scholarly journals Observations on the Curative Effect of a Holmium Laser Under a Flexible Ureteroscope in the Treatment of Endogenous Renal Cysts Combined with Renal Calculi

2021 ◽  
Author(s):  
Qi Cai ◽  
Kaisen Liao
Keyword(s):  
Kidney Stones ◽  
Renal Cyst ◽  
Renal Cysts ◽  
Renal Calculi ◽  
Holmium Laser ◽  
Maximum Diameter ◽  
Curative Effect ◽  
Kidney Cysts ◽  
Flexible Ureteroscope ◽  
First Choice

Abstract Background: To explore and analyse the curative effects of a holmium laser under a flexible ureteroscope in the treatment of endogenous renal cysts complicated with renal calculi. Methods: Seven patients with endogenous renal cysts and renal calculi were admitted to our hospital from April 2019 to April 2021. The renal calculi was smashed by a holmium laser under a flexible ureteroscope, and the kidney cysts were opened by holmium laser endotomy. Window decompression was performed, indwelling the ureteral double-J tube for 1 month after the operation. After 1 month, when the patient was hospitalized and the double-J tube was removed, a flexible ureteroscope was inserted into the renal pelvis to confirm the effect of window opening and lithotripsy, and CT or B-ultrasound was reviewed. Results: Among the 7 patients with endogenous renal cysts and kidney stones, one patient was scheduled to undergo an internal incision after successful lithotripsy. The renal cyst wall tissue was surrounded by the renal artery, and the internal incision was terminated. One patient had an unsuccessful lithotripsy due to the poor angle of the kidney stone but was successfully treated for the renal cyst. The remaining 5 patients successfully underwent lithotripsy and internal incision surgery, of which 2 cases had difficulty finding kidney cysts and stones during the operation and needed assistance in locating kidney cysts and kidney stones under B-ultrasound monitoring. The average operation time was 42 minutes. When the catheter was extubated, the diameter of the renal cyst window was 0.5 cm to 2.5 cm under a flexible ureteroscope. The stone discharge was fair. There were residual gravels in the lower calyx of the kidney in two patients, and the stone basket was removed. After extubation, the maximum diameter of the renal cyst was reduced by more than half by CT or B-ultrasound, the effect of fenestration and decompression was achieved, and there were no obvious residual stones. Conclusions: A holmium laser under a flexible ureteroscope has a reliable curative effect in the simultaneous treatment of endogenous renal cysts with kidney stones, with little damage, quick recovery, and low cost. It can be used as the first choice for the treatment of endogenous renal cysts with kidney stones.

scholarly journals Long-term outcome after flexible ureteroscopy with holmium laser for simultaneous treatment of a single renal cyst and ipsilateral renal stones

2019 ◽  
Vol 47 (8) ◽  
pp. 3601-3612 ◽  
Author(s):  
Zhu Zewu ◽  
Chen Hequn ◽  
Cui Yu ◽  
Li Yang ◽  
Yang Zhongqing ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Intraoperative Complications ◽  
Renal Cysts ◽  
Holmium Laser ◽  
Flexible Ureteroscopy ◽  
Simultaneous Treatment ◽  
Period Range ◽  
Term Outcome ◽  
Long Term Outcome

Objective To assess the long-term outcome of simultaneous treatment of a single renal cyst and ipsilateral stones with transurethral flexible ureteroscopy (FURS) lithotripsy and internal cyst drainage. Methods Patients who underwent simultaneous treatment with FURS lithotripsy and internal cyst drainage in our institution between July 2014 and September 2017 were enrolled. The cyst wall was identified endoscopically and a 1–3-cm window was created in the wall using a holmium laser. The proximal end of a double-J stent was placed in the cystic cavity to facilitate internal drainage. Results Thirteen patients underwent simultaneous treatment. No intraoperative complications with Clavien grading score >2 were noted in any patients. Mean stone burden and cyst diameter were 1.6 (range: 0.9–2.5) cm and 5.8 (range: 3.0–7.1) cm, respectively. Stone-free rates after single and complementary procedures were 84.6% and 92.3%, respectively. During the mean 33.1-month follow-up period (range: 17–54 months), seven patients (53.8%) achieved full resolution of renal cysts, five patients (38.5%) maintained >50% size reduction, and one patient (7.6%) experienced recurrence at 18 months postoperatively. Conclusions FURS with a holmium laser may constitute a safe and effective alternative procedure for simultaneous treatment of a single renal cyst and ipsilateral stones.

