Tim Large1, Charles Upshur Nottingham2, John Ethan Brinkman3, Deepak Kumar Agarwal4, Andrea Ferrero5, Michael W Sourial6, Karen Lynne Stern7, Marcelino E Rivera8, Bodo E Knudsen9, Mitchell R Humphreys10,11, Amy Krambeck12. 1. Indiana University School of Medicine, 12250, Urology, 1801 N Senate Blvd, Suite 220, Indianapolis, Indiana, United States, 46202; timlarge@iupui.edu. 2. Indiana University School of Medicine, Urology, 1701 North Senate Avenue, Indianapolis, Indiana, United States, 46202; cunottingham@gmail.com. 3. Indiana University School of Medicine, 12250, Urology, 535 Barnhill Drive, IU Simon Comprehensive Cancer Center 150, Indianapolis, Indiana, United States, 46202-5114; jebrinkm@iu.edu. 4. Indiana University School of Medicine, Urology, Indianapolis, Indiana, United States; dkagarwa@iu.edu. 5. Mayo Clinic, 6915, Rochester, Minnesota, United States; ferrero.andrea@mayo.edu. 6. Ohio State University Wexner Medical Center, 12306, Department of Urology, 915 Olentangy River Road, Suite 3100, Columbus, Ohio, United States, 43212; Michael.Sourial@osumc.edu. 7. Cleveland Clinic Foundation, Urology, 9500 Euclid Avenue, Q10-1, Cleveland, Ohio, United States, 44195; Stern.Karen@mayo.edu. 8. Indiana University Health Methodist Hospital, 22535, Urology, 1801 Senate Blvd, Ste 220, Indianapolis, Indiana, United States, 46202; mrivera7@iuhealth.org. 9. Ohio State University Medical Center, Department of Surgery, Division of Urology, 4833 University Hospitals Clinic, 456 West 10th Avenue, 915 Olentangy River Road, Columbus, Ohio, United States, 43212; bodo.knudsen@osumc.edu. 10. Mayo Clinic, Department of Urology, 5777 E Mayo Blvd, Phoenix, Arizona, United States, 85054. 11. Indiana, United States; humphreys.mitchell@mayo.edu. 12. Indiana University School of Medicine, 12250, Urology, 1801 Senate Blvd. #220, Indianapolis, Indiana, United States, 46202; gecoots2@gmail.com.
Abstract
INTRODUCTION: Currently, there are multiple intracorporeal lithotripters available for use in percutaneous nephrolithotomy (PCNL). This study aimed to evaluate the efficiency of two novel lithotripters; TrilogyTM and ShockPulse-SE. METHODS: This is a prospective, multi-institutional, randomized trial comparing outcomes of PCNLusing two novel lithotripters between February 2019 and June 2020. The study assessed objective measures of stone clearance time, stone clearance rate, device malfunction, stone-free rates, and complications. Device assessment was provided via immediate postoperative survey by primary surgeons. RESULTS: There were 100 standard PCNLs completed using either a TrilogyTM or ShockPulse-SE lithotrite. Using quantitative Stone Analysis Software to estimate stone volume, the mean stone volume was calculated at 4.18 ± 4.79 cm3 and 3.86 ± 3.43 cm3 for the Trilogy and ShockPulse-SE groups respectively . Stone clearance rates were found to be 1.22 ± 1.67 and 0.77 ± 0.68 cm3/min for TrilogyTM versus ShockPulse-SE (p=0.0542). When comparing TrilogyTM to ShockPulse-SE in a multivariate analysis, total OR time (104.4 ± 48.2 vs 121.1 ± 59.2 min p=0.126), rates of secondary procedures (17.65% vs 40.81% p=0.005), and device malfunctions (1.96% vs 34.69% p<0.001), were less, respectively. There was no difference in final stone free rates between devices. CONCLUSION: The TrilogyTM lithotripter removed stones significantly faster than previous generations of intracorporeal lithotripters. In the case of large stones the efficiency of the TrilogyTM device optimizes clearance and operating times.
RCT Entities:
INTRODUCTION: Currently, there are multiple intracorporeal lithotripters available for use in percutaneous nephrolithotomy (PCNL). This study aimed to evaluate the efficiency of two novel lithotripters; TrilogyTM and ShockPulse-SE. METHODS: This is a prospective, multi-institutional, randomized trial comparing outcomes of PCNL using two novel lithotripters between February 2019 and June 2020. The study assessed objective measures of stone clearance time, stone clearance rate, device malfunction, stone-free rates, and complications. Device assessment was provided via immediate postoperative survey by primary surgeons. RESULTS: There were 100 standard PCNLs completed using either a TrilogyTM or ShockPulse-SE lithotrite. Using quantitative Stone Analysis Software to estimate stone volume, the mean stone volume was calculated at 4.18 ± 4.79 cm3 and 3.86 ± 3.43 cm3 for the Trilogy and ShockPulse-SE groups respectively . Stone clearance rates were found to be 1.22 ± 1.67 and 0.77 ± 0.68 cm3/min for TrilogyTM versus ShockPulse-SE (p=0.0542). When comparing TrilogyTM to ShockPulse-SE in a multivariate analysis, total OR time (104.4 ± 48.2 vs 121.1 ± 59.2 min p=0.126), rates of secondary procedures (17.65% vs 40.81% p=0.005), and device malfunctions (1.96% vs 34.69% p<0.001), were less, respectively. There was no difference in final stone free rates between devices. CONCLUSION: The TrilogyTM lithotripter removed stones significantly faster than previous generations of intracorporeal lithotripters. In the case of large stones the efficiency of the TrilogyTM device optimizes clearance and operating times.
Authors: Mark A Assmus; Matthew S Lee; Mayandi Sivaguru; Deepak K Agarwal; Tim Large; Bruce W Fouke; Amy E Krambeck Journal: World J Urol Date: 2022-02-15 Impact factor: 4.226
Authors: Charles Joseph O'Connor; Donnacha Hogan; Lee Chien Yap; Louise Lyons; Derek Barry Hennessey Journal: World J Urol Date: 2022-08-24 Impact factor: 3.661