scholarly journals Clinical Outcomes of Retrograde Intrarenal Surgery as a Primary Treatment for Staghorn Calculi: A Single-Center Experience

2019 ◽  
Vol 12 ◽  
pp. 117956111985477 ◽  
Author(s):  
Naoya Niwa ◽  
Kazuhiro Matsumoto ◽  
Takashi Ohigashi ◽  
Akari Komatsuda ◽  
Masahiro Katsui ◽  
...  
Keyword(s):  
Independent Predictor ◽  
Perioperative Complications ◽  
Primary Treatment ◽  
X Rays ◽  
Effective Treatment Option ◽  
Retrograde Intrarenal Surgery ◽  
Staghorn Calculi ◽  
Single Center Experience ◽  
Computed Tomography Scans ◽  
Free Status

Objective: We investigated the efficacy and safety of retrograde intrarenal surgery (RIRS) as a primary treatment for staghorn calculi. Methods: From 2012 to 2016, we identified 39 patients with staghorn calculi who received RIRS as a primary treatment. During the study period, no staghorn calculi were treated primarily with percutaneous nephrolithotomy or any other modality. A stone-free status after RIRS was defined as no detectable stone fragments on X-rays or computed tomography scans. Results: Of 39 patients who received 134 procedures (median 3 procedures per patient; range: 1-11; mean stone length: 60.5 ± 23.0 mm), 18 (46%) and 21 (54%) had staghorn calculi <60 and >60 mm in maximum length, respectively. The stone-free rates after the first and final procedures were 21% (8 of 39) and 62% (24 of 39), respectively; overall, 39% (7 of 18) and 78% (14 of 18), respectively, for the 18 patients with <60 mm staghorn calculi; and 5% (1 of 21) and 48% (10 of 21), respectively, for the 21 patients with >60 mm calculi. Multivariate analysis revealed a maximum stone length >60 mm to be the only independent predictor of a stone-free status after the first and final procedures. During the treatment series, perioperative complications occurred in 16 (41%) patients. Only one patient presented with a Clavien-Dindo grade III complication (malposition of a ureteral stent). Conclusions: RIRS is a safe and effective treatment option for staghorn calculi.

scholarly journals Relevance of comorbidities and antithrombotic medication as risk factors for reoperation in patients with chronic subdural hematoma

2021 ◽  
Author(s):  
Alexander Younsi ◽  
Lennart Riemann ◽  
Cleo Habel ◽  
Jessica Fischer ◽  
Christopher Beynon ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Multivariate Analyses ◽  
Independent Predictor ◽  
Perioperative Complications ◽  
Chronic Subdural Hematoma ◽  
Western Society ◽  
Increased Risk ◽  
Surgical Evacuation ◽  
Antithrombotic Medication ◽  
Univariate Analyses

AbstractIn an aging Western society, the incidence of chronic subdural hematomas (cSDH) is continuously increasing. In this study, we reviewed our clinical management of cSDH patients and identified predictive factors for the need of reoperation due to residual or recurrent hematomas with a focus on the use of antithrombotic drugs. In total, 623 patients who were treated for cSDH with surgical evacuation between 2006 and 2016 at our department were retrospectively analyzed. Clinical and radiological characteristics and laboratory parameters were investigated as possible predictors of reoperation with univariate and multivariate analyses. Additionally, clinical outcome measures were compared between patients on anticoagulants, on antiplatelets, and without antithrombotic medication. In univariate analyses, patients on anticoagulants and antiplatelets presented significantly more often with comorbidities, were significantly older, and their risk for perioperative complications was significantly increased. Nevertheless, their clinical outcome was comparable to that of patients without antithrombotics. In multivariate analysis, only the presence of comorbidities, but not antithrombotics, was an independent predictor for the need for reoperations. Patients on antithrombotics do not seem to necessarily have a significantly increased risk for residual hematomas or rebleeding requiring reoperation after cSDH evacuation. More precisely, the presence of predisposing comorbidities might be a key independent risk factor for reoperation. Importantly, the clinical outcomes after surgical evacuation of cSDH are comparable between patients on anticoagulants, antiplatelets, and without antithrombotics.

