A multicentric non-randomized prospective observational study on the clinical efficiency of thulium fibre laser in large volume stones (> 1000 $ mm^{3} $)

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..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:41

Enthalten in:

World journal of urology - 41(2023), 8 vom: 07. Juli, Seite 2289-2295

Sprache:

Englisch

Beteiligte Personen:

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

Links:

Volltext [lizenzpflichtig]

Themen:

Ablation speed
Large volume
Laser efficacy
RIRS
Thulium fibre laser

RVK:

RVK Klassifikation

Anmerkungen:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s00345-023-04476-y

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2144936056

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