SuperPulse Thulium Fiber Laser vs. Holmium:YAG: En Sammenligning
Formålet med denne undersøgelse var at sammenligne effektiviteten af lithotripsy, komplikationer og stone-free rate mellem pulseret holmium:YAG (Ho:YAG) og SuperPulse thulium fiber laser ved retrograd intrarenal kirurgi. Resultaterne viste ingen signifikante forskelle mellem de to laserbehandlingsmetoder [J Urol. 2025 Mar;213(3):274-282. doi: 10.1097/JU.0000000000004310].
I dette prospektive, randomiserede studie blev 66 patienter med CT-bekræftede intrarenale sten mellem 5 og 20 mm tilfældigt tildelt pulseret Ho:YAG (Moses 2.0, 120 W) eller SuperPulse thulium fiber laser (60 W). Primært endepunkt var den absolutte stone-free rate (0 fragment) 6 uger postoperativt, vurderet ved CT. Sekundære endepunkter omfattede størrelsen af resterende fragmenter, laserens effektivitet og postoperative komplikationer. Kategoriske variable blev sammenlignet ved hjælp af χ2 eller Fisher’s eksakte test, mens kontinuerlige variable blev analyseret med Mann-Whitney U test.
Resultaterne viste, at de absolutte stone-free rates var 79% for Ho:YAG og 82% for thulium fiber laser, uden signifikante forskelle (P = .8). Størrelsen af resterende fragmenter var også ensartet, med mindre end 3 mm i 18% og 6.1% af tilfældene, samt ≥ 3 mm i 3% og 12% (P = .4). Yderligere analyser indikerede, at den samlede anvendte energi og lasetid var ensartet mellem grupperne, ligesom laserens ablationshastighed og effektivitet. Komplikationsraterne var også sammenlignelige, hvilket indikerer, at begge metoder kan anvendes med lignende sikkerhed og effektivitet.
Dette er en AI-genereret oversættelse og opsummering. Læseren bør konsultere den originale kilde for validering og ikke træffe kliniske beslutninger udelukkende på baggrund af dette resumé.
#Urologi
Læs hele studiet her: [source_link]
Læs hele studiet her: læs her
generer et html link ud fra Based on the provided information from the study published in the Journal of Urology, here is a structured way to fill in the code, assuming you are looking for a structured summary or data representation. Below is a template that you can adjust according to your specific coding requirements:
“`python
# Study Information
study_info = {
“title”: “Comparison of Pulse-Modulated Holmium:YAG and SuperPulse Thulium Fiber Laser for Intrarenal Stones”,
“journal”: “Journal of Urology”,
“publication_date”: “March 2025”,
“volume”: 213,
“issue”: 3,
“pages”: “274-282”,
“doi”: “10.1097/JU.0000000000004310”,
“pmid”: “39918120”,
}
# Study Purpose
purpose = “To compare lithotripsy efficiency, complications, and stone-free rates between pulse-modulated Ho:YAG and SuperPulse thulium fiber laser in retrograde intrarenal surgery.”
# Study Design
study_design = {
“type”: “Prospective Randomized Trial”,
“participants”: {
“total”: 66,
“groups”: {
“Ho:YAG”: 33,
“Thulium Fiber Laser”: 33
},
“inclusion_criteria”: {
“diagnosis”: “CT-confirmed intrarenal stones”,
“size_range_mm”: “5-20”
}
},
“outcomes”: {
“primary”: “Absolute stone-free rate at 6 weeks postoperatively evaluated by CT”,
“secondary”: [
“Residual fragment size”,
“Laser efficiency”,
“Postoperative complications”
]
}
}
# Results Summary
results = {
“absolute_stone_free_rates”: {
“Ho:YAG”: “79%”,
“Thulium Fiber Laser”: “82%”,
“p_value”: 0.8
},
“residual_fragments”: {
“0.9”
},
“complications”: {
“Ho:YAG”: “6.1%”,
“Thulium Fiber Laser”: “9.1%”,
“p_value”: “>0.9”
}
}
# Conclusions
conclusions = “No discernible differences between pulse-modulated Ho:YAG and SuperPulse thulium fiber laser in terms of stone-free rates, laser efficiency, and complications.”
# Keywords
keywords = [
“laser”,
“pulse-modulated high power holmium:YAG laser (Ho:YAG)”,
“stone-free rate”,
“superpulse thulium fiber laser (TFL)”
]
# Printing structured data
print(“Study Information:”, study_info)
print(“Purpose:”, purpose)
print(“Study Design:”, study_design)
print(“Results:”, results)
print(“Conclusions:”, conclusions)
print(“Keywords:”, keywords)
“`
This code defines a structured format for the study data, making it easier to access and manipulate the information programmatically. Adjust it according to the programming language or data structure you are using.
# SuperPulse Thulium Fiber Laser vs. Holmium:YAG: En Sammenligning
I løpet av de siste årene har laserbehandling blitt en stadig mer populær metode innen medisinsk behandling og kirurgi. To av de mest brukte laserteknologiene er SuperPulse Thulium Fiber Laser og Holmium:YAG-laser. Begge disse laserne har sine unike egenskaper, bruksområder og fordeler. Denne artikkelen vil gi en sammenligning av de to teknologiene, og diskutere deres anvendelser, fordeler og ulemper.