Factors associated with the stone‐free status after retrograde intrarenal surgery in children

2021 ◽  
Author(s):  
Oguzhan Kahraman ◽  
Hasan Serkan Dogan ◽  
Ahmet Asci ◽  
Tariq Asi ◽  
Hakan Bahadir Haberal ◽  
...  
Keyword(s):  
Retrograde Intrarenal Surgery ◽  
Factors Associated ◽  
Free Status

scholarly journals External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cong Wang ◽  
ShouTong Wang ◽  
Xuemei Wang ◽  
Jun Lu
Keyword(s):  
Scoring System ◽  
Kidney Stone ◽  
Medical Center ◽  
External Validation ◽  
Retrograde Intrarenal Surgery ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Stone Density ◽  
Free Rate ◽  
Free Status

Abstract Background The R.I.R.S. scoring system is defined as a novel and straightforward scoring system that uses the main parameters (kidney stone density, inferior pole stones, stone burden, and renal infundibular length) to identify most appropriate patients for retrograde intrarenal surgery (RIRS). We strived to evaluate the accuracy of the R.I.R.S. scoring system in predicting the stone-free rate (SFR) after RIRS. Methods In our medical center, we retrospectively analyzed charts of patients who had, between September 2018 and December 2019, been treated by RIRS for kidney stones. A total of 147 patients were enrolled in the study. Parameters were measured for each of the four specified variables. Results Stone-free status was achieved in 105 patients (71.43%), and 42 patients had one or more residual fragments (28.57%). Differences in stone characteristics, including renal infundibulopelvic angle, renal infundibular length, lower pole stone, kidney stone density, and stone burden were statistically significant in patients whether RIRS achieved stone-free status or not (P < 0.001, P: 0.005, P < 0.001, P < 0.001, P: 0.003, respectively). R.I.R.S. scores were significantly lower in patients treated successfully with RIRS than patients in which RIRS failed (P < 0.001). Binary logistic regression analyses revealed that R.I.R.S. scores were independent factors affecting RIRS success (P = 0.033). The area under the curve of the R.I.R.S. scoring system was 0.737. Conclusions Our study retrospectively validates that the R.I.R.S. scoring system is associated with SFR after RIRS in the treatment of renal stones, and can predict accurately.

scholarly journals Comparison of Sinus X-rays with Computed Tomography Scans in Acute Sinusitis

2008 ◽  
Vol 1 (3) ◽  
pp. 235-239 ◽  
Author(s):  
Thomas F. Burke ◽  
Andrew T. Guertler ◽  
James H. Timmons
Keyword(s):  
Computed Tomography ◽  
Acute Sinusitis ◽  
X Rays ◽  
Computed Tomography Scans

Comparison of scoring systems for predicting stone-free status and complications after retrograde ıntrarenal surgery

2020 ◽  
Author(s):  
Ridvan Ozbek ◽  
Cagri Senocak ◽  
Hakan Bahadir Haberal ◽  
Erman Damar ◽  
Fahri Erkan Sadioglu ◽  
...  
Keyword(s):  
Scoring Systems ◽  
Retrograde Intrarenal Surgery ◽  
Free Status

Hepatocellular Carcinoma Occurrence/Recurrence after Direct-Acting Antivirals for Hepatitis C in Egyptian Cohort: Single-Center Experience

2019 ◽  
Vol 37 (6) ◽  
pp. 488-497
Author(s):  
Sameh A. Lashen ◽  
Mohammed M. Shamseya ◽  
Marwa A. Madkour
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
De Novo ◽  
Independent Predictor ◽  
Alpha Fetoprotein ◽  
Direct Acting Antivirals ◽  
Single Center ◽  
Single Center Experience ◽  
Direct Acting ◽  
Hcc Recurrence

Background: Conflicting data have been published about the risk of hepatocellular carcinoma (HCC) following direct-acting antivirals (DAAs). We investigated the incidence of HCC occurrence/recurrence after DAAs therapy. Patients and Methods: Retrospectively, we analyzed data of 392 patients with F3–4 fibrosis and cirrhosis treated by DAAs during the period from August 2015 to May 2018. In HCC-experienced patients, HCC treatment modality, and the duration between HCC management and DAAs initiation were recorded. In all patients, pretreatment clinicolaboratory evaluation, and imaging before, during and after DAAs were done. Results: De novo HCC occurred in 7.6% of naïve patients, while recurrence appeared in 28% of patients with previous HCC. Pretreatment alpha-fetoprotein was an independent predictor of HCC occurrence, while the time between HCC ablation and the beginning of DAAs was the only predictor of HCC recurrence (p < 0.001). Half of the patients who started DAAs before 6 months had HCC recurrence, while patients who started DAAs at ≥6 months had no recurrence (p< 0.0001). Conclusions: Although HCC occurrence after DAAs was not high, recurrence was apparently high. Pretreatment alpha-fetoprotein is a predictor for de novo HCC. The time between HCC ablation and DAAs was the strongest predictor of recurrence.

