Mp78-16 Prospective Randomized Controlled Trial of Trilogy vs Holmium High Power Laser Lithotripsy for Kidney Stones Guy's 1 & 2 in Minipcnl (Triholmium Trial)

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) V (MP78)1 May 2024MP78-16 PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF TRILOGY VS HOLMIUM HIGH POWER LASER LITHOTRIPSY FOR KIDNEY STONES GUY'S 1 & 2 IN MINIPCNL (TRIHOLMIUM TRIAL) Braulio O. Manzo, Allan R. Casale, Edgard E. Lozada, Jhonathan C. Jimenez, Patricio G. Campos, Nezahuacoyotl Gonzaga, and Hector M. Sanchez Braulio O. ManzoBraulio O. Manzo , Allan R. CasaleAllan R. Casale , Edgard E. LozadaEdgard E. Lozada , Jhonathan C. JimenezJhonathan C. Jimenez , Patricio G. CamposPatricio G. Campos , Nezahuacoyotl GonzagaNezahuacoyotl Gonzaga , and Hector M. SanchezHector M. Sanchez View All Author Informationhttps://doi.org/10.1097/01.JU.0001008856.05210.73.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Currently, lithotripsy in mini-PCNL has been performed with high-power laser lithotripsy, but it has a high cost and requires a particular electric installation. Therefore, it is convenient to make a comparison between the results of lithotripsy with Ho: YAG laser energy and the new LithoClast Trilogy EMS and thereby determine which is the most effective method in the resolution of kidney stones through a miniaturized percutaneous tract. METHODS: After institutional review board approval (CI-HRAEB-056-2020), we performed a prospective, double-blind, randomized, single-center, control trial comparing two lithotripsy methods in MiniPCNL: Swiss Lithoclast TrilogyÒ (EMS-Nyon) and the High Power Laser - Lumenis PulsedÒ 100 H (Lumenis Be Ltd -Israel) in patients with GUY's 1 and 2 kidney stones (ClinicalTrials.gov ID NCT04559321). The enrollment period began in August 2020 and was stopped in August 2023 due to the Data and Safety Monitoring Board (DSMB) recommendations to stop the study because of the clear evidence of efficacy of one arm of the study. RESULTS: We aleatorized 83 patients (40 in the laser group and 43 in the Swiss Trilogy group). Demographically, both groups were very similar. With a mean age of 46.4 yrs (+/- 13.7) and 45.3 yrs (+/-12.2) for groups 1 and 2 respectively (p: 0.7) with a maximal stone diameter of 20.1mm (+/- 5.8) and 20.8 mm (+/- 7.6) (p: 0.631) and the mean stone volume of 1602 (915-2766) and 1488 (703-2735) mm3 (p: 0.649) respectively. Perioperative outcomes were also homogeneous for both groups, with a mean FST of 24.3s (+/-9.7) and 21.35s (+/- 9.7) and a mean surgical time of 75.1 min (+/- 26.6) and 85.9 min (+/- 28.1) respectively (p: 0.077). The lithotripsy rate was similar for both groups, with 179 mm3/min (124-279) and 212 mm3/min (154-324) with a p-value of 0.218. Clearance times were 8.02 min (3.4-14.4) and 5.7 min (3.3-10.8) with a p-value of 0.199. For the postoperative outcomes, the complications rate was 4 (10) and 1(2.3), respectively, with a p-value of 0.142. The final stone-free rate was 28 (70) and 38 (88.4), with a satirically significant difference (p: 0.038). CONCLUSIONS: Mini-PCNL with Trilogy lithotripsy (1.5 mm probe) shows similar results and efficacy to Mini-PCNL with high power holmium laser employing lithotripsy rate, operative time, and complications rate but was superior in the stone-free rate. Source of Funding: EMS (EMS-Nyon) provided the trilogy device and probes for the study © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1270 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Braulio O. Manzo More articles by this author Allan R. Casale More articles by this author Edgard E. Lozada More articles by this author Jhonathan C. Jimenez More articles by this author Patricio G. Campos More articles by this author Nezahuacoyotl Gonzaga More articles by this author Hector M. Sanchez More articles by this author Expand All Advertisement PDF downloadLoading ...