Prediction of The Energy Required for Ho:YAG Laser Lithotripsy of Urinary Stones Energy Required For Laser Lithotripsy
Vol. 18 No. 03 (2021),
21 July 2021
Purpose: In this study, we aimed to find a more accurate predicting constant value of energy per mm3xHounsfield Unit (HU) to ablate urinary stones by endoscopic stone treatment.
Material And Methods: The files of 142 patients who underwent rigid or flexible ureteroscopic laser lithotripsy
in our clinic between December 2018 and March 2020 were evaluated retrospectively. Total energy administered for the ablation of the stone was obtained from the registry of the Ho:YAG laser and recorded to the follow-up forms. The constant value was calculated for each stone, and the final mean value was figured out by calculation of the mean of all constant values.
Results: The study was conducted with 142 patients; 102 males and 40 females. The mean age of the population was 46.61 ± 14.58 years. The number of stones was 1.27 ± 0.67. The mean constant value of energy needed per mm3xHU for urinary stones was 22.87 milliwatt.
Conclusion: This study was conducted to report a predictive constant value and is the very first study evaluating the energy prediction per mm3xHU. The data of the study showed that the constant value is 22.87 mW/mm3xHU. Urologists may estimate the required energy and plan the surgery according to the outcomes of the study. As a future aspect of our study, the constant value may represent predictive information about the time and accuracy of the operation.
- laser lithotripsy
- flexible ureteroscopy
How to Cite
2. Enikeev D, Taratkin M, Klimov R, et al. Thulium-fiber laser for lithotripsy: first clinical experience in percutaneous nephrolithotomy. World J Urol. 2020.
3. Barone B, Crocetto F, Vitale R, et al. Retrograde Intra Renal Surgery (RIRS) versus Percutaneous Nephrolithotomy (PCNL) for renal stones >2cm. A systematic review and meta-analysis. Minerva Urol Nefrol. 2020.
4. Knipper S, Tiburtius C, Gross AJ, Netsch C. Is Prolonged Operation Time a Predictor for the Occurrence of Complications in Ureteroscopy? Urol Int. 2015;95:33-7.
5. Komeya M, Odaka H, Asano J, et al. Development and internal validation of a nomogram to predict perioperative complications after flexible ureteroscopy for renal stones in overnight ureteral catheterization cases. World J Urol. 2019.
6. Kuroda S, Ito H, Sakamaki K, et al. A new prediction model for operative time of flexible ureteroscopy with lithotripsy for the treatment of renal stones. PLoS One. 2018;13:e0192597.
7. Sugihara T, Yasunaga H, Horiguchi H, et al. A nomogram predicting severe adverse events after ureteroscopic lithotripsy: 12 372 patients in a Japanese national series. BJU Int. 2013;111:459-66.
8. Panthier F, Ventimiglia E, Berthe L, et al. How much energy do we need to ablate 1 mm(3) of stone during Ho:YAG laser lithotripsy? An in vitro study. World J Urol. 2020.
9. Patel SR, Nakada SY. Quantification of preoperative stone burden for ureteroscopy and shock wave lithotripsy: current state and future recommendations. Urology. 2011;78:282-5.
10. Mekayten M, Lorber A, Katafigiotis I, et al. Will Stone Density Stop Being a Key Factor in Endourology? The Impact of Stone Density on Laser Time Using Lumenis Laser p120w and Standard 20 W Laser: A Comparative Study. J Endourol. 2019;33:585-9.
11. Ofude M, Shima T, Yotsuyanagi S, Ikeda D. Stone Attenuation Values Measured by Average Hounsfield Units and Stone Volume as Predictors of Total Laser Energy Required During Ureteroscopic Lithotripsy Using Holmium:Yttrium-Aluminum-Garnet Lasers. Urology. 2017;102:48-53.
12. Jain R, Omar M, Chaparala H, et al. How Accurate Are We in Estimating True Stone Volume? A Comparison of Water Displacement, Ellipsoid Formula, and a CT-Based Software Tool. J Endourol. 2018;32:572-6.
