Láser de fibra de tulio: ¿revolucionario o frenesí mediático?
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v83i1.1013Palabras clave:
Tulio, láseres de estado sólido, litotricia láser, urolitiasis, láser Holmiun-YAGResumen
Descripción: El láser de holmio: itrio-aluminio-granate (Ho:YAG) se ha convertido en el dispositivo de litotripsia intra-corpórea de referencia desde que se utilizó por primera vez en la década de 1980. Recientemente, el láser de fibra de tulio (TFL) se introdujo en el entorno clínico, con el potencial de abordar algunas de las limitaciones inherentes de los dispositivos Ho:YAG. En particular, los primeros estudios sugirieron que el TFL proporciona una mayor capacidad de pulverización y fragmentación, menor retropulsión y una mayor tasa libre de litiasis en comparación con el láser Ho:YAG.
Relevancia: Si se confirman las afirmaciones iniciales sobre las ventajas de pulverización del TFL, esto sería un avance significativo en el campo de endourología. La capacidad de pulverizar litos de mayor tamaño en un menor tiempo quirúrgico, podría extender las aplicaciones de la ureteroscopía y reducir la necesidad de procedimientos más invasivos.
Conclusión: La experiencia inicial con el TFL es prometedora y sugiere una ventaja sobre la litotripsia con láser Ho:YAG. Se requieren ensayos clínicos prospectivos y aleatorizados, con un diseño adecuado, para delinear las ventajas, desventajas y optimizar los resultados clíncos de los pacientes.
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Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
