{"title":"输尿管镜碎石术中钬激光与铥光纤激光治疗输尿管结石的疗效——一项前瞻性、随机、单中心研究。","authors":"Subash Kaushik Tg, Hariharasudhan Sekar, Chandru T, Sriram Krishnamoorthy","doi":"10.1007/s00345-025-05568-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The use of lasers has created a major impact in the management of stones. The aim of our study is to evaluate and compare the effectiveness and safety profile of Thulium fiber laser (TFL) and Holmium: YAG (Ho: YAG) laser in ureteric stones.</p><p><strong>Methods: </strong>It is a prospective randomized single-centre study carried out from December 2022 to December 2023. About 110 patients were subjected to the study with 55 randomized to each group. All underwent ureterorenoscopic lithotripsy either with TFL or Ho: YAG laser. Patient demographic data, stone-related factors, and complications were analyzed in both groups and compared.</p><p><strong>Results: </strong>Mean stone volume was comparable in the Ho: YAG laser and TFL group (578.62 [SD 296.48] mm<sup>3</sup> vs. 556.64 [SD 246.18] mm<sup>3</sup>; P = 0.67). Mean total operative time was significantly different between the two groups (Ho: YAG - 27.3 (SD 2.77) vs. TFL - 24.8 (SD 2.58) minutes, P = 0.005). Mean lasing time was also found to be significantly different (Ho: YAG - 15.16 (SD 3.97) vs. TFL - 13.13 (SD 3.21) minutes, P = 0.004). Ablation speed was also significantly different (Ho: YAG mean 35.67 (SD 9.13) vs. TFL mean 40.48 (SD 10.60) mm<sup>3</sup>/min, P = 0.012). Stone-free rates (SFR) at 3 months follow-up were similar in TFL and Ho: YAG laser group.</p><p><strong>Conclusions: </strong>Shorter lasing time, decreased overall operative time, and higher ablation speed are a few selective advantages of TFL over Ho: YAG laser. The SFR and complication rates remained almost the same in both.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"167"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of holmium: YAG laser vs. Thulium fiber laser for ureteric stones during ureterorenoscopic lithotripsy - a prospective, randomized single-centre study.\",\"authors\":\"Subash Kaushik Tg, Hariharasudhan Sekar, Chandru T, Sriram Krishnamoorthy\",\"doi\":\"10.1007/s00345-025-05568-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The use of lasers has created a major impact in the management of stones. The aim of our study is to evaluate and compare the effectiveness and safety profile of Thulium fiber laser (TFL) and Holmium: YAG (Ho: YAG) laser in ureteric stones.</p><p><strong>Methods: </strong>It is a prospective randomized single-centre study carried out from December 2022 to December 2023. About 110 patients were subjected to the study with 55 randomized to each group. All underwent ureterorenoscopic lithotripsy either with TFL or Ho: YAG laser. Patient demographic data, stone-related factors, and complications were analyzed in both groups and compared.</p><p><strong>Results: </strong>Mean stone volume was comparable in the Ho: YAG laser and TFL group (578.62 [SD 296.48] mm<sup>3</sup> vs. 556.64 [SD 246.18] mm<sup>3</sup>; P = 0.67). Mean total operative time was significantly different between the two groups (Ho: YAG - 27.3 (SD 2.77) vs. TFL - 24.8 (SD 2.58) minutes, P = 0.005). Mean lasing time was also found to be significantly different (Ho: YAG - 15.16 (SD 3.97) vs. TFL - 13.13 (SD 3.21) minutes, P = 0.004). Ablation speed was also significantly different (Ho: YAG mean 35.67 (SD 9.13) vs. TFL mean 40.48 (SD 10.60) mm<sup>3</sup>/min, P = 0.012). Stone-free rates (SFR) at 3 months follow-up were similar in TFL and Ho: YAG laser group.</p><p><strong>Conclusions: </strong>Shorter lasing time, decreased overall operative time, and higher ablation speed are a few selective advantages of TFL over Ho: YAG laser. 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引用次数: 0
摘要
导言：激光的使用对宝石的管理产生了重大影响。本研究的目的是评价和比较铥光纤激光（TFL）和钬激光（Ho: YAG）治疗输尿管结石的有效性和安全性。方法：该研究为前瞻性随机单中心研究，于2022年12月至2023年12月进行。约110名患者接受了这项研究，每组随机分为55名。所有患者均行输尿管镜下TFL或Ho: YAG激光碎石术。对两组患者的人口学资料、结石相关因素和并发症进行分析和比较。结果：Ho: YAG激光组和TFL组的平均结石体积相当(578.62 [SD 296.48] mm3 vs. 556.64 [SD 246.18] mm3；p = 0.67)。两组平均总手术时间差异有统计学意义(Ho: YAG - 27.3 （SD 2.77) vs TFL - 24.8 (SD 2.58) min, P = 0.005）。平均激光时间也有显著差异(Ho: YAG - 15.16 （SD 3.97) vs. TFL - 13.13 （SD 3.21）分钟，P = 0.004）。消融速度也有显著差异(Ho: YAG平均值35.67 （SD 9.13) vs TFL平均值40.48 (SD 10.60) mm3/min, P = 0.012）。TFL组和Ho: YAG激光组随访3个月无结石率（SFR）相似。结论：TFL较Ho: YAG激光具有激光时间短、整体手术时间短、消融速度快等选择性优势。两组患者的SFR和并发症发生率几乎相同。
Outcomes of holmium: YAG laser vs. Thulium fiber laser for ureteric stones during ureterorenoscopic lithotripsy - a prospective, randomized single-centre study.
Introduction: The use of lasers has created a major impact in the management of stones. The aim of our study is to evaluate and compare the effectiveness and safety profile of Thulium fiber laser (TFL) and Holmium: YAG (Ho: YAG) laser in ureteric stones.
Methods: It is a prospective randomized single-centre study carried out from December 2022 to December 2023. About 110 patients were subjected to the study with 55 randomized to each group. All underwent ureterorenoscopic lithotripsy either with TFL or Ho: YAG laser. Patient demographic data, stone-related factors, and complications were analyzed in both groups and compared.
Results: Mean stone volume was comparable in the Ho: YAG laser and TFL group (578.62 [SD 296.48] mm3 vs. 556.64 [SD 246.18] mm3; P = 0.67). Mean total operative time was significantly different between the two groups (Ho: YAG - 27.3 (SD 2.77) vs. TFL - 24.8 (SD 2.58) minutes, P = 0.005). Mean lasing time was also found to be significantly different (Ho: YAG - 15.16 (SD 3.97) vs. TFL - 13.13 (SD 3.21) minutes, P = 0.004). Ablation speed was also significantly different (Ho: YAG mean 35.67 (SD 9.13) vs. TFL mean 40.48 (SD 10.60) mm3/min, P = 0.012). Stone-free rates (SFR) at 3 months follow-up were similar in TFL and Ho: YAG laser group.
Conclusions: Shorter lasing time, decreased overall operative time, and higher ablation speed are a few selective advantages of TFL over Ho: YAG laser. The SFR and complication rates remained almost the same in both.
期刊介绍：
The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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