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Erschienen in:
01.12.2015 | Urology - Original Paper
Comparing the efficacy and safety of 365- and 550-μm laser fibers in semirigid ureteroscopic Ho:YAG lithotripsy
Erschienen in: International Urology and Nephrology | Ausgabe 12/2015
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Purpose
To compare the efficacy and safety of 365- and 550-μm Ho:YAG laser fiber in semirigid ureteroscopic lithotripsy and to identify parameters that may affect laser energy and time during the procedure.
Methods
A database of 111 patients who undergone a semirigid ureteroscopy (SRURS) for ureteral stone lithotripsy was analyzed. A 365-μm core fiber was used in 56 cases, and a multiple-uses 550-μm laser fiber was used in 55 cases. A standard 6.4 W protocol (8 Hz, 0.8 J/pulse) was used in all cases. The association between laser fiber diameter and several preoperative, intraoperative and postoperative parameters was evaluated.
Results
Mean stone burden was 54.1 ± 39.1 mm2, and postoperative stone-free and complication rate was 100.0 and 16.2 %, respectively. The 550-μm laser fiber diameter was significantly associated with lower laser energy (p = 0.01), energy/mm3 (p = 0.031), number of pulses (p = 0.012), laser time (p = 0.012) and laser time/mm3 (p = 0.043), while it did not affect postoperative outcomes. The multivariate analysis showed that shorter procedure duration, smaller stone burden and the 550-μm laser fiber were all significant independent predictors for decreased laser energy consumption.
Conclusion
The 550-μm laser fiber may decrease laser energy and time during SRURS lithotripsy with Ho:YAG laser compared to the 365 μm. Given its lower cost, it may represent the optimal choice for semirigid procedures.