Navigating urolithiasis treatment: assessing the practicality and performance of thulium fiber laser, holmium YAG, and thulium YAG in real-world scenarios.
World J Urol
; 41(10): 2627-2636, 2023 Oct.
Article
em En
| MEDLINE
| ID: mdl-37468656
ABSTRACT
BACKGROUND:
The management of urolithiasis has undergone significant advancements with the introduction of pulsed lasers, particularly the holmiumyttrium-aluminum-garnet (HoYAG) laser, which is currently considered the gold standard in endourology. However, the HoYAG laser has certain limitations, such as the inability to support small laser fibers (150 µm) and the requirement of a heavy water cooling system, making it challenging to transfer between operating rooms. These limitations have led to the emergence of new laser technologies, including the thulium fiber laser (TFL) and the thuliumyttrium-aluminum-garnet laser (TmYAG), as potential alternatives to the HoYAG laser.METHODS:
In this review, we aimed to evaluate the effectiveness and safety of TFL, HoYAG, and TmYAG lasers in real-life scenarios by comparing clinical trial data with laboratory findings. A literature review was conducted, and relevant in vitro studies and clinical trials until March 2023 were analyzed.RESULTS:
The findings indicate that TFL has demonstrated high ablation efficiency for stones of any composition, size, and location, superior the capabilities of HoYAG lasers. TFL has shown superior dusting and fragmentation abilities, lower retropulsion, and increased patient safety. The laser parameters, such as ablation efficiency, speed, operative time, dust quality, retropulsion, visibility, temperature safety, and stone-free rate, were compared between laboratory studies and clinical outcomes.CONCLUSION:
Although the number of studies on TFL is limited, the available evidence suggests that TFL represents a significant advancement in laser technology for lithotripsy. However, further research is needed to fully explore the implications and limitations of TFL and TmYAG lasers.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Litotripsia a Laser
/
Urolitíase
/
Lasers de Estado Sólido
Limite:
Humans
Idioma:
En
Revista:
World J Urol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
França