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<p>To assess and compare the clinical effectiveness, operative efficiency, stone clearance, and perioperative safety of Super-Pulse Thulium Fiber Laser (SP-TFL) versus Holmium: YAG (Ho: YAG) laser in flexible ureteroscopic management of upper ureteral and renal stones. A multicenter retrospective analysis was performed including 297 patients treated with ureteroscopic lithotripsy between June 2023 and October 2024. Patients were stratified according to laser type: SP-TFL (<i>n</i> = 95) and Ho: YAG (<i>n</i> = 202). The primary endpoint was stone-free rate (SFR), while secondary measures included operative and lithotripsy times, postoperative complications classified by Clavien–Dindo, perioperative white blood cell (WBC) changes, and length of hospitalization. All analyses were conducted using R software. SP-TFL achieved a higher early SFR at 24–48&#xa0;h compared with Ho: YAG (87.4% vs. 76.2%, <i>P</i> = 0.038), while one-month SFRs were similar (94.7% vs. 92.1%, <i>P</i> = 0.55). Operative (55 vs. 75&#xa0;min) and lithotripsy times (30 vs. 50&#xa0;min) were significantly shorter with SP-TFL (both <i>P</i> &lt; 0.001). Hospital stay did not differ. The SP-TFL group had less postoperative WBC elevation and fewer overall complications (18.9% vs. 40.1%, <i>P</i> = 0.017), including fewer grade II events. Compared with Ho: YAG, SP-TFL was associated with reduced operative and lithotripsy times, higher early clearance, and fewer complications, while one-month SFR remained similar. Taken together, these findings suggest that SP-TFL may represent a more efficient and safer option for managing upper ureteral and renal stones in real-world clinical practice.</p>

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Efficacy and safety of super-pulse thulium fiber laser compared to holmium: YAG laser for ureteral and renal stones: a multicenter retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Muhammad Usman,
  • Zhouhang Li,
  • Qingyou Zheng,
  • Yang Cui,
  • Changlong Cai,
  • Wang He,
  • Kewei Xu

摘要

To assess and compare the clinical effectiveness, operative efficiency, stone clearance, and perioperative safety of Super-Pulse Thulium Fiber Laser (SP-TFL) versus Holmium: YAG (Ho: YAG) laser in flexible ureteroscopic management of upper ureteral and renal stones. A multicenter retrospective analysis was performed including 297 patients treated with ureteroscopic lithotripsy between June 2023 and October 2024. Patients were stratified according to laser type: SP-TFL (n = 95) and Ho: YAG (n = 202). The primary endpoint was stone-free rate (SFR), while secondary measures included operative and lithotripsy times, postoperative complications classified by Clavien–Dindo, perioperative white blood cell (WBC) changes, and length of hospitalization. All analyses were conducted using R software. SP-TFL achieved a higher early SFR at 24–48 h compared with Ho: YAG (87.4% vs. 76.2%, P = 0.038), while one-month SFRs were similar (94.7% vs. 92.1%, P = 0.55). Operative (55 vs. 75 min) and lithotripsy times (30 vs. 50 min) were significantly shorter with SP-TFL (both P < 0.001). Hospital stay did not differ. The SP-TFL group had less postoperative WBC elevation and fewer overall complications (18.9% vs. 40.1%, P = 0.017), including fewer grade II events. Compared with Ho: YAG, SP-TFL was associated with reduced operative and lithotripsy times, higher early clearance, and fewer complications, while one-month SFR remained similar. Taken together, these findings suggest that SP-TFL may represent a more efficient and safer option for managing upper ureteral and renal stones in real-world clinical practice.