High- vs low-power holmium laser lithotripsy: a prospective, randomized study in patients undergoing multitract minipercutaneous nephrolithotomy.

Abstract

OBJECTIVE:

To determine the efficacy and safety of high-power holmium: yttrium aluminum-garnet (Ho:YAG) laser lithotripsy for multitract modified minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of patients with large staghorn renal calculi.

METHODS:

A randomized, prospective study was conducted. Two-hundred seventy-three consecutive patients (291 renal units) with large staghorn renal calculi were randomized to undergo multitract MPCNL with 30-W low-power or 70-W high-power Ho:YAG laser lithotripsy. Both groups were compared in terms of perioperative findings and postoperative outcomes, including procedure time, stone-free rate, length of hospital stay, transfusion rates, renal function recovery, and other complications.

RESULTS:

The average patient age was 49.2 years (range 22-73) and mean stone size was 5.54±0.7 cm. The 2 groups had some comparable perioperative findings and outcome, including tracts required per operated renal unit (n), blood loss, postoperative fever, postoperative hospital stay, stone-free rate, and improvement of operated renal function. The operation time in the high-power group was significantly shorter than that in the low-power group (129.20±17.2 vs 105.18±14.2, P<.01).

CONCLUSION:

A combination of multitract MPCNL and high-power Ho:YAG laser lithotripsy can greatly decrease the operative time without increasing the intraoperative complications or delaying postoperative renal function recovery when compared with low-power Ho:YAG laser lithotripsy.

• Authors: Shushang Chen, Lingfeng Zhu, Shunliang Yang, Weizhen Wu, Lianming Liao, Jianming Tan
• Journal: Urology (Urology) Vol. 79 Issue 2 Pg. 293-7 (Feb 2012) ISSN: 1527-9995 [Electronic] United States
• PMID: 22001100 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Video-Audio Media)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Combined Modality Therapy
• Female
• Fever (epidemiology, etiology)
• Humans
• Lasers, Solid-State (therapeutic use)
• Lithotripsy, Laser (methods)
• Low-Level Light Therapy (methods)
• Male
• Middle Aged
• Nephrolithiasis (radiotherapy, surgery)
• Nephrostomy, Percutaneous (methods)
• Postoperative Complications (epidemiology, etiology)
• Prospective Studies
• Treatment Outcome
• Young Adult