{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:52:47Z","timestamp":1777589567852,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Percutaneous nephrolithotomy (PCNL) is the gold standard for treating kidney stones &gt;20 mm because of its superior stone-free rates (SFR). However, high-power holmium lasers may challenge this standard. This study evaluates the feasibility, safety, and efficacy of high-power holmium laser retrograde intrarenal surgery (RIRS) for the treatment of kidney stones &gt;20 mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis of patients with kidney stones &gt;20 mm treated with either 80W- or 120 W holmium laser RIRS between January 2020 and August 2024. Clinical, intraoperative, and postoperative data were collected. Outcomes included SFR, operative time, complications, and hospital stay. Comparisons between the older-generation (80 W) and newer-generation (120 W) systems were performed using the Mann\u2013Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      test and chi-square test, and multivariable analyses identified predictors of non-stone-free status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 118 patients were included: 31 in the older-generation (80 W) group and 87 in the newer-generation (120 W) group. RIRS using the newer-generation 120 W laser was associated with a shorter operative time (66\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      79 minutes,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and higher SFR at 5 weeks (82.7%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      58.1%, p = 0.006), 6 months (92%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      64.5%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and 1 year (96.5%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      83.8%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.016) postoperative evaluations. Complication rates did not differ significantly between groups (5.7%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      3.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.208). In multivariable analysis, the use of older-generation 80 W laser was an independent predictor of non-stone-free status at both the first (OR 4.4,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.004) and second (OR 8.8,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001) follow-up visits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Treatment of renal stones larger than 2 cm with the newer-generation 120 W Ho:YAG laser is effective, with higher SFR rate and shorter operative time, compared to the older-generation 80 W Ho:YAG laser.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08927790251388465","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T01:08:42Z","timestamp":1761959322000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["High-Power Retrograde Intrarenal Surgery Holmium Laser Lithotripsy for Kidney Stones Larger Than 20 mm"],"prefix":"10.1177","author":[{"given":"Orel","family":"Hemo","sequence":"first","affiliation":[{"name":"Department of Urology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel."},{"name":"The Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asaf","family":"Shvero","sequence":"additional","affiliation":[{"name":"Department of Urology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel."},{"name":"The Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorit E.","family":"Zilberman","sequence":"additional","affiliation":[{"name":"Department of Urology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel."},{"name":"The Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zohar A.","family":"Dotan","sequence":"additional","affiliation":[{"name":"Department of Urology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Kleinmann","sequence":"additional","affiliation":[{"name":"Department of Urology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel."},{"name":"The Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-017-2008-6"},{"issue":"8","key":"e_1_3_3_3_2","first-page":"Cd007044","article-title":"Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones","volume":"8","author":"Srisubat A","year":"2023","unstructured":"Srisubat A, , Potisat S, , Lojanapiwat B, et al. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database Syst Rev, 2023; 8(8):Cd007044.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2021.02.008"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2022.04.004"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2011.0314"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000363509"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-015-0768-2"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-6051.23.05577-5"},{"issue":"4","key":"e_1_3_3_10_2","first-page":"441","article-title":"Retrograde intra renal surgery versus percutaneous nephrolithotomy for renal stones >2 cm. A systematic review and meta-analysis","volume":"72","author":"Barone B","year":"2020","unstructured":"Barone B, , Crocetto F, , Vitale R, et al. Retrograde intra renal surgery versus percutaneous nephrolithotomy for renal stones >2 cm. A systematic review and meta-analysis. Minerva Urologica e Nefrologica = The Italian Journal of Urology and Nephrology, 2020; 72(4):441\u2013450.","journal-title":"Minerva Urologica e Nefrologica = The Italian Journal of Urology and Nephrology"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000001092"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04438-4"},{"key":"e_1_3_3_13_2","unstructured":"Skolarikos A Jung H Neisius A Pet\u0159\u00edk A Somani B Tailly T Gambaro G. EAU guidelines on Urolithiasis. presented at the EAU Annual Congress Paris 2024. 2024."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.5152\/tud.2023.23142"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022704"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acuroe.2017.02.008"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0090"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562872221097345"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-021-01282-2"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0181"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2021.0870"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2021.02.014"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-020-0970-9"},{"issue":"3","key":"e_1_3_3_24_2","first-page":"437","article-title":"Risk factors for infectious complications after retrograde intrarenal surgery\u2013a systematic review and narrative synthesis","volume":"74","author":"Dybowski B","year":"2021","unstructured":"Dybowski B, , Bres-Niewada E, , Rzeszutko M, et al. Risk factors for infectious complications after retrograde intrarenal surgery\u2013a systematic review and narrative synthesis. Cent European J Urol, 2021; 74(3):437\u2013445.","journal-title":"Cent European J Urol"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2018.0395"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0658"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-04933-2"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12775"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-017-0297-0"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1677-5538.IBJU.2014.01.04"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-014-0650-7"},{"issue":"1","key":"e_1_3_3_32_2","first-page":"72","article-title":"Recent\u2004scoring\u2004systems\u2004predicting\u2004stone-free\u2004status after retrograde intrarenal surgery; A systematic review and meta-analysis","volume":"75","author":"\u00d6zman O","year":"2022","unstructured":"\u00d6zman O, , Akg\u00fcl HM, , Ba\u015fata\u00e7 C, et al.; RIRSearch Study Group. Recent\u2004scoring\u2004systems\u2004predicting\u2004stone-free\u2004status after retrograde intrarenal surgery; A systematic review and meta-analysis. Cent European J Urol, 2022; 75(1):72\u201380.","journal-title":"Cent European J Urol"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08927790251388465","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08927790251388465","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08927790251388465","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:17:42Z","timestamp":1777407462000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08927790251388465"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":31,"alternative-id":["10.1177\/08927790251388465"],"URL":"https:\/\/doi.org\/10.1177\/08927790251388465","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,24]]},"article-number":"08927790251388465"}}