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Meta-Analysis
. 2024 Feb 19;24(1):44.
doi: 10.1186/s12894-024-01419-6.

Comparison of Thulium Fiber Laser versus Holmium laser in ureteroscopic lithotripsy: a Meta-analysis and systematic review

Xiaoyu Tang  1   2 , Shaojie Wu  1 , Zhilong Li  1 , Du Wang  3 , Cheng Lei  3 , Tongzu Liu  1 , Xinghuan Wang  4 , Sheng Li  5   6
Affiliations
Meta-Analysis

Comparison of Thulium Fiber Laser versus Holmium laser in ureteroscopic lithotripsy: a Meta-analysis and systematic review

Xiaoyu Tang et al. BMC Urol. .

Abstract

Objectives: To compare the efficacy and safety of thulium fiber laser (TFL) to holmium: YAG (Ho: YAG) laser in ureteroscopic lithotripsy for urolithiasis.

Methods: PubMed, Web of Science, Embase, CENTRAL, SinoMed, CNKI database, VIP and Wanfang Database were systematically searched for all relevant clinical trials until September 2023. References were explored to identify the relevant articles. Meta-analysis was carried out for the retrieved studies using RevMan5.4.1 software, and the risk ratio, mean difference and 95% confidence interval were expressed. Statistical significance was set at p < 0.05. The main outcomes of this meta-analysis were stone-free rate (SFR), perioperative outcomes and intraoperative or postoperative complications.

Results: Thirteen studies, including 1394 patients, were included. According to the results of pooled analysis, TFL was associated with significantly higher stone-free rate (SFR) [0.52, 95% CI (0.32, 0.85), P = 0.009], shorter operation time [-5.47, 95% CI (-8.86, -2.08), P = 0.002], and less stone migration [0.17, 95% CI (0.06, 0.50), P = 0.001]. However, there was no significant difference in terms of the laser time, duration of hospital stay, drop of hemoglobin level, total energy, postoperative ureteral stenting, the incidence of intraoperative complications or postoperative complications between TFL and Ho: YAGs.

Conclusion: The findings of this study demonstrated several advantages of TFL in terms of higher SFR, shorter operative time and less stone migration.

Trial registration: The protocol of this systematic review was listed in PROSPERO ( www.crd.york.ac.uk/PROSPERO ) (Protocol number: CRD42022362550).

Keywords: Ho:YAG; Meta-analysis; Systematic review; Thulium fiber laser; Ureteroscopic lithotripsy; Urolithiasis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The screening process in the meta-analysis
Fig. 2
Fig. 2
Forest plot comparing TFL and Ho: YAG in terms of stone-free rate
See this image and copyright information in PMC

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References

    1. Zeng G, Zhao Z, Mazzon G, Pearle M, Choong S, Skolarikos A, et al. European Association of Urology Section of Urolithiasis and International Alliance of Urolithiasis Joint Consensus on Retrograde Intrarenal Surgery for the Management of Renal Stones. Eur Urol Focus. 2021;S2405-4569:00290-X. - PubMed
    1. Jones P, Beisland C, Ulvik Ø. Current status of thulium fibre laser lithotripsy: an up-to-date review. BJU Int. 2021;128:531–538. doi: 10.1111/bju.15551. - DOI - PubMed
    1. Traxer O, Keller EX. Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser. World J Urol. 2020;38:1883–1894. doi: 10.1007/s00345-019-02654-5. - DOI - PMC - PubMed
    1. Winship B, Wollin D, Carlos E, Peters C, Li J, Terry R, et al. The Rise and Fall of High Temperatures During Ureteroscopic Holmium Laser Lithotripsy. J Endourol. 2019;33:794–799. doi: 10.1089/end.2019.0084. - DOI - PubMed
    1. Martov AG, Ergakov DV, Guseinov MA, Andronov AS, Dutov SV, Vinnichenko VA, et al. Initial experience in clinical application of thulium laser contact lithotripsy for transurethral treatment of urolithiasis. Urologiia. 2018;1:112–20. - PubMed

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