Pd47-03 a Prospective Randomized Controlled Trial Comparing the Efficacy and Efficiency of Thulium Fibre Laser and Holmium: Yttrium Aluminium Garnet Laser for Stone Lithotripsy During Retrograde Intrarenal Surgery for Renal Calculus of 1 to 2 Cm

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) IV (PD47)1 May 2024PD47-03 A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFICACY AND EFFICIENCY OF THULIUM FIBRE LASER AND HOLMIUM: YTTRIUM ALUMINIUM GARNET LASER FOR STONE LITHOTRIPSY DURING RETROGRADE INTRARENAL SURGERY FOR RENAL CALCULUS OF 1 TO 2 CM Prashant A. Nanavati, Amish J. Wani, Gopal R. Tak, Deepak Ragoori, Purna Chandra Reddy, and Mallikarjua Chiruvella Prashant A. NanavatiPrashant A. Nanavati , Amish J. WaniAmish J. Wani , Gopal R. TakGopal R. Tak , Deepak RagooriDeepak Ragoori , Purna Chandra ReddyPurna Chandra Reddy , and Mallikarjua ChiruvellaMallikarjua Chiruvella View All Author Informationhttps://doi.org/10.1097/01.JU.0001008652.62443.0a.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In current era, RIRS (Retrograde Intra-Renal Surgery) is one of the most preferred treatment options for treatment of 1-2 cm size renal calculus. Ho:YAG (Holmium: Yttrium Aluminium Garnette) has been an inseparable part of RIRS armamentarium since its conception. Recently introduction of TFL (Thulium Fiber Laser) technology has shown promising results in preclinical studies and pilot clinical trials. We conducted this Randomized Controlled Trial with the prime objective to compare stone free rates and perioperative parameters while using Ho:YAG laser and TFL for 1-2 cm renal stone management. METHODS: In this prospective randomized controlled trial we included patients with solitary renal calculus of 1-2 cm size, who were planned for primary RIRS (Non-pre-stented) at our tertiary institute. Standard procedure of RIRS was performed using ureteric access sheath in all cases. Ho:YAG Laser or TFL were used as per randomization with fixed dusting and fragmentation settings. Patients' demographic and clinical data, perioperative parameters were documented. Stone free rate was assessed with NCCT KUB at one month at the time of DJ stent removal. RESULTS: Total (n=113) patients with mean age of 44.9±13.1 years were enrolled in this RCT with equally distributed stone volume and density in both groups. Primary outcome of stone free rate showed no significant difference between Ho:YAG and TFL group (92.73% vs 93.10%, p–0.938). Energy utilization, Lasing-time and Operative-time were comparable in both groups, Ablation speed was slightly better with TFL though not statistically significant. (1.14±1.07 vs 0.95±0.59 cumm/sec, p –0.238). TFL had clear edge over Ho:YAG laser in terms of lesser retropulsion (p-<0.001). Post-operative complications were comparable in both groups. CONCLUSIONS: We conclude that both lasers are equally safe and effective for management of 1-2 cm renal stones with RIRS, with slight advantage to TFL due to its ability to keep the stone stable during lasing process, though multicentric RCTs with larger sample sizes are required to generate robust evidence. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e981 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Prashant A. Nanavati More articles by this author Amish J. Wani More articles by this author Gopal R. Tak More articles by this author Deepak Ragoori More articles by this author Purna Chandra Reddy More articles by this author Mallikarjua Chiruvella More articles by this author Expand All Advertisement PDF downloadLoading ...