## Teknologisk Oversikt
**SuperPulse Thulium Fiber Laser (SPTFL)**
SuperPulse Thulium Fiber Laser er en av de nyeste fremskrittene innen laserteknologi. Den bruker en thulium-dopet fiber som lasermedium, noe som gir en bølgelengde på omtrent 1940 nm. Denne bølgelengden er spesielt effektiv for vannabsorpsjon, noe som gjør den ideell for mykvevskirurgi og dermatologiske behandlinger. SPTFL kan levere korte, intense pulser av lys, noe som reduserer termisk skade på omgivende vev og gir presis kontroll over behandlingen.
**Holmium:YAG Laser**
Holmium:YAG-laseren, på den annen side, er en mer etablert teknologi som har vært i bruk siden 1960-tallet. Denne laseren opererer på en bølgelengde på 2100 nm, også effektiv for vannabsorpsjon. Holmium:YAG-laserne er kjent for sin evne til å kutte og fordampe vev, noe som gjør dem populære i urologi, ortopedi og generell kirurgi. De kan levere både kontinuerlig og pulserende strøm, noe som gir fleksibilitet i bruken.
## Bruksområder
### SuperPulse Thulium Fiber Laser
SuperPulse Thulium Fiber Laser anvendes ofte innen:
– **Dermatologi**: Behandling av arr, rynker og hudforyngelse.
– **Gynækologi**: Behandling av vaginal atrofi og andre relaterte tilstander.
– **Urologi**: For behandling av benign prostatahyperplasi (BPH) og nyrestein.
– **Ortopedi**: Kirurgiske inngrep på bløtdeler og vev.
### Holmium:YAG Laser
Holmium:YAG-laser brukes gjerne i:
– **Urologi**: For å knuse nyrestein (lithotripsy) og for å utføre reseksjoner av prostata.
– **Ortopedi**: For leddkirurgi og fjerning av bløtdeler.
– **Generell kirurgi**: For å kutte og fordampe vev under kirurgiske inngrep.
## Fordeler og Ulemper
### SuperPulse Thulium Fiber Laser
**Fordeler:**
1. **Minimalt invasiv**: Den gir presis behandling med minimal skading av omkringliggende vev.
2. **Kortere helbredelsestid**: Pasienter opplever ofte raskere rehabilitering.
3. **Allsidighet**: Kan brukes til en rekke behandlinger, fra kosmetiske inngrep til medisinske prosedyrer.
**Ulemper:**
1. **Kostnad**: Nyere teknologi kan være dyrere enn tradisjonelle lasere.
2. **Begrenset erfaring**: Siden det er en nyere teknologi, kan det være mindre klinisk erfaring sammenlignet med Holmium:YAG.
### Holmium:YAG Laser
**Fordeler:**
1. **Velprøvd teknologi**: Har vært i bruk i flere tiår med omfattende klinisk dokumentasjon.
2. **Fleksibilitet**: Kan brukes til både kutting og fordampe vev.
3. **Effektiv ved steinbehandling**: Spesielt effektiv for behandling av nyrestein.
**Ulemper:**
1. **Termisk skade**: Kan forårsake mer termisk skade på omkringliggende vev sammenlignet med Thulium Fiber Laser.
2. **Lenger helbredelsestid**: Pasienter kan oppleve lengre tid for rehabilitering.
## Konklusjon
Valget mellom SuperPulse Thulium Fiber Laser og Holmium:YAG-laser avhenger i stor grad av den spesifikke kliniske situasjonen og behandlingsbehovet. SuperPulse Thulium Fiber Laser tilbyr en moderne, minimalt invasiv tilnærming med raskere helbredelsestid og presisjon, mens Holmium:YAG-laseren er en pålitelig, velprøvd teknologi med bred anvendelse og fleksibilitet. Begge teknologier har sine unike fordeler og ulemper, og det er viktig for helsepersonell å vurdere pasientens spesifikke behov når de velger hvilken laser som skal brukes.
**Journal Reference**:
J Urol. 2025 Mar;213(3):274-282.
doi: 10.1097/JU.0000000000004310.
Epub 2025 Feb 7.
**Affiliation**:
1 Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York.
**PMID**: 39918120
**DOI**: 10.1097/JU.0000000000004310
### Abstract
**Purpose**:
This study aimed to evaluate the efficiency of lithotripsy, complication rates, and stone-free outcomes when using pulse-modulated holmium:YAG (Ho:YAG) versus SuperPulse thulium fiber laser systems in retrograde intrarenal surgery.
**Materials and Methods**:
A randomized prospective trial was performed involving patients with CT-confirmed intrarenal stones measuring between 5 and 20 mm. Participants were randomly assigned to receive treatment with either pulse-modulated Ho:YAG (Moses 2.0, 120 W) or SuperPulse thulium fiber laser (60 W). The primary outcome measured was the absolute stone-free rate (0 fragments) at 6 weeks post-surgery, assessed via CT scan. Secondary outcomes included the size of residual fragments, laser efficiency, and any postoperative complications. Statistical analyses were conducted using χ2 or Fisher exact tests for categorical variables, and Mann-Whitney U tests for continuous variables.
