scholarly journals Transurethral use of nephroscope in the management of bladder stone

2014 ◽  
Vol 9 (1) ◽  
pp. 14-18
Author(s):  
Ghanshyam S Sigdel ◽  
A Agarwal ◽  
N Laminchhane ◽  
WK Belokar
Keyword(s):  
Medical Records ◽  
Operative Time ◽  
Bladder Stone ◽  
Endoscopic Management ◽  
Medical Sciences ◽  
Stone Size ◽  
Bladder Stones ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate

Objective: Endoscopic management of bladder stone is a well established procedure. The objective of this study was to evaluate the usefulness of transurethral use of nephroscope in the management of bladder stones. Materials and methods: We retrospectively analyzed the medical records of patients who had undergone treatment of bladder stones through transurethral use of nephroscope in our hospital. Various demographic, stone related, intraoperative and postoperative parameters were studied. Results: The mean stone size was 18.1± 6.8 millimetres. Mean operative time and duration of hospital stay were 42.2 minutes and 2.4 days respectively. Intraoperative and postoperative complications occurred in 8 and 16 percent respectively, which were minor and managed without further interventions. Stone free rate was 100 percent. Conclusion: Bladder stones in adults can be effectively managed with the transurethral use of nephroscope without significant complications. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 14-18 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9668

scholarly journals The Safety and Efficacy of Mini Percutaneous Nephrolithotomy During Learning Curve

2019 ◽  
Vol 18 (2) ◽  
pp. 42-47
Author(s):  
Bikash Bikram Thapa ◽  
Bina Basnet ◽  
Bikash Bahadur Rayamajhi ◽  
Narayan Thapa ◽  
Bharat Bhadur Bhandari
Keyword(s):  
Learning Curve ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Operative Time ◽  
Medium Size ◽  
Stone Size ◽  
Access Sheath ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate

Introduction: Since its introduction in 1976, percutaneous renal stone surgery has undergone several modifications. Reduction in size of access sheath was one of them which was first reported by Jackman in 1998. The miniaturisation of access sheath in Mini-Percutaneous Nephrolithotomy surgery has significantly reduced the intervention related morbidity with similar outcome as of standard Percutaneous Nephrolithotomy. Methods: This is a prospective cohort study where a single surgeon without previous experience of independent PCNL surgery performed Mini PCNL under controlled condition for renal stone sized 10 to 30 mm. The outcome was measured in terms of stone free rate and postoperative complications. The association of stone free rate and drop in haemoglobin level with different preoperative and operative variables were calculated with Pearson’s correlation test and p value <0.05 was considered significant. Results: Mini PCNL was performed in total of 63 renal units. The mean age was 37.8 ± 9.9 years with male: female ratio of 1.8:1. The average stone size was 16.8 ± 2.9 mm. The mean operative time was 55.2 ± 19.0 (30-110) minutes. The stone free rate was 98.2 ± 3.6 %. The mean drop in haemoglobin was 1.3 ± 0.8 and blood transfusion rate was 4.7%. The average hospital stay was 2.6 ± 1.3 days. The grade I complications was 15.8% and grade II and III was 7.9% each. Stone free rate was significantly associated with stone number (r = -0.47, p = 0.004). Similarly fall in haemoglobin was associated with total operative time (r = 0.49, p = 0.003). The stone size, hardness of stone (HU) and size of access sheath had no significant association with stone free rate and fall in haemoglobin. Conclusions: Mini PCNL is as effective as standard PCNL with higher safety margin in small and medium size stone (10 to 30 mm) during learning curve of endo-urology procedure.  

scholarly journals Application of Pneumatic Lithotripter and Holmium Laser in the Treatment of Ureteral Stones and Kidney Stones in Children

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Marcin Życzkowski ◽  
Rafał Bogacki ◽  
Krzysztof Nowakowski ◽  
Bartosz Muskała ◽  
Paweł Rajwa ◽  
...  
Keyword(s):  
Operative Time ◽  
Treatment Options ◽  
Population Based ◽  
Holmium Laser ◽  
Ureteral Stones ◽  
Stone Free Rate ◽  
Group A ◽  
The Mean ◽  
Laser Group ◽  
Free Rate

