Pd10-11 Thulium Laser Lithotripsy for Retrograde Intra-Renal Surgeries : Yag or Fiber? A Prospective Evaluation

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) II (PD10)1 May 2024PD10-11 THULIUM LASER LITHOTRIPSY FOR RETROGRADE INTRA-RENAL SURGERIES : YAG OR FIBER? A PROSPECTIVE EVALUATION Frederic Panthier, Catalina Solano, Stessy Kutchukian, Luigi Candela, Steeve Doizi, Mariela Corrales, Marie Chicaud, and Olivier Traxer Frederic PanthierFrederic Panthier , Catalina SolanoCatalina Solano , Stessy KutchukianStessy Kutchukian , Luigi CandelaLuigi Candela , Steeve DoiziSteeve Doizi , Mariela CorralesMariela Corrales , Marie ChicaudMarie Chicaud , and Olivier TraxerOlivier Traxer View All Author Informationhttps://doi.org/10.1097/01.JU.0001008748.59024.cb.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium:yttrium-aluminium-garnet (Ho:YAG) and Thulium Fiber (TFL) lasers are currently the two laser sources recommended for endocorporeal laser lithotripsy. Recently, the pulsed-Thulium:YAG (Tm:YAG) laser was proposed for ELL, We aimed to compare Tm:YAG and TFL in terms of efficiency and safety in laser lithotripsy during retrograde intrarenal surgery (RIRS). METHODS: A prospective single-center comparative study included patients with ureteral and renal stones who underwent RIRS using Thulio(pulsed-Tm:YAG, Dornier©,Germany) or TFL Drive(TFL, Coloplast©, Danemark). RIRS was performed by two operators (one per group). Demographics, stone size, stone density, laser-on time (LOT) and laser settings were recorded. We also assessed the ablation speed (mm3/s), energy consumption (J/mm3) values for each procedure. Postoperative results (stone free rate(SFR<3 mm fragments) and zero fragment rate(ZFR)) were also recorded. RESULTS: 36 and 39 patients were included in Tm:YAG and TFL group, respectively(Table 1).Groups presented similar demographics but for High Blood Pressure(53 vs 23%, p=0,005), anatomical abnormalities(8 vs 33%, p=0,03), lower pole(8 vs 26%, p=0,04) and pelvic stones(25 vs 13%, p=0,04, respectively for Tm:YAG and TFL). If the median (IQR) maximum diameter was higher for Tm:YAG compared to TFL(p=0,001), no difference in stone volume was found. TFL was associated with smaller laser fiber diameters (150/200 vs 270 µm), shorter LOT (<0,001), lower UAS insertion (0,01) rates but similar laser settings(Table 2). The median (IQR) J/mm3 was similar (14 vs 17 (p=0,2)) but Tm:YAG presented higher ablation speed (0,9 vs 0, 73 mm3/s, p=0,04). SFR were similar among groups (75 vs 77%, p=0,8) but ZFR was higher in TFL group (39 vs 64%, p=0,008). No difference in complications were reported. CONCLUSIONS: We reported the first in vivo comparison between Tm:YAG and TFL during RIRS for lithotripsy. Tm:YAG presents similar SFR and safety profiles but its ability to dust seems lower compared to TFL (lower energy consumption and ZFR). Source of Funding: Frederic Panthier has declared consultant for Dornier MedTech © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e190 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Frederic Panthier More articles by this author Catalina Solano More articles by this author Stessy Kutchukian More articles by this author Luigi Candela More articles by this author Steeve Doizi More articles by this author Mariela Corrales More articles by this author Marie Chicaud More articles by this author Olivier Traxer More articles by this author Expand All Advertisement PDF downloadLoading ...