title: High- vs low-power holmium laser lithotripsy: a prospective, randomized study in patients undergoing multitract minipercutaneous nephrolithotomy.
abstract: OBJECTIVE
  To determine the efficacy and safety of high-power holmium: yttrium aluminum-garnet (Ho:YAG) laser lithotripsy for multitract modified minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of patients with large staghorn renal calculi.
  
  
  METHODS
  A randomized, prospective study was conducted. Two-hundred seventy-three consecutive patients (291 renal units) with large staghorn renal calculi were randomized to undergo multitract MPCNL with 30-W low-power or 70-W high-power Ho:YAG laser lithotripsy. Both groups were compared in terms of perioperative findings and postoperative outcomes, including procedure time, stone-free rate, length of hospital stay, transfusion rates, renal function recovery, and other complications.
  
  
  RESULTS
  The average patient age was 49.2 years (range 22-73) and mean stone size was 5.54±0.7 cm. The 2 groups had some comparable perioperative findings and outcome, including tracts required per operated renal unit (n), blood loss, postoperative fever, postoperative hospital stay, stone-free rate, and improvement of operated renal function. The operation time in the high-power group was significantly shorter than that in the low-power group (129.20±17.2 vs 105.18±14.2, P<.01).
  
  
  CONCLUSIONS
  A combination of multitract MPCNL and high-power Ho:YAG laser lithotripsy can greatly decrease the operative time without increasing the intraoperative complications or delaying postoperative renal function recovery when compared with low-power Ho:YAG laser lithotripsy.
authors: Department of Urology, Fuzhou General Hospital, Xiamen University, Fuzhou, Fujian, China.
authors: Shushang
authors: S
authors: Chen
authors: Lingfeng
authors: L
authors: Zhu
authors: Shunliang
authors: S
authors: Yang
authors: Weizhen
authors: W
authors: Wu
authors: Lianming
authors: L
authors: Liao
authors: Jianming
authors: J
authors: Tan
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D017602:Lithotripsy, Laser / Q000379:methods*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000532:radiotherapy* / Q000601:surgery*; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult