New Generation Pulse Modulation in Holmium:YAG Lasers: A Systematic Review of the Literature and Meta-Analysis
Por:
Sanchez-Puy, A, Bravo-Balado, A, Diana, P, Baboudjian, M, Piana, A, Giron, I, Kanashiro, AK, Angerri, O, Contreras, P, Eisner, BH, Balana, J, Sanchez-Martin, FM, Millan, F, Palou, J, Emiliani, E
Publicada:
1 jun 2022
Resumen:
(1) Background: New pulse modulation (PM) technologies in Holmium:YAG lasers are available for urinary stone treatment, but little is known about them. We aim to systematically evaluate the published evidence in terms of their lithotripsy performance. (2) Methods: A systematic electronic search was performed (MEDLINE, Scopus, and Cochrane databases). We included all relevant publications, including randomized controlled trials, non-randomized comparative and non-comparative studies, and in-vitro studies investigating Holmium:YAG lithotripsy performance employing any new PM. (3) Results: Initial search yielded 203 studies; 24 studies were included after selection: 15 in-vitro, 9 in-vivo. 10 In-vitro compared Moses with regular PM, 1 compared Quanta's, 1 Dornier MedTech's, 2 Moses with super Thulium Fiber Laser, and 1 compared Moses with Quanta PMs. Six out of seven comparative studies found a statistically significant difference in favor of new-generation PM technologies in terms of operative time and five out of six in fragmentation time; two studies evaluated retropulsion, both in favor of new-generation PM. There were no statistically significant differences regarding stone-free rate, lasing and operative time, and complications between Moses and regular PM when data were meta-analyzed. (4) Conclusions: Moses PM seems to have better lithotripsy performance than regular modes in in-vitro studies, but there are still some doubts about its in-vivo results. Little is known about the other PMs. Although some results favor Quanta PMs, further studies are needed.
Filiaciones:
Sanchez-Puy, A:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Univ Autonoma Barcelona, Dept Surg, Barcelona 08193, Spain
Bravo-Balado, A:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Diana, P:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Baboudjian, M:
Aix Marseille Univ, Conception Acad Hosp, AP HM, Dept Urol & Kidney Transplantat, F-13005 Marseille, France
Piana, A:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Giron, I:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Kanashiro, AK:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Angerri, O:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Contreras, P:
Hosp Aleman Buenos Aires, Dept Urol, C1118 AAT, Buenos Aires, DF, Argentina
Eisner, BH:
Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA 02114 USA
Balana, J:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Sanchez-Martin, FM:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Millan, F:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Palou, J:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Univ Autonoma Barcelona, Dept Surg, Barcelona 08193, Spain
Emiliani, E:
IUNA, Fdn Puigvert, Dept Urol, Barcelona 08017, Spain
Green Published, gold
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