

(34 citation statements)

References 26 publications

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“…35 In a recent ex vivo study by Proietti et al, the continuous-wave output of the Thulium laser (TL) laser represents an advantage compared to the Holmium laser in terms of a less deeper incision depth, whereas a larger vaporization and coagulation area, resulting in a lower risk profile (increase risk of bleeding and impaired endoscopic vision) and at the same time being more efficient at tissue destruction. 36 In 2011, Defidio et al, 37 in a series of 59 cases of UTUC, demonstrated a not inferior efficacy in terms of oncological outcomes of the TL compared to the Holmium laser. More recently, Musi et al, 38 reported the outcomes of a large cohort of UTUC patients (n = 42) undertaking TL laser vaporization: the authors showed an 81% recurrencefree survival with a median follow-up of 44 months, a very low complications rate, comparable with literature.…”

Section: Upper Tract Urothelial Carcinomamentioning

confidence: 99%

Section: Upper Tract Urothelial Carcinomamentioning

confidence: 99%

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RETRACTED: Laser technology in urologic oncology

et al. 2022

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Laser technology has been used in Urology since the 80s with a lot of different applications in endoscopic and open surgery. With the developments of the technology and the introduction of new active medium and source of laser energy, this technology have become the gold standard not only in stone surgery but even in benign prostate enlargement (BPE) surgical treatment. Regarding urologic oncology, laser energy has now reached an important role in focal therapy and in conservative treatment. The possibility of having better functional outcomes without any relevant impact on oncological results led to an increased use of laser in penile surgery, with a significant mention in urological guidelines for this option. In urothelial cancers as well, both in conservative management of upper tract tumors that in the treatment of non muscle invasive bladder cancer, a clear role of these relatively new source of energy have been demonstrated. Finally, both in prostate that in renal cancer the strategy of focal therapy may take advantage from this precise and fine technology. In this review we analyzed and described the applications of laser energy in urological cancers with a specific focus on penile, urothelial and prostate cancer.

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Section: Upper Tract Urothelial Carcinomamentioning

confidence: 99%

Section: Upper Tract Urothelial Carcinomamentioning

confidence: 99%

RETRACTED: Laser technology in urologic oncology

et al. 2022

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“…Compared to Ho:YAG laser, Tm:YAG laser provides maximum hemostatic effects, leading to clear visibility during ablation of multiple UFEPs. Tm:YAG laser also provides a lower risk of iatrogenic ureteral stricture due to its shallow penetration depth 6 . In our case, the change from Ho:YAG to Tm:YAG laser enabled the resection of multiple UFEPs, maintaining clear visualization during ablation.…”

Section: Discussionmentioning

confidence: 71%

“…The central wavelength of Tm:YAG laser is 1.75–2.22 μm, which closely matches the 1.92 μm wavelength that denotes peak water absorption in tissues, resulting in more efficient and rapid tissue cutting. Furthermore, Tm:YAG laser’s continuous wave and shallow penetration (0.4 mm) can provide maximum hemostatic and coagulation effects and a lower risk of tissue perforation, while more effectively destroying tissues 6 . Recently, Tm:YAG laser was used for endoscopic laser treatment of upper urinary tract carcinoma, and its use is expected to expand to nephron‐sparing surgeries 5,7 …”

Section: Discussionmentioning

confidence: 99%

Successful endoscopic treatment using thulium YAG laser for multiple ureteral fibroepithelial polyps in a pediatric patient

et al. 2022

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Introduction: Ureteral fibroepithelial polyps are extremely rare and cause ureteropelvic junction obstruction in the pediatric population. Recent advancements in endoscopic treatment, such as holmium:yttrium-aluminum-garnet laser, have created more options for practitioners to treat multiple ureteral fibroepithelial polyps cases. However, the use of holmium:yttrium-aluminum-garnet laser multilobulated ureteral fibroepithelial polyps may have technical difficulties. Case presentation: An 11-year-old boy with intermittent right flank pain revealed multiple ureteral fibroepithelial polyps approximately 3 cm long at the right ureteropelvic junction. The ureteral fibroepithelial polyps were resected using flexible ureteroscopy using thulium:YAG laser. A second-look ureteroscopy revealed no recurrence, residual polyps, or ureteral stricture. At 1-year follow-up, ultrasonography showed no hydronephrosis on the affected side. Conclusion: Thulium:YAG laser provides clear visibility due to its high hemostatic and evaporation effects. To the best of our knowledge, this is the first pediatric case of multiple ureteral fibroepithelial polyps successfully treated with endoscopic resection using thulium:YAG laser, with a favorable clinical outcome.

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“…Thulium:YAG lasers have a wavelength of 2.0 mm and 0.25 mm depth of penetration. In ex vivo porcine models, thulium:YAG has shown a lower risk profile compared to holmium:YAG due to decreased depth of incision, larger coagulation area, and larger total laser area (68). In the clinical setting, thulium:YAG has shown good safety and efficacy in recent trials, with recurrence rates of approximately 19% and predominantly minor complications (69,70).…”

Section: Percutaneous Approachesmentioning

confidence: 99%

The role of endoscopic management and adjuvant topical therapy for upper tract urothelial cancer

Chien¹,

Chua²,

Doppalapudi³

et al. 2022

Front. Urol.

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Upper tract urothelial carcinoma (UTUC) has traditionally been managed with radical nephroureterectomy, and while this approach remains the gold standard for high-risk disease, endoscopic, kidney-sparing management has increasingly been adopted for low-risk disease as it preserves kidney function without compromising oncologic outcomes. Ureteroscopy and percutaneous renal access not only provide diagnoses by tumor visualization and biopsy, but also enable treatment with electrocautery or laser ablation. Several modalities exist for laser ablative treatments including thulium:YAG, neodymium:YAG, holmium:YAG, and combinations of the preceding. Furthermore, due to high recurrence rates after endoscopic management, adjuvant intracavitary instillation of various agents such as mitomycin C and bacillus Calmette-Guerin have been used given benefits seen in non-muscle invasive urothelial bladder cancer. Other formulations also being studied include gemcitabine, anthracyclines, and immunotherapies. More recently, Jelmyto, a mitomycin reverse thermal gel, has been developed to allow for adequate drug delivery time and potency since urine flow could otherwise dilute and washout topical therapy. In this article, the authors review techniques, indications, best practices, and areas of current investigation in endoscopic management and adjuvant topical therapy for UTUC.

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Thulium:YAG Versus Holmium:YAG Laser Effect on Upper Urinary Tract Soft Tissue: Evidence from an Ex Vivo Experimental Study

Cited by 31 publications

References 26 publications

RETRACTED: Laser technology in urologic oncology

RETRACTED: Laser technology in urologic oncology

Successful endoscopic treatment using thulium YAG laser for multiple ureteral fibroepithelial polyps in a pediatric patient

The role of endoscopic management and adjuvant topical therapy for upper tract urothelial cancer

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