scholarly journals RARE-32. PEDIATRIC METASTATIC SKULL BASE CHORDOMA WITH TP53 MUTATION – A CASE REPORT AND REVIEW OF THE LITERATURE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii449-iii449
Author(s):  
Akira Shimada ◽  
Kazuhiko Kurozumi ◽  
Kiichiro Kanamitsu ◽  
Hisashi Ishida Ishida ◽  
Kaori Fujiwara ◽  
...  
Keyword(s):  
Skull Base ◽  
Tp53 Mutation ◽  
Cranial Nerves ◽  
Gamma Knife Radiosurgery ◽  
Biological Behavior ◽  
Maximum Diameter ◽  
Cervical Lymph Nodes ◽  
First Choice ◽  
Systemic Metastasis ◽  
Skull Base Chordoma

Abstract Chordoma is an uncommon bone tumor arising from notochordal remnant, which accounts for 1–4% of all bone malignancies. It commonly occurs along the cranial-spinal axis, and skull base is one of most frequent sites, representing 35–49% of all chordoma cases. Surgical resection is widely accepted as the first choice of treatment. There are only limited number of reports about pediatric chordoma cases, and its biological behavior including genetic backgrounds were largely unknown. Here, we present a 5 year-old girl with a large aggressive skull base chordoma of 6 cm in maximum diameter, which eventually had multiple systemic metastasis. We initially tried chemotherapy based on the protocol for the osteosarcoma, but in vain. Because the tumor was highly vascularized on angiography, after embolization of the feeding arteries and bilateral internal maxillary arteries, endoscopic endonasal surgery was performed. The tumor was sufficiently removed, achieving effective mass reduction, and the residual tumors involving the lower cranial nerves and craniocervial junction were additionally treated with Gamma Knife radiosurgery. However, one month later, it showed systemic metastasis to bilateral cervical lymph nodes and lung. We tried chemotherapy with nivolmab and imatinib for this patient, whereas they showed the partial effect. The genetic analysis revealed somatic TP53 c.569C>T, (p.P190L) mutation in chordoma specimen. In the past literature, we found only one study of the adult chordoma cases, in which majority of the patients had somatic TP53 mutation (p.P72R). Further investigation with large number of the cases is essential to clarify the molecular biology of pediatric chordomas.

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

Complex cystine kidney stones treated with combined robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy

2017 ◽  
Vol 85 (2) ◽  
pp. 76-78 ◽  
Author(s):  
Luca Meggiato ◽  
Francesco Cattaneo ◽  
Fabio Zattoni ◽  
Fabrizio Dal Moro ◽  
Paolo Beltrami ◽  
...  
Keyword(s):  
Kidney Stones ◽  
Renal Stones ◽  
Renal Calculi ◽  
Robot Assisted ◽  
Intraoperative Bleeding ◽  
Laparoscopic Pyelolithotomy ◽  
Urinary Infections ◽  
Hospital Referral ◽  
Combined Technique ◽  
Rare Autosomal Recessive Disease

Introduction: Cystinuria, a rare autosomal recessive disease characterized by a defect in cystine renal reabsorption, can often determine complex cystine renal calculi, leading to important complications such as urinary obstruction, urinary infections, and impaired kidney function. Complex kidney stones can have a difficult management and can be very arduous to treat. Case description: We present the case of a 20-year-old Jeowah’s witness woman with complex cystine renal stones treated with combined robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy. Conclusions: The combination of robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy can be useful to achieve an immediate high stone clearance rate also in complex renal stones. This combined technique could be indicated to minimize intraoperative bleeding. Moreover, it can also be used in pediatric cases or when there is no ureteral compliance. However, this strategy can be performed only in hospital referral centers by expert surgeons.