13. Al Busaidy SS, Kurukkal SN, Al Hooti QM, Alsaraf MS, Al Mamari SA, Al Saeedi AK. Is RIRS emerging as the preferred option for the management of 2 cm-4 cm renal stones: our experience. Can J Urol. 2016;23:8364-7.
14. Cabrera JD, Manzo BO, Torres JE, et al. Mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of 10-20 mm lower pole renal stones: a systematic review and meta-analysis. World J Urol. 2019.
15. Bozkurt OF, Resorlu B, Yildiz Y, Can CE, Unsal A. Retrograde intrarenal surgery versus percutaneous nephrolithotomy in the management of lower-pole renal stones with a diameter of 15 to 20 mm. J Endourol. 2011;25:1131-5.
16. Bai Y, Wang X, Yang Y, Han P, Wang J. Percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones up to 2 cm in patients with solitary kidney: a single centre experience. BMC Urol. 2017;17:9.
17. Bader MJ, Gratzke C, Walther S, et al. Efficacy of retrograde ureteropyeloscopic holmium laser lithotripsy for intrarenal calculi >2 cm. Urol Res. 2010;38:397-402.
18. Erbin A, Tepeler A, Buldu I, Ozdemir H, Tosun M, Binbay M. External Comparison of Recent Predictive Nomograms for Stone-Free Rate Using Retrograde Flexible Ureteroscopy with Laser Lithotripsy. J Endourol. 2016;30:1180-4.
19. Mursi K, Elsheemy MS, Morsi HA, Ali Ghaleb AK, Abdel-Razzak OM. Semi-rigid ureteroscopy for ureteric and renal pelvic calculi: Predictive factors for complications and success. Arab J Urol. 2013;11:136-41.
20. Ito H, Kawahara T, Terao H, et al. Utility and limitation of cumulative stone diameter in predicting urinary stone burden at flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. PLoS One. 2013;8:e65060.
21. Ito H, Sakamaki K, Kawahara T, et al. Development and internal validation of a nomogram for predicting stone-free status after flexible ureteroscopy for renal stones. BJU Int. 2015;115:446-51.
22. Yamashita S, Kohjimoto Y, Iba A, Kikkawa K, Hara I. Stone size is a predictor for residual stone and multiple procedures of endoscopic combined intrarenal surgery. Scand J Urol. 2017;51:159-64.
23. Goldberg H, Golomb D, Shtabholtz Y, et al. The "old" 15 mm renal stone size limit for RIRS remains a clinically significant threshold size. World J Urol. 2017;35:1947-54.
24. Takazawa R, Kitayama S, Tsujii T. Appropriate kidney stone size for ureteroscopic lithotripsy: When to switch to a percutaneous approach. World J Nephrol. 2015;4:111-7.
25. Bas O, Tuygun C, Dede O, et al. Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures-a single-center experience. World J Urol. 2017;35:819-26.
26. Joseph P, Mandal AK, Singh SK, Mandal P, Sankhwar SN, Sharma SK. Computerized tomography attenuation value of renal calculus: can it predict successful fragmentation of the calculus by extracorporeal shock wave lithotripsy? A preliminary study. J Urol. 2002;167:1968-71.
27. Gupta NP, Ansari MS, Kesarvani P, Kapoor A, Mukhopadhyay S. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int. 2005;95:1285-8.
28. Ito H, Kuroda S, Kawahara T, Makiyama K, Yao M, Matsuzaki J. Clinical factors prolonging the operative time of flexible ureteroscopy for renal stones: a single-center analysis. Urolithiasis. 2015;43:467-75.
29. Sorokin I, Cardona-Grau DK, Rehfuss A, et al. Stone volume is best predictor of operative time required in retrograde intrarenal surgery for renal calculi: implications for surgical planning and quality improvement. Urolithiasis. 2016;44:545-50.
- Abstract Viewed: 0 times
- 6442/pdf Downloaded: 0 times