New Generation Pulse Modulation in Holmium:YAG Lasers

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. A systematic electronic search was performed (MEDLINE, Scopus, a...

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Detalles Bibliográficos
Autores: Sánchez-Puy, Antoni, Bravo-Balado, Alejandra|||0000-0002-9555-393X, Diana, Pietro|||0000-0002-3259-1314, Baboudjian, Michael|||0000-0001-6935-3873, Piana, Alberto|||0000-0001-9247-7938, Girón, Irene, Kanashiro, Andrés|||0000-0002-5064-1442, Angerri Feu, Oriol|||0000-0003-3363-6585, Contreras, Pablo, Eisner, Brian Howard|||0000-0002-8891-4100, Balañà, Josep|||0000-0001-8248-822X, Sánchez Martín, Francisco María|||0000-0002-9198-8717, Millán Rodríguez, Félix|||0000-0002-0660-6914, Palou, Juan|||0000-0003-1264-5327, Emiliani, Esteban|||0000-0003-4488-0022
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:290569
Acceso en línea:https://ddd.uab.cat/record/290569
https://dx.doi.org/urn:doi:10.3390/jcm11113208
Access Level:acceso abierto
Palabra clave:Holmium
Laser
Pulse modulation
Urinary stones
Descripción
Sumario: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. 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. 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. 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.

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