Holmium: YAG Laser Lithotripsy Versus Pneumatic Lithotripsy for Treatment of Distal Ureteral Calculi: A Meta-Analysis

Now lithoclast has become more popular tool than various intracorporeal lithotripters for the treatment of ureteric stones. Recently the Holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of ureteric stones. This study was conducted to compare the use of Forceps and Dormia basket in the management of ureteric stone between Holmium: YAG Laser and Pneumatic Lithotripsy. It was a longitudinal follow-up comparative study conducted at Combined Military Hospital, Dhaka. All the respondents were admitted patients in Combined Military Hospital Dhaka, under Urology Ward. A total of 100 patients were enrolled for this study under convenient purposive sampling method. They all were admitted with the complaints of upper ureteric stone who underwent ureteroscopic lithotripsy from October 2010 to September 2012. In 50 patients, Laser Lithotripsy (LL) was used and in other 50 patients Pneumatic Lithotripsy (PL) was used. Same ureteroscope, video monitor, baskets and irrigation devices were used in both the samples. Patients were followed up after 1st and 3rd months interval. Lithotripsy follow-up was done with radiograph and ultrasonography of kidney, ureter and bladder. Patients with migrated fragments or incomplete clearance were underwent an auxiliary procedure such as shock wave lithotripsy. Mean stone size was 1.36 ± 0.36 cm in group Laser lithotripsy (LL) and 1.37± 0.36 cm in group Pneumatic lithotripsy (PL). The immediate stone clearance rate was significantly higher in Group LL (94.0%) than Group PL (76.0%). Proximal migration of fragments were 6.0% in LL group and 24.0% in PL group. Use of stone retrieval equipment (baskets, forceps) was 16.0% and 64.0% in LL and PL group respectively (p<0.05). On the other hand stone fragments clearance requiring auxiliary procedures were 6% and 24% in LL and PL group respectively. The mean lithotripsy time was 40.46 ± 19.25 min and 36.86 ± 14.83 min the LL and PL group respectively. Use of stone retrieval equipment(baskets, forceps) was significantly lower in Holmium: YAG assisted ureteroscopy than pneumatic lithotripsy group. Bangladesh Med J. 2019 Jan; 48 (1): 26-30

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MP-08.12: Holmium: YAG Laser Lithotripsy with Semirigid Ureterorenoscope for Treatment of Ureteral Calculi: Report of 1398 Cases

Urology ◽

10.1016/j.urology.2009.07.962 ◽

2009 ◽

Vol 74 (4) ◽

pp. S83

Author(s):

Z. Wu ◽

Q. Ding ◽

H. Jiang ◽

P. Gao ◽

Y. Zhang

Keyword(s):

Laser Lithotripsy ◽

Ureteral Calculi ◽

Yag Laser

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Comparison of Holmium: YAG Laser and Pneumatic Lithotripsy in the Treatment of Ureteral Stones: An Update Meta-Analysis

Urologia Internationalis ◽

10.1159/000448692 ◽

2016 ◽

Vol 98 (2) ◽

pp. 125-133 ◽

Cited By ~ 16

Author(s):

Shulian Chen ◽

Liang Zhou ◽

Tangqiang Wei ◽

Deyi Luo ◽

Tao Jin ◽

...

Keyword(s):

Meta Analysis ◽

Ureteral Stones ◽

Yag Laser ◽

Pneumatic Lithotripsy

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Ureteroscopic Management of Ureteral Calculi: Pneumatic versus Holmium: YAG Laser Lithotripsy

Open Journal of Urology ◽

10.4236/oju.2016.63008 ◽

2016 ◽

Vol 06 (03) ◽

pp. 36-42 ◽

Cited By ~ 1

Author(s):

Sarwar Noori Mahmood ◽

Diar Hameed Bajalan

Keyword(s):

Laser Lithotripsy ◽

Ureteral Calculi ◽

Yag Laser

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Comparison of pneumatic lithotripsy versus laser lithotripsy for upper ureteral calculi

International Surgery Journal ◽

10.18203/2349-2902.isj20213590 ◽

2021 ◽

Vol 8 (9) ◽

pp. 2644

Author(s):

Ershad Hussain Galeti ◽

Saqib Shahab ◽

Mriganka Deuri Bharali

Keyword(s):

Yttrium Aluminum Garnet ◽

Randomized Study ◽

Laser Lithotripsy ◽

Ureteral Calculi ◽

Pneumatic Lithotripsy ◽

Stone Fragmentation ◽

Stone Free Rate ◽

Mean Size ◽

Second Procedure ◽

Free Rate

Background: Several modalities are available for upper ureteric stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet lithotripsy has favourable outcomes. In this study we studied 50 patients who underwent ureteroscopic pneumatic lithotripsy or laser lithotripsy. This study aims to to compare the outcome of PL and LL in the management of upper ureteric calculi.Methods: This is a prospective, randomized study of 50 cases; 25 cases of TUL with pneumatic lithotripter and 25 cases of TUL with laser lithotripter over two years. The purpose of this study was to analyze the factors predicting the stone-free rate, assess the complications following PL and LL, and assess the need for a second procedure if retropulsion of calculi occurs.Results: Two groups were similar in age, gender, mean size of stones, retropulsion and complications. There was a statistical difference in terms of stone free rate in favour of LL group (p≤0.05) and mean operative time in favor of the PL group (p≤ 0.05). Conclusions: In conclusion, we found that both the PL and LL approaches were effective and safe for upper ureteric calculi, but the LL method had advantages, especially in stone free rate, over the PL treatment. Another advantage of the LL method was safe stone fragmentation in upper ureteral calculi due to lower retropulsion rate in contrast with the PL method.

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