Objective.Treatment options for urolithiasis in children include URSL and RIRS. Various types of energy are used in the disintegration of deposits in these procedures. We decided to evaluate the usefulness of URSL and RIRS techniques and compare the effectiveness of pneumatic lithotripters and holmium lasers in the child population based on our experience.Materials and Methods.One hundred eight (108) children who underwent URSL and RIRS procedures were enrolled in the study and divided into two (2) groups according to the type of energy used: pneumatic lithotripter versus holmium laser. We evaluated the procedures’ duration and effectiveness according to the stone-free rate (SFR) directly after the procedure and after fourteen (14) days and the rate of complications.Results.The mean operative time was shorter in the holmium laser group. A higher SFR was observed in the holmium laser but it was not statistically significant in the URSL and RIRS procedures. The rate of complications was similar in both groups.Conclusions.The URSL and RIRS procedures are highly efficient and safe methods. The use of a holmium laser reduces the duration of the procedure and increases its effectiveness in comparison with the use of a pneumatic lithotripter.

scholarly journals Introducing in clinical practice a new laser suction handpiece for percutaneous nephrolithotomy

2021 ◽  
pp. 039156032110318
Author(s):  
Noam Bar-Yaakov ◽  
Haim Hertzberg ◽  
Ron Marom ◽  
Jemal Jikia ◽  
Roy Mano ◽  
...  
Keyword(s):  
Operative Time ◽  
Statistical Significance ◽  
Hounsfield Units ◽  
Stone Size ◽  
Stone Clearance ◽  
Stone Free Rate ◽  
Average Operative Time ◽  
Group A ◽  
Group B ◽  
Free Rate

Objective: To assess a novel combined laser suction handpiece (LSH) for performing PCNL in a clinical setting. Methods: The study comprised 40 consecutive PCNLs performed between May 2019 and February 2020. The first 20 procedures (Group A) were performed with conventional ultrasonic or pneumatic devices and the other 20 (Group B) were performed with the use of the new LSH. All patients were treated by tubeless supine PCNL. The groups were compared for demographics, clinical data, operative time, lithotrite effectiveness, stone clearance rate (SCR), and outcome. Results: Groups A and B were similar in age, and in stone size, complexity, and density (Hounsfield units) ( p < 0.05). The average operative time was 99 and 78 min, SCR 143 and 200 mm3/min, hospital stay 1.6 and 1.1 days, and stone-free rate 90% and 95%, respectively. Despite a trend toward better results with the new LSH, none of these comparisons reached statistical significance. Ineffective lithotripsy with the initial device (ultrasonic) requiring conversion to another modality (ballistic) occurred in six (30%) procedures in Group A, while all procedures were effectively accomplished with the LSH in Group B ( p = 0.02). There were two complications in Group A and none in Group B ( p > 0.05). Conclusions: The LSH is as effective and safe as the traditional lithotrites for performing PCNLs. This new tool completes the capabilities of the holmium laser high-power machines, enabling them to serve as the sole platform for all endourological treatments.

scholarly journals Non-Fluoroscopic Uretero-Lithotripsy for Distal and Mid Ureteric Stone: Is it Safe and Feasible? Single Center Experience

2017 ◽  
Vol 16 (1) ◽  
pp. 48-52
Author(s):  
Naser S Hussein ◽  
Hussein A Al Khumasi
Keyword(s):  
Operative Time ◽  
Intraoperative Complications ◽  
Medical Science ◽  
Ureteric Stone ◽  
Stone Size ◽  
Residual Stone ◽  
Single Center Experience ◽  
Stone Free Rate ◽  
Case Basis ◽  
Free Rate

Objective: To assess safety and feasibility of completely non-fluoroscopic ureteroscopy for treatment of mid and distal ureteric stone in term of stone free-rate and complications.Material and Methods: Over study period between January 2014 and January 2015, ninety-one complete fluoroscopy-less semirigid ureteroscopies were performed for treatment of symptomatic ureteric stones. Age, sex, stone size, location, side, operative time, auxiliary procedures, stonefree rate and complications, all were assessed. A Stone-free rate was defined as the lack of radiographic evidence of residual stone at 4 weeks. Postoperative imaging, and complications were grading according to modified Clavien classification system, which used initially to grade complications of general surgery.Results: The average age of our subjects was 32.9, with male and right side predominant, 68 % and 64.8% respectively. The average stone size and operative time were 10.07 and 32.08 respectively. Fifty six semirigid retrograde ureteroscopies were done for distal ureteric and 35 for mid ureteric stones, achieving 91.2% stone –free rate, with overall intraoperative complications of 18.6%. All cases were managed on day case basis, ureters were stenting preoperatively in 37 patients and all cases were stenting with an appropriate size of double J.Conclusion: Zero fluoroscopic semirigid retrograde ureteroscopy is a safe and feasible treatment modality for management of distal and mid ureteric stones.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.48-52

scholarly journals TRANSITION FROM PRONE TO SUPINE PERCUTANEOUS NEPHROLITOTOMY: EVALUATING THE LEARNING CURVE FROM THE SINGLE SURGEON EXPERIENCE

