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LETTERS TO EDITOR |
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| Year : 2022 | Volume
: 38
| Issue : 2 | Page : 162-163 |
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Re: Mahajan AD, Mahajan SA. Thulium fiber laser versus holmium:yttrium aluminum garnet laser for stone lithotripsy during mini-percutaneous nephrolithotomy: A prospective randomized trial. Indian J Urol 2022;38:42-7
Sudhindra Jayasimha
Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| Date of Submission | 24-Feb-2022 |
| Date of Acceptance | 19-Mar-2022 |
| Date of Web Publication | 1-Apr-2022 |
Correspondence Address:
Sudhindra Jayasimha
Department of Urology, Christian Medical College, Vellore, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/iju.iju_67_22
How to cite this article:
Jayasimha S. Re: Mahajan AD, Mahajan SA. Thulium fiber laser versus holmium:yttrium aluminum garnet laser for stone lithotripsy during mini-percutaneous nephrolithotomy: A prospective randomized trial. Indian J Urol 2022;38:42-7. Indian J Urol 2022;38:162-3 |
How to cite this URL:
Jayasimha S. Re: Mahajan AD, Mahajan SA. Thulium fiber laser versus holmium:yttrium aluminum garnet laser for stone lithotripsy during mini-percutaneous nephrolithotomy: A prospective randomized trial. Indian J Urol 2022;38:42-7. Indian J Urol [serial online] 2022 [cited 2022 May 24];38:162-3. Available from: https://www.indianjurol.com/text.asp?2022/38/2/162/342463 |
We read the article, “Thulium fiber laser versus holmium: yttrium aluminum garnet laser for stone lithotripsy during mini-percutaneous nephrolithotomy: A prospective randomized trial,[1]” with interest. The authors have elegantly demonstrated that the thulium fiber laser (TFL) showed a shorter stone disintegration time (11 min 19 s vs. 20 min 45 s, P < 0.001) and operating time (55 vs. 68 min, P = 0.001) with similar stone clearance rates (94.9 TFL vs. 90.9% holmium:yttrium aluminum garnet [Ho-YAG]). Most complications were minor and self-limiting while hematuria was more common in the thulium laser fiber arm (13 vs. 2, P = 0.002). The following details, if added, will enhance the quality of the article and make it a valuable contribution to the level 1 evidence in this area, which is lacking. These are in keeping with the CONSORT statement:[2]
- Time period in which the study was carried out
- Clinical Trials Registry – India number
- Whether anomalous stone-bearing kidneys were excluded
- Exclusions because the patient did not consent or was to loss to follow-up
- Primary outcome
- Sample size calculation and assumption made based on published literature
- Details of when and who performed the randomization and allocation concealment
- Exclusions during the operation (for example, if conventional percutaneous nephrolithotomy (PCNL) was required instead of mini-PCNL after randomization)
- If the difference in stone clearance rates between the TFL group (94.9%) and the Ho-YAG group (90.9%) was statistically significant.
The authors have mentioned that the mean hemoglobin drop was 56 g/dL in the holmium arm and 55 g/dL in the thulium arm (the mean hemoglobin in the two groups was 13.3 g/dL and 13.2 g/dL, respectively). These values are high and may require to be corrected.
The authors are to be congratulated for reporting the first randomized study comparing TFL with Ho-YAG in mini-PCNL and for the demonstration of the superior stone fragmentation by TFL which merits further study.
Financial support and sponsorship:
Nil.
Conflicts of interest:
There are no conflicts of interest.
 References | |  |
| 1. | Mahajan AD, Mahajan SA. Thulium fiber laser versus holmium: Yttrium aluminum garnet laser for stone lithotripsy during mini-percutaneous nephrolithotomy: A prospective randomized trial. Indian J Urol 2022;38:42-7.  [Full text] |
| 2. | Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. BMJ 2010;340:c332. |
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