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 (TRUST) group

Basit Öğe Kaydı
dc.contributor.authorOrtner, Gernot
dc.contributor.authorSomani, Bhaskar Kumar
dc.contributor.authorGuven, Selcuk
dc.contributor.authorKitzbichler, Gerhard
dc.contributor.authorTraxer, Olivier
dc.contributor.authorGiusti, Guido
dc.contributor.authorProietti, Silvia
dc.date.accessioned2024-02-23T13:43:45Z
dc.date.available2024-02-23T13:43:45Z
dc.date.issued2023
dc.departmentNEÜen_US
dc.description.abstractPurpose 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.Methods 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.Results 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.Conclusion 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.en_US
dc.identifier.doi10.1007/s00345-023-04632-4
dc.identifier.issn0724-4983
dc.identifier.issn1433-8726
dc.identifier.pmid37777981en_US
dc.identifier.scopus2-s2.0-85173101726en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1007/s00345-023-04632-4
dc.identifier.urihttps://hdl.handle.net/20.500.12452/10907
dc.identifier.wosWOS:001079738700001en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofWorld Journal Of Urologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectLaseren_US
dc.subjectUtucen_US
dc.subjectRirsen_US
dc.subjectUrsen_US
dc.subjectPercutaneousen_US
dc.subjectUrothelial Canceren_US
dc.titleExperts' 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 (TRUST) groupen_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu