摘要： “VaporTunnel” ureteroscopic holmium laser lithotripsy: Intraoperative and early postoperative outcomes. A prospective trial was conducted for patients undergoing holmium laser lithotripsy for ureteral stones. Patients were randomly assigned to have holmium laser lithotripsy with or without Vapor Tunnel technology. All procedures were performed by four experienced urologists. Quanta Cyber Ho 100 W generator with 365 μ fiber was used for all cases. Demographic data, stone parameters, perioperative complications and success rates were compared. The degree of stone retropulsion was graded on a Likert scale from zero-no retropulsion to 3-maximum retropulsion. Results: A total of 80 patients were included in the study (40 per each group). Both groups were comparable in terms of age, and pre-operative stone size (1.2 vs. 1.1 cm, p > 0.05). When compared with the Regular mode, Vapor Tunnel Technology was associated with significantly lower fragmentation time (20.4 vs. 16.1 min, p < 0.05) and total procedural time (49 vs. 35.7 min, p < 0.05). However, there were no significant differences in terms of total energy applied to the stones (9.9 vs. 10.7 KJ, p > 0.05). Vapor Tunnel technology was associated with significantly less retropulsion. There was no significant difference between both modes in terms of intraoperative complications. The success rate at the end of 1 month was comparable between both groups (92.3 vs. 88.3%, p > 0.05). Discussion: Vapor Tunnel technology is associated with significantly lower fragmentation and procedural times. The reduced fragmentation time is a result of the significantly lower retropulsion of the stones during laser lithotripsy; thus improving stone fragmentation efficiency.