**Results**:
A total of 66 patients were enrolled, with 33 receiving pulse-modulated Ho:YAG and 33 receiving SuperPulse thulium fiber laser. The absolute stone-free rates were 79% for Ho:YAG and 82% for the thulium laser (P = .8). Residual fragments measuring less than 3 mm were found in 18% of the Ho:YAG group and 6.1% of the thulium group (P = .3), while fragments of 3 mm or larger were present in 3% and 12%, respectively (P = .4). Total energy utilized (3.4 vs 3.1 kJ, P = .8) and duration of lasing (9.4 vs 12.8 minutes, P = .3) were comparable between groups. Laser efficiency (0.038 vs 0.055 mm³/J, P = .16), activity levels (46% vs 56%, P = .07), and ablation speed (0.40 vs 0.42 mm³/s, P > .9) showed no significant differences. Rates of emergency department visits (3.0% vs 6.1%, P > .9) and overall complications (6.1% vs 9.1%, P > .9) were also similar.
**Conclusions**:
In this single-center study, no significant differences were identified between the pulse-modulated Ho:YAG and SuperPulse thulium fiber laser in treating renal stones of 5 to 20 mm in terms of stone-free rates, laser efficiency, or complications.
**Keywords**:
Laser; pulse-modulated high power holmium:YAG laser (Ho:YAG); stone-free rate; superpulse thulium fiber laser (TFL).
### Publication Types
– Randomized Controlled Trial
– Comparative Study
### MeSH Terms
– Adult
– Aged
– Female
– Humans
– Kidney Calculi* / surgery
– Lasers, Solid-State* / therapeutic use
– Lithotripsy, Laser* / instrumentation
– Lithotripsy, Laser* / methods
– Male
– Middle Aged
– Prospective Studies
– Thulium* / therapeutic use
– Treatment Outcome
**Citation**
J Urol. 2025 Mar;213(3):274-282.
doi: 10.1097/JU.0000000000004310.
Epub 2025 Feb 7.
**Affiliation**
1 Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York.
**PMID:** 39918120
**DOI:** 10.1097/JU.0000000000004310
—
**Abstract**
**Purpose:** The study aims to assess the efficacy and safety of pulse-modulated holmium:YAG (Ho:YAG) and SuperPulse thulium fiber laser in retrograde intrarenal surgery for kidney stones.
**Materials and Methods:** In this prospective randomized trial, patients with CT-confirmed intrarenal stones measuring between 5 and 20 mm were randomly assigned to undergo treatment with pulse-modulated Ho:YAG (Moses 2.0, 120 W) or SuperPulse thulium fiber laser (60 W). The primary endpoint was the stone-free rate, defined as having no fragments (0 fragments) at 6 weeks post-surgery, confirmed via CT scan. Secondary outcomes included the size of any residual fragments, efficiency of the laser, and incidence of postoperative complications. Statistical analyses involved χ2 tests or Fisher exact tests for categorical data, and Mann-Whitney U tests for continuous data.
**Results:** A total of 66 patients were randomized into two groups: pulse-modulated Ho:YAG (n = 33) and SuperPulse thulium fiber laser (n = 33). The stone-free rates were 79% for Ho:YAG and 82% for the thulium laser (P = .8). Residual fragments smaller than 3 mm were found in 18% of the Ho:YAG group and 6.1% of the thulium group (P = .3), while fragments of 3 mm or larger were observed in 3% and 12% respectively (P = .4). Energy consumption (3.4 kJ vs 3.1 kJ, P = .8) and duration of laser application (9.4 min vs 12.8 min, P = .3) were comparable. Laser efficiency (0.038 vs 0.055 mm³/J, P = .16), operational activity (46% vs 56%, P = .07), and ablation speed (0.40 vs 0.42 mm³/s, P > .9) showed no significant differences. Rates of emergency department visits (3.0% vs 6.1%, P > .9) and complications (6.1% vs 9.1%, P > .9) were also similar.
**Conclusions:** Our single-center study indicates that there are no significant differences in stone-free rates, laser efficiency, or complication rates between high-power pulse-modulated Ho:YAG and SuperPulse thulium fiber laser for treating renal stones sized between 5 and 20 mm.
—
**Keywords:**
Laser; pulse-modulated high power holmium:YAG laser (Ho:YAG); stone-free rate; superpulse thulium fiber laser (TFL).
—
**Publication Types:**
– Randomized Controlled Trial
– Comparative Study
**MeSH Terms:**
– Adult
– Aged
– Female
– Humans
– Kidney Calculi* / surgery
– Lasers, Solid-State* / therapeutic use
– Lithotripsy, Laser* / instrumentation
– Lithotripsy, Laser* / methods
– Male
– Middle Aged
– Prospective Studies
– Thulium* / therapeutic use
– Treatment Outcome