Treatment outcomes with Holmium-Yag laser in percutaneous nephrolithotomy. A single center experience

Michael Nomikos, George Koritsiadis, George Athanasopoulos, Anastasios Tsalavoutas, Konstantinos Triantafyllidis, Sofianos Kanatas

Abstract


Introduction: To assess the efficacy of Holmium Yag laser during
percutaneous nephrolithotomy (PCNL) for the treatment of
large renal calculi.
Patients-Methods: The medical records of 69 consecutive
patients who underwent percutaneous nephrolithotomy by
a single surgeon were prospectively evaluated. Group A consisted
of 35 patients who underwent holmium Yag laser PCNL.
Group B consisted of 34 patients who received standard ballistic
lithotripsy. Laser settings were adjusted according to stone
density (from 40 to 60 Joules for stones with Housfield Units
(HU) >1000HU and 20 to 40 Joules for stones with HU<1000).
The stone free rate, operative time, fluoroscopy time, complication
rate and need for ancillary procedures were compared.
The SPSS software, version 19,0 (IBM, Armonk, NY) was used
for statistical analysis.
Results: The maximal stone diameter didn’t differ between
Groups, p=0,426. The operating time was shorter for Group
A, 115±22 min and 127±18 min for Group B, respectively
p=0.021. Fluoroscopy time (165 ± 111 sec for Group A and 157
± 120 sec for Group B, p= 0.635) and hospitalization time (4 ±
2 days) did not differ between Groups. There was no statistical
difference in SFR at the end of the procedure, p=0.322. Stone
free rates at one and three months postoperatively evaluated
by C.T. was 82,8% and 85,3% for Groups A and B, respectively
p=0,365. Ancillary procedures and complication rates were
also similar, p= 0.772 and p=0.922, respectively.
Conclusions: Holmium Yag laser seem a safe and effective
treatment modality for the management of large renal calculi
during PCNL.

Keywords


Holmium YAG laser;percutaneous nephrolithotomy

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DOI: http://dx.doi.org/10.19264/hj.v31i1.255