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Low-energy high-frequency Ho-YAG lithotripsy: is RIRS going forward? A case-control study.

D Peretti1, E Dalmasso2, A Pecoraro3

  • 1Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy. dario.peretti1990@gmail.com.

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Summary
This summary is machine-generated.

Low-Energy (LE), High-Frequency (HF) settings for Retrograde Intra-Renal Surgery (RIRS) reduced operative time and improved success rates for kidney stones. This feasible technique offers optimal stone-free outcomes compared to conventional RIRS.

Keywords:
ComparisonHigh-frequencyHolmium laserLithotripsyLow-energyUreteroscopy

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithiasis Treatment

Background:

  • Retrograde Intra-Renal Surgery (RIRS) is a key procedure for renal stone management.
  • Modulating laser parameters like energy and frequency can optimize RIRS outcomes.
  • Optimal settings for Ho:YAG lasers in RIRS for specific stone burdens require investigation.

Purpose of the Study:

  • To compare the efficacy and outcomes of Low-Energy (LE) High-Frequency (HF) RIRS versus conventional RIRS for single renal stones (10-20 mm).
  • To evaluate operative time, hospitalization, complications, and stone-free rates between the two RIRS techniques.

Main Methods:

  • Retrospective study of 199 patients with single renal stones (10-20 mm).
  • Group 1: RIRS using LE/HF settings with a 120-W Ho:YAG laser.
  • Group 2 (Control): RIRS using standard settings with a 30-W Ho:YAG laser; follow-up with CT scan at 3 months.

Main Results:

  • Mean operative time was significantly lower in the LE/HF group (56.6 min) compared to the conventional group (65.2 min) (p=0.01).
  • The LE/HF RIRS group showed a higher success rate (93%) compared to the conventional group (82%) (p=0.03).
  • Stone-free rates (69% vs 65%) and peri-operative complications were comparable between groups (p>0.05).

Conclusions:

  • Low-Energy High-Frequency (LE/HF) RIRS is a feasible and effective technique for treating renal stones.
  • LE/HF RIRS offers reduced operative time and superior success rates compared to conventional RIRS.
  • Further research is warranted to validate these findings and establish evidence-based guidelines.