Ex vivo study: is it possible to overcome the blurriness caused by holmium laser fragmentation of kidney stones?

Urolithiasis ◽  
2021 ◽  
Author(s):  
Murat Tuğrul Eren ◽  
Hakan Özveri ◽  
Murat Kolay ◽  
Neslihan Yıldırım Saral ◽  
Mustafa Serteser
Keyword(s):  
Kidney Stones ◽  
Ex Vivo ◽  
Holmium Laser ◽  
Ex Vivo Study

scholarly journals A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in Day Surgery Mode

2020 ◽  
Author(s):  
Xiao-Liang Zhu ◽  
Song-Jiang Wu ◽  
Yasmeen Bano ◽  
Wen-Li Liu ◽  
Ming-Hui jiang ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Previous History ◽  
Operation Time ◽  
Renal Cysts ◽  
Day Surgery ◽  
Simple Renal Cyst ◽  
Inpatient Ward ◽  
Medical Environment ◽  
History Of ◽  
Retroperitoneal Laparoscopy

Abstract Background: Under the constraints of the increasingly tight medical environment and cost, day surgery mode has become a favorable trend and attracts attention from clinicians. Currently, there are no standards or procedures on the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in day surgery mode. We attempted to investigate the feasibility and safety criteria of unilateral simple renal cyst decortication by retroperitoneal laparoscopy in the day surgery ward and to compare the advantages and the disadvantages with conventional inpatient ward mode.Methods: A total of 41 patients with unilateral simple renal cysts meeting surgical indications were enrolled in this study. To see whether patients in the day group could successfully complete the procedure and be admitted and discharged within 24 hours and to summarize the advantages and the advantages. The indexes of the operation time, time of hospitalization, postoperative complication rate, total costs of hospitalization and other indicators were compared between the two groups.Results: 41 cases of unilateral simple renal cyst decortication were completed successfully. Patients were followed up 10-12 months after surgery. The results of time of hospitalization, total costs of hospitalization and time of postoperative removal of drainage tube were statistically significant between the two groups of the day ward group and the inpatient ward group (P <0.05). Conclusions: We concluded the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in patients with unilateral renal cysts was safe and feasible in day surgery mode under certain indicative criteria. The criteria included patients’ age between 40 and 80 years, no previous history of abdominal surgery, CT showing a unilateral renal cyst (Bosniak I or II), preoperative ASA assessment was I or II, no contraindications to surgery or anesthesia, postoperative team management and discharge assessment. Advantage of reducing time of hospitalization and total medical cost may relieve the situation of the shortage of medical resources.

scholarly journals Renal complication of crizotinib: Crizotinib-associated complex renal cyst

2020 ◽  
Vol 21 (1) ◽  
pp. 44-56
Author(s):  
Warissara Jutidamrongphan ◽  
Pimporn Puttawibul
Keyword(s):  
Renal Impairment ◽  
Kinase Inhibitors ◽  
Renal Cyst ◽  
Renal Cysts ◽  
Small Cell ◽  
Small Cell Lung ◽  
Anaplastic Lymphoma ◽  
Renal Complication ◽  
Alk Positive ◽  
Cyst Development

Crizotinib is one of the first generations of tyrosine kinase inhibitors targeting anaplastic lymphoma kinase(ALK) and is recently found to be associated with the development of complex renal cysts with inconclusive explanation up to this time. Hereby, we discuss the hypothesis of Crizotinib-associated complex renal cyst development and coexisting renal impairment after initiation of the treatment in a 75-year-old man with ALK-positive non-small cell lung cancer whose complex renal cysts evolved after initiation and cessation of Crizotinib treatment. The coexistence as renal impairment persisted even after switching from Crizotinib to Ceritinib.

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