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01.12.2024 | Original Article

Is “Kidney Stone Calculator” efficient in predicting ureteroscopic lithotripsy duration? A holmium:YAG and thulium fiber lasers comparative analysis

verfasst von: Marie Chicaud, Stessy Kutchukian, Steeve Doizi, François Audenet, Laurent Berthe, Laurent Yonneau, Thierry Lebret, Marc-Olivier Timsit, Arnaud Mejean, Luigi Candela, Catalina Solano, Mariela Corrales, Igor Duquesne, Aurélien Descazeaud, Olivier Traxer, Fréderic Panthier

Erschienen in: World Journal of Urology | Ausgabe 1/2024

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Abstract

Purpose

This study aimed to evaluate the ability of Kidney Stone Calculator (KSC), a flexible ureteroscopy surgical planning software, to predict the lithotripsy duration with both holmium:YAG (Ho:YAG) and thulium fiber laser (TFL).

Methods

A multicenter prospective study was conducted from January 2020 to April 2023. Patients with kidney or ureteral stones confirmed at non-contrast computed tomography and treated by flexible ureteroscopy with laser lithotripsy were enrolled. “Kidney Stone Calculator” provided stone volume and subsequent lithotripsy duration estimation using three-dimensional segmentation of the stone on computed tomography and the graphical user interface for laser settings. The primary endpoint was the quantitative and qualitative comparison between estimated and effective lithotripsy durations. Secondary endpoints included subgroup analysis (Ho:YAG–TFL) of differences between estimated and effective lithotripsy durations and intraoperative outcomes. Multivariate analysis assessed the association between pre- and intraoperative variables and these differences according to laser source.

Results

89 patients were included in this study, 43 and 46 in Ho:YAG and TFL groups, respectively. No significant difference was found between estimated and effective lithotripsy durations (27.37 vs 28.36 min, p = 0.43) with a significant correlation (r = + 0.89, p < 0.001). Among groups, this difference did not differ (p = 0.68 and 0.07, respectively), with a higher correlation between estimated and effective lithotripsy durations for TFL compared to Ho:YAG (r = + 0.95, p < 0.001 vs r = + 0.81, p < 0.001, respectively). At multivariate analysis, the difference was correlated with preoperative (volume > 2000 mm³ (Ho:YAG), 500–750 mm³ SV and calyceal diverticulum (TFL)), operative (fragmentation setting (p > 0.001), and basket utilization (p = 0.05) (Ho:YAG)) variables.

Conclusion

KSC is a reliable tool for predicting the lithotripsy duration estimation during flexible ureteroscopy for both Ho:YAG and TFL. However, some variables not including laser source may lead to underestimating this estimation.

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Titel: Is “Kidney Stone Calculator” efficient in predicting ureteroscopic lithotripsy duration? A holmium:YAG and thulium fiber lasers comparative analysis
verfasst von: Marie Chicaud
Stessy Kutchukian
Steeve Doizi
François Audenet
Laurent Berthe
Laurent Yonneau
Thierry Lebret
Marc-Olivier Timsit
Arnaud Mejean
Luigi Candela
Catalina Solano
Mariela Corrales
Igor Duquesne
Aurélien Descazeaud
Olivier Traxer
Fréderic Panthier
Publikationsdatum: 01.12.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 1/2024
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04906-5

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Is “Kidney Stone Calculator” efficient in predicting ureteroscopic lithotripsy duration? A holmium:YAG and thulium fiber lasers comparative analysis