2021 ◽  
Vol 28 (2) ◽  
pp. 147-152
Author(s):  
Zulfikar Ali ◽  
Andika Afriansyah
Keyword(s):  
Learning Curve ◽  
Hospital Stay ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Major Complication ◽  
Hemoglobin Level ◽  
Stone Free Rate ◽  
Surgeon Experience ◽  
The Mean ◽  
Free Rate

Objective: This study aims to evaluate the learning curve of the urologist to perform supine PCNL and the perioperative outcome of patients based on a single surgeon’s experience. Material & Methods: 60 consecutive patients who underwent modified supine PCNL for renal stone were analyzed. A single experienced urological surgeon performed the supine PCNL. Mean operative time, drop in hemoglobin level, stone-free rate, complications, and length of hospital stay were analyzed to evaluate the learning curve of the surgeon. All parameters were compared among all six groups obtained from the 60 cases in chronological order. Besides, the outcomes of supine PCNL were also compared to prone PCNL. Results: Mean operative time from 60 cases of supine PCNL was 100 ± 27 minutes. The mean operative time was decreased over time, particularly after 20 cases. Significantly different mean operative times (89 ± 14 minutes vs. 126 ± 21 minutes, p < 0.001) in the groups of cases 21-60 compared to the group of 1–20 cases were observed. The total stone-free rate for supine PCNL from all cases was 68%. There was no difference regarding the reduction of hemoglobin level, stone-free rate, hospital stay, and complication rate. No major complication was found among study subjects. Supine PCNL showed similar outcome parameters compared to prone PCNL. Conclusion: The surgeon acquired the surgical competencies to perform supine PCNL after 20 cases. The supine PCNL could remove the kidney stone as effective and safe as prone PCNL.

scholarly journals Feasibility of one-shot dilation access in the pediatric age group

2022 ◽  
Vol 5 (1) ◽  
pp. e000311
Author(s):  
Alok Srivastava ◽  
Krishna Kumar Yadav ◽  
Anjana Singh ◽  
Anoop Kumar Srivastava ◽  
Sanjeet Kumar Singh
Keyword(s):  
Hospital Stay ◽  
Radiation Exposure ◽  
Operative Time ◽  
Pediatric Age Group ◽  
Stone Free Rate ◽  
Pelvicalyceal System ◽  
The Mean ◽  
Group 2 ◽  
Free Rate ◽  
Group 1

ObjectiveTo compare sequential fascial dilation (SFD) versus one-shot dilation (OSD) in the pediatric patients undergoing percutaneous nephrolithotomy.MethodsThe present study is an observational study. The study subjects were divided into two groups. In group 1, renal dilation was done using the SFD and in group 2, renal dilation was done using the OSD. The amount of time exposed to radiation during access to pelvicalyceal system was estimated. Complications, stone free rates, ancillary procedures for residual stones and hospital stay were compared. Modified Clavien-Dindo classification was used for grading the complications.ResultsRadiation exposure and operative time were less in OSD group (95% confidence interval (CI) 3.068 to 14.072, and 2.565 to 12.435, p<0.005). The mean drop of hematocrit was statistically less significant in OSD group (p=0.032). In both groups, complications, stone free rate and hospital stay were statistically insignificant.ConclusionsOSD is feasible in the children with reduced radiation exposure and shorter operative time. The outcome was similar to SFD.

scholarly journals Intraoperative flexible nephroscopy during percutaneous nephrolithotomy: An 8 years’ experience

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Yasir Masood ◽  
Nadeem Iqbal ◽  
Raja Mohsin Farooq ◽  
Sajid Iqbal ◽  
Faheemullah Khan
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Hounsfield Unit ◽  
Renal Stones ◽  
Stone Size ◽  
Group I ◽  
Stone Free Rate ◽  
Group Ii ◽  
Free Rate

