Gan Qinghua, Li Jun, Zhai Gaoqiang, Liu Bangfeng, Qin Yan, Tan Shuting, Wang Wei, Zeng Qinsong
Department of Urology, Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-Sen University, No.3 Fozi Ling Road, Qingxiu District, Nanning, 530022, Guangxi, China.
Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, Guangdong, People's Republic of China.
Eur J Med Res. 2025 May 12;30(1):379. doi: 10.1186/s40001-025-02591-7.
The purpose of this review is to compare the effectiveness of SuperPulsed thulium fiber laser (SP TFL) and holmium:yttrium-aluminum-garnet (Ho:YAG) laser in lithotripsy, with the aim of evaluating the differences between the two in key indicators, such as lithotripsy efficiency and safety, and providing reference for clinical selection of better lithotripsy methods.
By searching multiple authoritative medical databases (PubMed, Embase, and Web of Science databases) and including the results of relevant clinical studies and laboratory studies, the indexes involving SP TFL and Ho:YAG lasers in the included literature were analyzed.
We found a total of 24 relevant pieces of literature. The laser parameters, such as ablation efficiency, ablation speed, operative time, dust quality, retropulsion, visibility, temperature safety, and stone-free rate, were compared between laboratory studies and clinical outcomes. Preclinical studies have shown that SP TFL has a higher rate of stone ablation, a weaker retropulsion and a lower risk of fiber breakage. The results of clinical studies showed that the two methods were comparable in the ablation rate, laser time and operative time, stone-free rate and complication. SP TFL offered better endoscopic view quality and less retropulsion.
While the Ho:YAG laser remains the primary choice for endoscopic laser lithotripsy, the emergence of SP TFL offers a promising new option for the minimally invasive treatment of urinary calculi. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. SP TFL has a relatively short clinical application history, and further research is necessary to fully explore its long-term advantages, clinical significance, and possible limitations.
本综述旨在比较超脉冲铥光纤激光（SP TFL）与钬激光（Ho:YAG）在碎石术中的有效性，评估两者在碎石效率和安全性等关键指标上的差异，为临床选择更优的碎石方法提供参考。
通过检索多个权威医学数据库（PubMed、Embase和Web of Science数据库），纳入相关临床研究和实验室研究结果，分析纳入文献中涉及SP TFL和Ho:YAG激光的指标。
共找到24篇相关文献。比较了实验室研究和临床结果中的激光参数，如消融效率、消融速度、手术时间、碎末质量、结石回推、视野清晰度、温度安全性和结石清除率。临床前研究表明，SP TFL的结石消融率更高、结石回推较弱且光纤断裂风险较低。临床研究结果显示，两种方法在消融率、激光时间和手术时间、结石清除率及并发症方面相当。SP TFL提供了更好的内镜视野质量且结石回推更少。
虽然Ho:YAG激光仍是内镜激光碎石术的主要选择，但SP TFL的出现为尿路结石的微创治疗提供了一个有前景的新选择。参数范围、结石回推效应、激光光纤适应性和整体系统性能需要综合关注。SP TFL的临床应用历史相对较短，有必要进一步研究以充分探索其长期优势、临床意义和可能的局限性。
