Experts' recommendations in laser use for the treatment of upper tract urothelial carcinoma: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training Research in Urological Surgery and Technology (T.R.U.S.T.) group.

Humans Lithotripsy, Laser Carcinoma, Transitional Cell / surgery Lasers, Solid-State / therapeutic use Thulium Urinary Bladder Neoplasms Holmium
Laser Percutaneous RIRS URS UTUC Urothelial cancer

Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 07 07 2023
accepted: 14 09 2023
medline: 9 11 2023
pubmed: 1 10 2023
entrez: 1 10 2023
Statut: ppublish

Résumé

To highlight and compare experts' laser settings during endoscopic laser treatment of upper tract urothelial carcinoma (UTUC), to identify measures to reduce complications, and to propose guidance for endourologists. Following a focused literature search to identify relevant questions, a survey was sent to laser experts. We asked participants for typical settings during specific scenarios (ureteroscopy (URS), retrograde intrarenal surgery (RIRS), and percutaneous treatment). These settings were compared among the reported laser types to find common settings and limits. Additionally, we identified preventive measures commonly applied during surgery. Twenty experts completed the survey, needing a mean time of 12.7 min. Overall, most common laser type was Holmium-Yttrium-Aluminum-Garnet (Ho:YAG) (70%, 14/20) followed by Thulium fiber laser (TFL) (45%, 9/20), pulsed Thulium-Yttrium-Aluminum-Garnet (Tm:YAG) (3/20, 15%), and continuous wave (cw)Tm:YAG (1/20, 5%). Pulse energy for the treatment of distal ureteral tumors was significantly different with median settings of 0.9 J, 1 J and 0.45 J for Ho:YAG, TFL and pulsed Tm:YAG, respectively (p = 0.048). During URS and RIRS, pulse shapes were significantly different, with Ho:YAG being used in long pulse and TFL in short pulse mode (all p < 0.05). We did not find further disparities. Ho:YAG is used by most experts, while TFL is the most promising alternative. Laser settings largely do not vary significantly. However, further research with novel lasers is necessary to define the optimal approach. With the recent introduction of small caliber and more flexible scopes, minimal-invasive UTUC treatment is further undergoing an extension of applicability in appropriately selected patients.

Identifiants

DOI: 10.1007/s00345-023-04632-4 PMID: 37777981
pubmed: 37777981
doi: 10.1007/s00345-023-04632-4
pii: 10.1007/s00345-023-04632-4
doi:

Substances chimiques

yttrium-aluminum-garnet 0
Thulium 8RKC5ATI4P
Holmium W1XX32SQN1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3367-3376

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Gernot Ortner (G)

Department of Urology and Andrology, General Hospital Hall i.T, Milser Straße 10, 6060, Hall in Tirol, Austria. gerni_o@hotmail.com.
Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria. gerni_o@hotmail.com.
ORCID: 0000-0002-2454-6599

Bhaskar Kumar Somani (BK)

Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, England.

Selcuk Güven (S)

Department of Urology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.

Gerhard Kitzbichler (G)

Department of Urology and Andrology, General Hospital Hall i.T, Milser Straße 10, 6060, Hall in Tirol, Austria.

Olivier Traxer (O)

Sorbonne University, GRC n°20 Lithiase Renale, AP-HP, Hôpital Tenon, Paris, France.

Guido Giusti (G)

Department of Urology, San Raffaele Hospital, Milan, Italy.

Silvia Proietti (S)

Department of Urology, San Raffaele Hospital, Milan, Italy.

Evangelos Liatsikos (E)

Department of Urology, University of Patras, Patras, Greece.

Panagiotis Kallidonis (P)

Department of Urology, University of Patras, Patras, Greece.

Øyvind Ulvik (Ø)

Department of Urology, Haukeland University Hospital, Bergen, Norway.

Ioannis Kartalas Goumas (IK)

Department of Urology, Istituto Clinico Beato Matteo, Vigevano, Italy.

Mordechai Duvdevani (M)

Department of Urology, Hadassah Ein-Kerem University Hospital, The Hebrew University, Jerusalem, Israel.

Joyce Baard (J)

Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Guido M Kamphuis (GM)

Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Stefania Ferretti (S)

Department of Urology, Hospital and University of Modena, Modena, Italy.

Laurian Dragos (L)

Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Luca Villa (L)

Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.

Arkadiusz Miernik (A)

Department of Urology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.

Thomas Tailly (T)

Department of Urology, University Hospital Ghent, Ghent, Belgium.

Amelia Pietropaolo (A)

Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, England.

Saeed Bin Hamri (SB)

Urology Department at Specialized Medical Center SMC2, Riyadh, Saudi Arabia.

Athanasios Papatsoris (A)

2nd Department of Urology, Sismanoglio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Ali Serdar Gözen (AS)

Department of Urology, Medius Kliniken, Ruit, Baden-Württemberg, Germany.

Thomas R W Herrmann (TRW)

Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland.

Udo Nagele (U)

Department of Urology and Andrology, General Hospital Hall i.T, Milser Straße 10, 6060, Hall in Tirol, Austria.
Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.

Theodoros Tokas (T)

Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Greece.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Experts' recommendations in laser use for the...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie par ultrasons › Lithotritie › Lithotritie par laser › Experts' recommendations in laser use for the...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs épithéliales épidermoïdes et glandulaires › Carcinomes › Carcinome transitionnel › Experts' recommendations in laser use for the...
questionsmedicales.fr › Équipement et fournitures › Équipement et fournitures pour les applications des radiations › Lasers › Lasers à solide › Experts' recommendations in laser use for the...
questionsmedicales.fr › Produits chimiques inorganiques › Métaux › Terres rares › Lanthanides › Thulium › Experts' recommendations in laser use for the...
questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Tumeurs urologiques › Tumeurs de la vessie urinaire › Experts' recommendations in laser use for the...
questionsmedicales.fr › Produits chimiques inorganiques › Métaux › Terres rares › Lanthanides › Holmium › Experts' recommendations in laser use for the...