This study aimed to evaluate the ability of Kidney Stone Calculator (KSC), a flexible ureteroscopy surgical planning software, to predict the lithotripsy duration with both holmium:YAG (Ho:YAG) and thulium fiber laser (TFL).
A multicenter prospective study was conducted from January 2020 to April 2023. Patients with kidney or ureteral stones confirmed at non-contrast computed tomography and treated by flexible ureteroscopy with laser lithotripsy were enrolled. "Kidney Stone Calculator" provided stone volume and subsequent lithotripsy duration estimation using three-dimensional segmentation of the stone on computed tomography and the graphical user interface for laser settings. The primary endpoint was the quantitative and qualitative comparison between estimated and effective lithotripsy durations. Secondary endpoints included subgroup analysis (Ho:YAG-TFL) of differences between estimated and effective lithotripsy durations and intraoperative outcomes. Multivariate analysis assessed the association between pre- and intraoperative variables and these differences according to laser source.
89 patients were included in this study, 43 and 46 in Ho:YAG and TFL groups, respectively. No significant difference was found between estimated and effective lithotripsy durations (27.37 vs 28.36 min, p = 0.43) with a significant correlation (r = + 0.89, p < 0.001). Among groups, this difference did not differ (p = 0.68 and 0.07, respectively), with a higher correlation between estimated and effective lithotripsy durations for TFL compared to Ho:YAG (r = + 0.95, p < 0.001 vs r = + 0.81, p < 0.001, respectively). At multivariate analysis, the difference was correlated with preoperative (volume > 2000 mm3 (Ho:YAG), 500-750 mm3 SV and calyceal diverticulum (TFL)), operative (fragmentation setting (p > 0.001), and basket utilization (p = 0.05) (Ho:YAG)) variables.
KSC is a reliable tool for predicting the lithotripsy duration estimation during flexible ureteroscopy for both Ho:YAG and TFL. However, some variables not including laser source may lead to underestimating this estimation.
World journal of urology. 2024 Apr 13*** epublish ***
Marie Chicaud, Stessy Kutchukian, Steeve Doizi, François Audenet, Laurent Berthe, Laurent Yonneau, Thierry Lebret, Marc-Olivier Timsit, Arnaud Mejean, Luigi Candela, Catalina Solano, Mariela Corrales, Igor Duquesne, Aurélien Descazeaud, Olivier Traxer, Fréderic Panthier
GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France., Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Européen George Pompidou, 20 rue Leblanc, 75015, Paris, France., PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France., Université Versailles Saint-Quentin-Service d'Urologie, Hôpital Foch, 40 rue Worth, 92150, Suresnes, France., Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, Université Paris Cité, 123 boulevard de Port-Royal, 75014, Paris, France., Service d'Urologie, Centre Hospitalier Universitaire de Limoges, 2 avenue Martin Luther King, 87000, Limoges, France., GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France. .