scholarly journals Giant nontraumatic intradiploic arachnoid cyst in a young male

2016 ◽  
Vol 49 (5) ◽  
pp. 337-339 ◽  
Author(s):  
Rajesh Sharma ◽  
Puneet Gupta ◽  
Manik Mahajan ◽  
Poonam Sharma ◽  
Anchal Gupta ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Arachnoid Cyst ◽  
Young Male ◽  
Arachnoid Cysts ◽  
X Rays ◽  
Occipital Region ◽  
Resonance Imaging ◽  
Computed Tomography Scans ◽  
Intradiploic Arachnoid Cyst ◽  
Growing Mass

Abstract Intradiploic arachnoid cysts have scarcely been reported in the literature, most reported cases being secondary to trauma. Nontraumatic arachnoid cysts are quite rare and have been reported mostly in adults. Here, we report the case of a 16-year-old male presenting with a slowly growing mass in the occipital region and intermittent headaches. On the basis of the findings of X-rays, computed tomography scans, and magnetic resonance imaging scans of the head, the mass was diagnosed as a giant intradiploic arachnoid cyst.

Percutaneous-Based Management of Staghorn Calculi in Solitary Kidney: Combined Mini Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery

2014 ◽  
Vol 94 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Wen Zhong ◽  
Zhijian Zhao ◽  
Liang Wang ◽  
Sunil Swami ◽  
Guohua Zeng
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operation Time ◽  
Solitary Kidney ◽  
Retrograde Intrarenal Surgery ◽  
Staghorn Calculi ◽  
Combined Use ◽  
Stone Free Rate ◽  
Group 2 ◽  
Free Rate ◽  
Group 1

Introduction: Mini percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are well-established techniques with little morbidity. The combined use of standard PCNL and the mini-PCNL or the RIRS technique was evaluated and compared to investigate their own role in the management of staghorn calculi in solitary kidney. Materials and Methods: 23 patients received combined standard PCNL and mini-PCNL (group 1), and 22 patients received combined standard PCNL and RIRS (group 2). The treatment results and complications were evaluated and compared. Results: The mean operation time was 128.8 ± 9.1 min in group 1 and 109.8 ± 10.7 min in group 2 (p < 0.001). The decrease in hemoglobin level in group 1 was significantly higher than that in group 2 (3.5 ± 0.6 vs. 2.1 ± 0.5 g/dl, p < 0.001). The final stone-free rate was significantly higher (p = 0.038) in group 2 (90.9%) than in group 1 (65.2%). Conclusions: Combined standard PCNL and RIRS technique can extract the majority of staghorn calculi quickly by PCNL with EMS Lithoclast, and RIRS used simultaneously can reduce the need for multiple tracts and therefore reduce blood loss and potential morbidity related to multiple tracts, shorten the operation time and achieve a high stone-free rate.

Juvenile Nasopharyngeal Angiofibroma

1978 ◽  
Vol 87 (5) ◽  
pp. 630-632 ◽  
Author(s):  
Hugh F. Biller
Keyword(s):  
Surgical Resection ◽  
Clinical Examination ◽  
Adjunctive Therapy ◽  
Treatment Modality ◽  
Primary Treatment ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
X Rays ◽  
Arterial Ligation ◽  
Nasopharyngeal Angiofibroma ◽  
Primary Treatment Modality

The diagnosis of angiofibroma can be suspected in most cases by clinical examination, supplemented by routine x-rays and tomograms and is confirmed by angiography. Adjunctive therapy including embolization, estrogens, cryotherapy and arterial ligation is discussed. Surgical resection is the preferred treatment. Radiotherapy as the primary treatment modality is contra-indicated except in select cases.

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