Carlos A Riveros, Victor Chalfant, Thomas Melchart, Gurjot Singh, Ana M Forero, Braian Ledesma, Susan Harnett, Andrew A Stec, Michael Feloney, Joan C Delto, Dane E Klett
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Outcomes of interest included operative (operation, fragmentation, and lasing times; total energy used; and ablation speed) and perioperative parameters (stone-free rate and overall complication rate).</p><p><strong>Results: </strong>The search identified six studies eligible for analysis. Compared to standard HLL, Moses was associated with significantly shorter average lasing time (mean difference [MD] -0.95, 95% confidence interval [CI] -1.22 to -0.69 minutes), faster stone ablation speed (MD 30.45, 95% CI 11.56-49.33 mm<sup>3</sup>/min), and higher energy used (MD 1.04, 95% CI 0.33-1.76 kJ). Moses and standard HLL were not significantly different in terms of operation (MD -9.89, 95% CI -25.14 to 5.37 minutes) and fragmentation times (MD -1.71, 95% CI -11.81 to 8.38 minutes), as well as stone-free (odds ratio [OR] 1.04, 95% CI 0.73-1.49) and overall complication rates (OR 0.68, 95% CI 0.39-1.17).</p><p><strong>Conclusions: </strong>While perioperative outcomes were equivalent between Moses and standard HLL, Moses was associated with faster lasing time and stone ablation speeds at the expense of higher energy usage.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"75 4","pages":"409-417"},"PeriodicalIF":1.4000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/e9/CEJU-75-156.PMC9903166.pdf","citationCount":"2","resultStr":"{\"title\":\"Does Moses technology improve the efficiency and outcomes of standard holmium laser lithotripsy? 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Outcomes of interest included operative (operation, fragmentation, and lasing times; total energy used; and ablation speed) and perioperative parameters (stone-free rate and overall complication rate).</p><p><strong>Results: </strong>The search identified six studies eligible for analysis. Compared to standard HLL, Moses was associated with significantly shorter average lasing time (mean difference [MD] -0.95, 95% confidence interval [CI] -1.22 to -0.69 minutes), faster stone ablation speed (MD 30.45, 95% CI 11.56-49.33 mm<sup>3</sup>/min), and higher energy used (MD 1.04, 95% CI 0.33-1.76 kJ). 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引用次数: 2
摘要
导读:逆行输尿管镜钬激光碎石术(HLL)是治疗尿石症的标准方法。Moses技术已被证明可以提高体外破碎效率;然而,与标准HLL相比,其临床表现尚不清楚。我们进行了系统回顾和荟萃分析,评估Moses模式和标准HLL之间的效率和结果差异。材料和方法:我们检索了MEDLINE、EMBASE和CENTRAL数据库中比较Moses模式和标准HLL在成人尿石症患者中的随机临床试验和队列研究。关注的结果包括手术(手术、碎片和激光时间);使用的总能源;消融速度)和围手术期参数(结石游离率和总并发症发生率)。结果:检索确定了6项符合分析条件的研究。与标准HLL相比,Moses与较短的平均激光时间(平均差[MD] -0.95, 95%可信区间[CI] -1.22至-0.69分钟)、更快的结石消融速度(MD 30.45, 95% CI 11.56-49.33 mm3/min)和较高的能量消耗(MD 1.04, 95% CI 0.33-1.76 kJ)相关。Moses和标准HLL在手术(MD -9.89, 95% CI -25.14至5.37分钟)、碎裂时间(MD -1.71, 95% CI -11.81至8.38分钟)、无结石(优势比[OR] 1.04, 95% CI 0.73-1.49)和总并发症发生率(OR 0.68, 95% CI 0.39-1.17)方面无显著差异。结论:虽然Moses和标准HLL的围手术期结果相当,但Moses与更快的激光时间和更快的结石消融速度相关,但以更高的能量消耗为代价。
Does Moses technology improve the efficiency and outcomes of standard holmium laser lithotripsy? A systematic review and meta-analysis.
Introduction: Retrograde ureteroscopy with holmium laser lithotripsy (HLL) is a standard treatment for urolithiasis. Moses technology has been shown to improve fragmentation efficiency in vitro; however, it is still unclear how it performs clinically compared to standard HLL. We performed a systematic review and meta-analysis evaluating the differences in efficiency and outcomes between Moses mode and standard HLL.
Material and methods: We searched the MEDLINE, EMBASE, and CENTRAL databases for randomized clinical trials and cohort studies comparing Moses mode and standard HLL in adults with urolithiasis. Outcomes of interest included operative (operation, fragmentation, and lasing times; total energy used; and ablation speed) and perioperative parameters (stone-free rate and overall complication rate).
Results: The search identified six studies eligible for analysis. Compared to standard HLL, Moses was associated with significantly shorter average lasing time (mean difference [MD] -0.95, 95% confidence interval [CI] -1.22 to -0.69 minutes), faster stone ablation speed (MD 30.45, 95% CI 11.56-49.33 mm3/min), and higher energy used (MD 1.04, 95% CI 0.33-1.76 kJ). Moses and standard HLL were not significantly different in terms of operation (MD -9.89, 95% CI -25.14 to 5.37 minutes) and fragmentation times (MD -1.71, 95% CI -11.81 to 8.38 minutes), as well as stone-free (odds ratio [OR] 1.04, 95% CI 0.73-1.49) and overall complication rates (OR 0.68, 95% CI 0.39-1.17).
Conclusions: While perioperative outcomes were equivalent between Moses and standard HLL, Moses was associated with faster lasing time and stone ablation speeds at the expense of higher energy usage.