Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
GRC #20 Lithiase Urinaire, Sorbonne University, Hôpital Tenon, Paris, France.
Curr Opin Urol. 2020 Nov;30(6):853-860. doi: 10.1097/MOU.0000000000000815.
To evaluate emerging evidence and practical applications of thulium-fiber laser (TFL) for genitourinary soft tissue disease and urinary stone disease treatment.
A systematic review was developed using the PubMed, ScienceDirect, Wiley, SpringerLink and Mary Ann Liebert Scopus databases between 2012 and 2020 years, using the PRISMA statement. We analyzed recent publications including in vitro and in humans outcomes of surgery using TFL. This new laser technology can be used in soft tissue diseases and stones present in the genitourinary system. Most of the comparisons are made with the Ho:YAG laser, using completely different settings. Nevertheless, TFL is safe, feasible and effective in the management of urologic diseases, showing superiority to Ho:YAG even in some studies.
The introduction of pulsed TFL technology has enabled the ablation of stones at rates comparable to or better than currently existing lasers in vitro, while also potentially reducing stone retropulsion. TFL is effective in treating genitourinary soft tissue diseases, including benign prostatic hyperplasia, and early data indicate that it may be effective in the treatment of urinary stone disease. More clinical studies are needed to better understand the indications for this novel technology and clarify its position in the urologic endoscopy armamentarium.
评估铥光纤激光（TFL）在治疗泌尿生殖系统软组织疾病和尿路结石病方面的新证据和实际应用。
使用 PRISMA 声明，我们在 2012 年至 2020 年间在 PubMed、ScienceDirect、Wiley、SpringerLink 和 Mary Ann Liebert Scopus 数据库中开发了一个系统综述，分析了最近的出版物，包括使用 TFL 进行的体外和人类手术结果。这项新技术可用于治疗泌尿生殖系统中存在的软组织疾病和结石。大多数比较都是与 Ho：YAG 激光进行的，使用完全不同的参数。然而，TFL 在治疗泌尿科疾病方面是安全、可行和有效的，即使在一些研究中也显示出优于 Ho：YAG 的优越性。
脉冲 TFL 技术的引入使结石的消融速度与目前体外现有的激光相当或更快，同时还可能减少结石的逆行。TFL 可有效治疗泌尿生殖系统软组织疾病，包括良性前列腺增生症，早期数据表明，它可能对尿路结石病的治疗有效。需要更多的临床研究来更好地了解这项新技术的适应证，并阐明其在泌尿科内镜设备中的地位。
