TY  - JOUR
TI  - A multicenter-based critical analysis of laser settings during
intrarenal laser lithotripsy by the Turkish academy of urology
prospective study group (ACUP study)
AB  - Objective: In this multicenter prospective study, we aimed to evaluate the use of holmium:yttrium–-
aluminum–garnet laser during retrograde intrarenal surgery for kidney stones and the relationship between
laser-related parameters and procedure-related perioperative parameters.
Material and methods: The 769 patients whose laser setting parameters (fiber thickness, number of shots,
frequency (max.), laser power (max.), and total energy) were completely registered were included in this
study program. The intraoperative ureteral lesions were evaluated using postureteroscopic lesion scale
(PULS) scores and the postoperative complications with the modified Clavien-Dindo classification system.
Results: The maximum levels of laser power and the frequency were used in the middle calyceal stones; the
value of total energy consumed was found to be higher gain in cases with multiple stones (all parameters P <
.05). There was a significant positive correlation among (mean number of shots [P < .001, r ¼ 0.46], frequency
[P ¼ .009, r ¼ 0.1], maximum power [P < .001, r ¼ 0.11], total energy [P < .001, r ¼ 0.25]), anesthesia
time (P < .001, r ¼ 0.42), surgery time (P < .001, r ¼ 0.47), and stone size. The mean number of shots
increased (P < .001, r ¼ 0.25), and the frequency level decreased (P < .001, r ¼ –0.17) significantly with
increasing Hounsfield unit (HU) values. Again, the mean number of shots and maximum laser power
increased in correlation with the increasing hospitalization time (P ¼ .004, r ¼ 0.09 and P ¼ .02, r ¼ 0.07,
respectively). In addition, it was observed that higher laser subparameter values and thicker fibers were used
in PULS grade 2.
Conclusion: As the stone size and HU values increased, laser-setting parameters were found to show significant
variability. The increase in different parameters of the laser setting was found to be associated with longer anesthesia
time, surgery time, and hospitalization period and increased risk of local trauma with PULS grade.
AU  - sönmez, mehmet giray
AU  - KILIÇ, Özcan
AU  - Muslumanoglu, Ahmet Yaser
AU  - Erkurt, Bülent
AU  - Atis, Gokhan
AU  - SECKINER, ILKER
AU  - Sarıca, Kemal
AU  - Tugcu, Volkan
AU  - Tuncel, Altug
AU  - karabulut, ibrahim
AU  - Tefik, Tzevat
AU  - Ergin, Giray
AU  - Guven, Selcuk
DO  - 10.5152/tud.2022.21214
PY  - 2022
JO  - Turkish Journal of Urology
VL  - 48
IS  - 1
SN  - 2149-3235
SP  - 64
EP  - 73
DB  - TRDizin
UR  - http://search/yayin/detay/520188
ER  -