New Generation Pulse Modulation in Holmium:YAG Lasers : A Systematic Review of the Literature and Meta-Analysis
Sánchez-Puy, Antoni (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Bravo-Balado, Alejandra (Fundació Puigvert)
Diana, Pietro (Fundació Puigvert)
Baboudjian, Michael (APHM Conception Academic Hospital)
Piana, Alberto (Fundació Puigvert)
Girón, Irene (Fundació Puigvert)
Kanashiro, Andrés (Fundació Puigvert)
Angerri, Oriol (Institut d'Investigació Biomèdica Sant Pau)
Contreras, Pablo (Hospital Alemán (Argentina))
Eisner, Brian Howard (Harvard Medical School)
Balañà, Josep (Fundació Puigvert)
Sánchez-Martín, Francisco M. (Fundació Puigvert)
Millán Rodríguez, Félix (Fundació Puigvert)
Palou, Juan (Institut d'Investigació Biomèdica Sant Pau)
Emiliani, Esteban (Institut d'Investigació Biomèdica Sant Pau)

Date:	2022
Abstract:	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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Ressenya ; recerca ; Versió publicada
Subject:	Holmium ; Laser ; Pulse modulation ; Urinary stones
Published in:	Journal of clinical medicine, Vol. 11 Núm. 11 (6-1 2022) , p. 3208, ISSN 2077-0383

DOI: 10.3390/jcm11113208
PMID: 35683595

19 p, 1.1 MB

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