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Experts' recommendations in laser use for the treatment of upper tract urothelial carcinoma: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training Research in Urological Surgery and Technology (T.R.U.S.T.) group.
Ortner, Gernot; Somani, Bhaskar Kumar; Güven, Selcuk; Kitzbichler, Gerhard; Traxer, Olivier; Giusti, Guido; Proietti, Silvia; Liatsikos, Evangelos; Kallidonis, Panagiotis; Ulvik, Øyvind; Goumas, Ioannis Kartalas; Duvdevani, Mordechai; Baard, Joyce; Kamphuis, Guido M; Ferretti, Stefania; Dragos, Laurian; Villa, Luca; Miernik, Arkadiusz; Tailly, Thomas; Pietropaolo, Amelia; Hamri, Saeed Bin; Papatsoris, Athanasios; Gözen, Ali Serdar; Herrmann, Thomas R W; Nagele, Udo; Tokas, Theodoros.
Afiliação
  • Ortner G; Department of Urology and Andrology, General Hospital Hall i.T, Milser Straße 10, 6060, Hall in Tirol, Austria. gerni_o@hotmail.com.
  • Somani BK; Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria. gerni_o@hotmail.com.
  • Güven S; Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, England.
  • Kitzbichler G; Department of Urology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
  • Traxer O; Department of Urology and Andrology, General Hospital Hall i.T, Milser Straße 10, 6060, Hall in Tirol, Austria.
  • Giusti G; Sorbonne University, GRC n°20 Lithiase Renale, AP-HP, Hôpital Tenon, Paris, France.
  • Proietti S; Department of Urology, San Raffaele Hospital, Milan, Italy.
  • Liatsikos E; Department of Urology, San Raffaele Hospital, Milan, Italy.
  • Kallidonis P; Department of Urology, University of Patras, Patras, Greece.
  • Ulvik Ø; Department of Urology, University of Patras, Patras, Greece.
  • Goumas IK; Department of Urology, Haukeland University Hospital, Bergen, Norway.
  • Duvdevani M; Department of Urology, Istituto Clinico Beato Matteo, Vigevano, Italy.
  • Baard J; Department of Urology, Hadassah Ein-Kerem University Hospital, The Hebrew University, Jerusalem, Israel.
  • Kamphuis GM; Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Ferretti S; Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Dragos L; Department of Urology, Hospital and University of Modena, Modena, Italy.
  • Villa L; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Miernik A; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
  • Tailly T; Department of Urology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
  • Pietropaolo A; Department of Urology, University Hospital Ghent, Ghent, Belgium.
  • Hamri SB; Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, England.
  • Papatsoris A; Urology Department at Specialized Medical Center SMC2, Riyadh, Saudi Arabia.
  • Gözen AS; 2nd Department of Urology, Sismanoglio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
  • Herrmann TRW; Department of Urology, Medius Kliniken, Ruit, Baden-Württemberg, Germany.
  • Nagele U; Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
  • Tokas T; Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland.
World J Urol ; 41(11): 3367-3376, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37777981
PURPOSE: To highlight and compare experts' laser settings during endoscopic laser treatment of upper tract urothelial carcinoma (UTUC), to identify measures to reduce complications, and to propose guidance for endourologists. METHODS: Following a focused literature search to identify relevant questions, a survey was sent to laser experts. We asked participants for typical settings during specific scenarios (ureteroscopy (URS), retrograde intrarenal surgery (RIRS), and percutaneous treatment). These settings were compared among the reported laser types to find common settings and limits. Additionally, we identified preventive measures commonly applied during surgery. RESULTS: Twenty experts completed the survey, needing a mean time of 12.7 min. Overall, most common laser type was Holmium-Yttrium-Aluminum-Garnet (Ho:YAG) (70%, 14/20) followed by Thulium fiber laser (TFL) (45%, 9/20), pulsed Thulium-Yttrium-Aluminum-Garnet (Tm:YAG) (3/20, 15%), and continuous wave (cw)Tm:YAG (1/20, 5%). Pulse energy for the treatment of distal ureteral tumors was significantly different with median settings of 0.9 J, 1 J and 0.45 J for Ho:YAG, TFL and pulsed Tm:YAG, respectively (p = 0.048). During URS and RIRS, pulse shapes were significantly different, with Ho:YAG being used in long pulse and TFL in short pulse mode (all p < 0.05). We did not find further disparities. CONCLUSION: Ho:YAG is used by most experts, while TFL is the most promising alternative. Laser settings largely do not vary significantly. However, further research with novel lasers is necessary to define the optimal approach. With the recent introduction of small caliber and more flexible scopes, minimal-invasive UTUC treatment is further undergoing an extension of applicability in appropriately selected patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Bexiga Urinária / Carcinoma de Células de Transição / Litotripsia a Laser / Lasers de Estado Sólido Tipo de estudo: Guideline Limite: Humans Idioma: En Revista: World J Urol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Áustria País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Bexiga Urinária / Carcinoma de Células de Transição / Litotripsia a Laser / Lasers de Estado Sólido Tipo de estudo: Guideline Limite: Humans Idioma: En Revista: World J Urol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Áustria País de publicação: Alemanha