Efficacy and safety of thulium fiber laser versus holmium: yttrium-aluminum-garnet laser in lithotripsy for urolithiasis: a systematic review and meta-analysis.

IF 2 2区 医学 Q2 UROLOGY & NEPHROLOGY
Rui Chen, Yuxuan Song, Yang Liu, Jincong Li, Caipeng Qin, Tao Xu
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Abstract

This meta-analysis compares the efficacy and safety of thulium fiber laser (TFL) with holmium: yttrium-aluminum-garnet (Ho: YAG) laser in lithotripsy for urolithiasis. A literature search was conducted across PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov to identify studies published up to July 2024. Studies evaluating clinical outcomes for urolithiasis treated with either Ho: YAG laser or TFL were included. The meta-analysis, using RevMan 5.4 software, focused on comparing the stone-free rate (SFR) between the two lasers. A total of 21 studies were included. TFL was associated with a significantly higher SFR (RR 1.09, 95% CI: 1.02 to 1.16; P = 0.01), shorter operation time (SMD - 1.24, 95% CI: -1.82 to -0.66; P < 0.001), shorter lasing time (SMD - 1.26, 95% CI: -1.98 to -0.54; P < 0.001), shorter hospital stay (SMD - 2.08, 95% CI: -4.15 to -0.02; P = 0.05), reduced stone basket usage (SMD 0.50, 95% CI: 0.33 to 0.76; P = 0.001), and a lower total number of intraoperative complications (RR 0.67, 95% CI: 0.47 to 0.96; P = 0.03). However, TFL was also associated with a higher risk of postoperative sepsis (RR 5.32, 95% CI: 1.71 to 16.56; P = 0.004). Subgroup analyses revealed that TFL achieved a higher SFR in several subgroups, including ureteral stones, non-MOSES technology, and follow-up periods of ≥ 3 months, among others. In conclusion, TFL lithotripsy shows superior efficiency and safety compared to the Ho: YAG laser, though the increased risk of postoperative sepsis warrants further investigation.

铥光纤激光与钬钇铝石榴石激光碎石治疗尿石症的疗效和安全性:一项系统综述和荟萃分析。
本荟萃分析比较了铥光纤激光(TFL)与钬钇铝石榴石激光(Ho: YAG)在尿石症碎石治疗中的疗效和安全性。通过PubMed、Embase、Web of Science、Cochrane Central Register of Controlled Trials (Central)和ClinicalTrials.gov进行文献检索,以确定截至2024年7月发表的研究。研究评估了Ho: YAG激光或TFL治疗尿石症的临床结果。使用RevMan 5.4软件进行meta分析,重点比较两种激光器的无结石率(SFR)。共纳入21项研究。TFL与SFR显著升高相关(RR 1.09, 95% CI: 1.02 ~ 1.16;P = 0.01),手术时间较短(SMD = 1.24, 95% CI: -1.82 ~ -0.66;P
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Urolithiasis
Urolithiasis UROLOGY & NEPHROLOGY-
CiteScore
4.50
自引率
6.50%
发文量
74
期刊介绍: Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.
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