Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Holmium: Yag Versus Thulium Fiber Laser Lithotripsy in Retrograde Intrarenal Surgery for Renal Calculi: A Single Centre Comparative Study
P. Reshma, J. Sasi Kumar, Y. Anil Reddy, C.H. Vamsheedhar, A. Jagadeeswar and S. Sagar
Page: 454-458 | Received 20 Apr 2024, Published online: 23 Jun 2024
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Abstract
Holmium laser lithotripsy, introduced in 1993, is widely used for its efficiency in stone fragmentation but is limited by a fiber diameter of 200 micrometers. The Thulium Fiber Laser (TFL), first studied in 2005, offers high power output through smaller fibers (as small as 50 micrometers), providing better irrigation flow and enhanced instrument deflection. TFL demonstrates a significantly higher stone ablation rate and less stone retropulsion compared to Holmium: YAG laser. This study aimed to evaluate the safety and efficacy of TFL compared to Holmium: YAG laser lithotripsy for renal calculi during retrograde intrarenal surgery (RIRS). A retrospective analysis was conducted on 70 patients with renal calculi (0.5 to 2 cm) treated between July 1, 2019 July 31, 2022, at Mamata Medical College, Khammam. Patients were divided into two groups: Thulium Fiber Laser Lithotripsy (Group T) and Holmium: YAG Laser Lithotripsy (Group H). Data were analyzed using SPSS with p<0.05 considered significant. No significant differences were observed between the groups in baseline characteristics. Stone disintegration time was significantly shorter in Group T (15.4 ± 3.1 minutes) compared to Group H (26.8±4.7 minutes) (p = 0.04). Group T also had lower stone retropulsion (5.7% vs. 22.8%, p = 0.04) and shorter overall procedure duration (41.5±7.5 minutes vs. 66.7±8.6 minutes, p = 0.03). Stone‐free rates, hospital stay postoperative complications were comparable, though renal mucosal abrasions were higher in Group T (11.4% vs. 2.8%, p = 0.163). TFL demonstrated shorter stone disintegration time, reduced stone retropulsion shorter procedure duration compared to Holmium: YAG laser, with no significant differences in stone‐free rates, hospital stay, or postoperative complications. However, TFL was associated with a higher incidence of renal mucosal abrasions.
How to cite this article:
P. Reshma, J. Sasi Kumar, Y. Anil Reddy, C.H. Vamsheedhar, A. Jagadeeswar and S. Sagar. Holmium: Yag Versus Thulium Fiber Laser Lithotripsy in Retrograde Intrarenal Surgery for Renal Calculi: A Single Centre Comparative Study.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.7.454.458
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.7.454.458