Scholarlink

Background <p>Thulium Fiber Laser (TFL) has emerged as a promising alternative to Holmium: YAG for lithotripsy, yet its safety profile remains fragmented across various trials. This study aims to synthesize available evidence to determine the pooled complication rates associated with TFL lithotripsy .</p> Methods <p>A systematic review was conducted following PRISMA guidelines. We searched PubMed, Cochrane CENTRAL, and ClinicalTrials.gov for studies reporting complications of TFL in adult patients with urolithiasis. The primary outcome was the overall complication rate. Secondary outcomes included Clavien–Dindo grading, specific adverse events (fever, sepsis, injury), and stone-free rate (SFR). A random-effects meta-analysis was performed using the Freeman–Tukey double-arcsine transformation.</p> Results <p>Thirty-eight studies involving 3,329 patients were included. The pooled overall complication rate was 10.42% (95% CI: 8.01%–13.10%; I²=81.9%). Major complications (Clavien–Dindo III–V) were rare, with a pooled rate of 1.19% (95% CI: 0.68%–1.84%). Specific event rates included fever (2.45%), ureteral injury (1.37%), bleeding (1.07%), urosepsis (0.77%), ureteral strictures (0.70) and acute pyelonephritis (0.59%). Meta-regression identified operative time as a significant predictor of complications (<i>p</i> = 0.041), whereas stone size was not (<i>p</i> = 0.358). Subgroup analysis showed higher complication rates in pure renal stone treatments (13.83%) compared to ureteral stones (10.64%). The pooled Stone-Free Rate (SFR) was 87.61% (95% CI: 83.61%–91.12%).</p> Conclusion <p>Thulium Fiber Laser lithotripsy demonstrates a pretty favorable safety profile with a very low incidence of high-grade complications (&lt; 1.2%) and high efficacy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Complications of thulium fiber laser lithotripsy: a systematic review and meta-analysis by the EAU-YAU endourology and urolithiasis working group

  • 期刊论文

  • 发表日期：

    2026年5月11日

查看全文
  • Stamatios Katsimperis,
  • Lazaros Tzelves,
  • Patrick Juliebø-Jones,
  • Arman Tsaturyan,
  • Eugenio Ventimiglia,
  • Senol Tonyali,
  • Rifat Burak Ergül,
  • Matthias Boeykens,
  • Victoria Jahrreiss,
  • Angelis Peteinaris,
  • Theodoros Spinos,
  • Alberto Olivero,
  • Amelia Pietropaolo,
  • Begoña Ballesta-Martinez,
  • Andreas Skolarikos

摘要

Background

Thulium Fiber Laser (TFL) has emerged as a promising alternative to Holmium: YAG for lithotripsy, yet its safety profile remains fragmented across various trials. This study aims to synthesize available evidence to determine the pooled complication rates associated with TFL lithotripsy .

Methods

A systematic review was conducted following PRISMA guidelines. We searched PubMed, Cochrane CENTRAL, and ClinicalTrials.gov for studies reporting complications of TFL in adult patients with urolithiasis. The primary outcome was the overall complication rate. Secondary outcomes included Clavien–Dindo grading, specific adverse events (fever, sepsis, injury), and stone-free rate (SFR). A random-effects meta-analysis was performed using the Freeman–Tukey double-arcsine transformation.

Results

Thirty-eight studies involving 3,329 patients were included. The pooled overall complication rate was 10.42% (95% CI: 8.01%–13.10%; I²=81.9%). Major complications (Clavien–Dindo III–V) were rare, with a pooled rate of 1.19% (95% CI: 0.68%–1.84%). Specific event rates included fever (2.45%), ureteral injury (1.37%), bleeding (1.07%), urosepsis (0.77%), ureteral strictures (0.70) and acute pyelonephritis (0.59%). Meta-regression identified operative time as a significant predictor of complications (p = 0.041), whereas stone size was not (p = 0.358). Subgroup analysis showed higher complication rates in pure renal stone treatments (13.83%) compared to ureteral stones (10.64%). The pooled Stone-Free Rate (SFR) was 87.61% (95% CI: 83.61%–91.12%).

Conclusion

Thulium Fiber Laser lithotripsy demonstrates a pretty favorable safety profile with a very low incidence of high-grade complications (< 1.2%) and high efficacy.