Evidence map›Paper›PMID 35729369›Full record

ArticleWorld journal of urology2022

Ureteroscopy with thulium fiber laser lithotripsy results in shorter operating times and large cost savings.

James R Ryan, Mitchell H Nguyen, Joshua A Linscott, Samuel W Nowicki, Evelyn James, Brian M Jumper, Maria Ordoñez, Johann P Ingimarsson

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Adoption of thulium fiber laser for lithotripsy A scoping review and bibliometric analysis.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026
    Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. Review
  17. Article
  18. Review
  19. Review
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

James R RyanTufts University School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA. jryan1@mmc.org.ORCID http://orcid.org/0000-0003-2084-9581
Mitchell H NguyenDivision of Urology, Maine Medical Center, 100 Brickhill Ave, South Portland, ME, 04106, USA.
Joshua A LinscottDivision of Urology, Maine Medical Center, 100 Brickhill Ave, South Portland, ME, 04106, USA.
Samuel W NowickiTufts University School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA.
Evelyn JamesBrown School of Public Health, 121 South Main Street, Providence, RI, USA.
Brian M JumperDivision of Urology, Maine Medical Center, 100 Brickhill Ave, South Portland, ME, 04106, USA.
Maria OrdoñezDivision of Urology, Maine Medical Center, 100 Brickhill Ave, South Portland, ME, 04106, USA.
Johann P IngimarssonDivision of Urology, Maine Medical Center, 100 Brickhill Ave, South Portland, ME, 04106, USA.
Maine Medical Center · USTufts University · USBrown University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProlonged ureteroscopy (URS) is associated with complications including ureteral perforation, stricture, and urosepsis. As laser lithotripsy is one of the most common urologic procedures, small cost savings per case can have a large financial impact. This retrospective study was designed to determine if Thulium fiber laser (TFL) lithotripsy decreases operative time and costs compared to standard Holmium:YAG (Ho:YAG) lithotripsy without pulse modulation.

methodsA retrospective review of URS with laser lithotripsy was conducted for 152 cases performed from August 2020 to January 2021. Variables including cumulative stone size, location, chemical composition, prior ureteral stenting, and ureteral access sheath use were recorded for each case. A cost benefit analysis was performed to show projected cost savings due to potentially decreased operative times.

resultsCompared to Ho:YAG, use of TFL resulted in an average decrease of 12.9 min per case (p = .021, 95% CI [2.03-23.85]). In subgroup analysis of cases with cumulative stone diameter less than 15 mm, the difference was 14.0 min (p = .007, CI [3.95-23.95]). For cases less than 10 mm, the mean difference was 17.3 min in favor of TFL (p = .002, 95% CI [6.89-27.62]). This ~ 13 min reduction in operative time resulted in saving $440/case in direct operating room costs giving our institution a range of $294,000 to $381,900 savings per year.

conclusionsTFL has a significantly shorter operative time and decreased cost when compared to the standard Ho:YAG for equivalent kidney stone and patient characteristics. Longer term follow up is needed to see if recurrence rates are affected.

Indexed as

Lasers, Solid-StateLithotripsyLithotripsy, LaserUreteral CalculiCost SavingsHumansRetrospective StudiesThuliumUreteroscopyThuliumLithotripsyNephrolithiasisStonesUreteroscopy

Identifiers

PMID35729369
PMCPMC9213046
OpenAlexW4283206557

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.