| Purpose: To compare the clinical efficacy and safety between the FURL with 365μm and 200μm holmium laser for treating nephrolithiasis.Materials and methods: A prospective randomized controlled trial was performed including analysis of data from 200 patients with nephrolithiasis.A total 180 patients were randomized into two groups according to 1:1 ratio.In 365μm holmium laser group,kidney stones were disintegrated into less than 2mm fragments with a 365μm holmium laser fiber with the settings of 30-45 W under direct visualization;In control group,the conventional 200μm holmium laser with the setting of 16-20 W was used.Descriptive statistics and logistic regression analyses tested the association among operation time,stone free rete(SFR)and incidence of complications.Results: Operation time in the FURL with 365μm laser was significantly shortened and no significance was observed in the complication rate.Stone size and location were identified as two major confounding factors for the operation time and SFR.Moreover,the FURL using 365μm laser showed less operation time for renal stones with the diameter between 1 and 2 cm,stones located in lower calyx and multiple calculi;Stones larger than 2 cm and/or located in lower pole inclined to present better SFR using the FURL with 365μm laser.Conclusions: Our study firstly reported the highly efficient of flexible ureteroscopic lithotripsy using 365-μm holmium laser for nephrolithiasis in this cohort,which showed significantly shortened the operation time for the stones larger than 2cm.Moreover,the comparable safety and higher cost-effectiveness were observed in 365μm group. |
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