Details

Autor(en) / Beteiligte

• Singh, Abhishek
• Vaddi, Chandra Mohan
• Ganesan, Soundarya
• Batra, Rohan
• Ramakrishna, Paidakula
• Swamy, Siddalinga
• Anandan, Hemnath
• Babu, Manas
• Panda, Rakesh
• Ganpule, Arvind
• Sabnis, Ravindra
• Desai, Mahesh

Titel

A multicentric non-randomized prospective observational study on the clinical efficiency of thulium fibre laser in large volume stones (> 1000 mm3)

Ist Teil von

• World journal of urology, 2023-08, Vol.41 (8), p.2289-2295

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2023

Quelle

SpringerNature Journals

Beschreibungen/Notizen

• Purpose Our objective was to analyse the clinical efficiency of TFL in large volume stones during retrograde intrarenal surgery. Materials and methods Patients with large volume renal stones (> 1000 mm 3 ) operated at two different centres, from May 2020 to April 2021, were enrolled in this study. Retrograde intrarenal surgery was performed using 60W Superpulse thulium fibre laser™ (IPG Photonics, Russia). Demographic data, stone parameters, laser time, and total operating time were recorded, and laser efficacy (J/mm 3 ) and ablation speed (mm 3 /s) were calculated. NCCT KUB was done at 3 months postoperatively to calculate stone-free rate. Results A total of 76 patients were included and analysed in the study. Mean stone volume was 1753.12 ± 1245.81 (1169.27–2193.25) mm 3 , mean stone density was 1104.46 ± 313.09 (875.00–1317.00) HU, mean laser time was 537.79 ± 689.89 (21.00–1080.00) sec, mean operating time was 43.38 ± 12.96 (35.00–51.25) min, mean laser efficacy was 20.30 ± 15.5 (8.88–25.57) J/mm 3 , and mean ablation speed was 1.32 ± 0.7 (0.82–1.64) mm 3 /sec. A strong positive correlation was found between the stone volume and ablation speed ( r  = 0.659, p  = 0.000), and a moderate negative correlation was found between the stone volume and laser efficacy (J/mm 3 ) ( r  = − 0.392, p  = 0.000). With increasing volume of the stone, J/mm 3 decreased significantly and ablation speed increased significantly ( p  < 0.001). Complications occurred in 21.05% (16/76) patients, most of which were Clavien grades 1–2. Overall SFR is 96.05%. Conclusion Laser efficiency increases at higher stone volumes (> 1000 mm 3 ), as less energy is required to ablate every mm 3 of stone.