Objectives: To see the effect of intra operative antegrade flexible nephroscopy during Percutaneous nephrolithotomy on stone free rate. Methods: We retrospectively reviewed electronic medical records of patients who underwent percutaneous nephrolithotomy from 2010 to 2017 for renal stones >2cm. Patients found eligible were divided in, Group-I who did not have intraoperative Flexible nephroscopy and Group-II who had flexible nephroscopy during percutaneous nephrolithotomy. All procedures were done by senior consultants. Variables like Mean age, side, stone size, skin to stone distance and Hounsfield unit were compared. Outcomes like Stone free rate, hospital stay and operative time were compared between the groups. Results: The study included 248 patients, consisting 85 (34.3%) females and 163 (65.7%) males. Mean age ± SD was 45.8±13.8 years. Both group were similar in characteristics like mean age, stone size, skin to stone distance and Hounsfield units. The overall stone free rate was 71%. It was not significantly different between the groups, 76% in Group-II vs. 67% in Group-I. However stone free rate markedly improved with flexible nephroscopy in patients with staghorn calculi. Mean operative time and hospital stay were similar between the groups. Conclusions: Intraoperative flexible nephroscopy during percutaneous nephrolithotomy significantly increases stone free rate in patients with staghorn stones. doi: https://doi.org/10.12669/pjms.37.3.3565 How to cite this:Masood Y, Iqbal N, Farooq RM, Iqbal S, Khan F. Intraoperative flexible nephroscopy during percutaneous nephrolithotomy: An 8 years’ experience. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3565 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Retrograde intrarenal surgery in the management of solitary large renal stones, 2-3 cm: a single center experience

2021 ◽  
Vol 8 (3) ◽  
pp. 939
Author(s):  
Ahmed Eissa ◽  
Maged Ragab ◽  
Giampoalo Bianchi ◽  
Ayman Hassan
Keyword(s):  
Operative Time ◽  
Treatment Options ◽  
Renal Stones ◽  
Complication Rates ◽  
Retrograde Intrarenal Surgery ◽  
Stone Size ◽  
Single Center Experience ◽  
Stone Free Rate ◽  
Efficient Alternative ◽  
The Mean

Background: Nephrolithiasis represents a major health burden worldwide. Several treatment options are available for renal stones such as open stone surgery, percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shockwave lithotripsy. PCNL is considered the gold standard treatment for large renal stones (>2 cm); however, it is associated with higher blood loss, complication rates, and longer hospitalization. In this setting, we aimed to assess the value of RIRS in the management of single large renal stones between 2-3 cm. Methods: The database of our center was reviewed to include all the patients who underwent RIRS for single large renal stone (2-3 cm) between February 2018 and April 2019. All the patients were evaluated by preoperative computed tomography to evaluate the stone size, site, and density. Furthermore, the following variables were also collected; pre- and post-operative hemoglobin and creatinine, the operative time, stone free rate (SFR), and duration of hospital stay. All the statistical analysis was performed using SPSS version 20.Results: Overall, the data of 31 patients were retrieved for the current study. The mean age of the patients was 56.9±12.9 years, and the mean stone size was 22.6±7 mm. The mean operative time was 96.4±37.3 minutes and the SFR was 74.2% after single session of RIRS. No major postoperative complications were reported in the current series.Conclusions: RIRS is a safe and efficient alternative to PCNL in the management of single renal stones between 2-3 cm; however, further prospective studies are required to confirm these findings.

scholarly journals Stone-free rate after semirigid ureteroscopy with holmium laser lithotripsy versus laparoscopic ureterolithotomy for upper ureteral calculi: a multicenter study

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Ahmed Issam Ali ◽  
Ali M. Abdel-Karim ◽  
Ahmed A. Abd El Latif ◽  
Amr Eldakhakhny ◽  
Ehab M. Galal ◽  
...  
Keyword(s):  
Operative Time ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Holmium Laser Lithotripsy ◽  
Stone Free Rate ◽  
Stone Migration ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Free Rate

Abstract Background Different treatment options were used to treat upper ureteral calculi. The aim of our study is to compare the stone-free rate and postoperative outcomes between semirigid ureteroscope with holmium laser lithotripsy and laparoscopic ureterolithotomy for the management of large solitary upper ureteral stones. Sixty-seven patients with a solitary upper ureteral stone who had LU or semirigid ureteroscopy in the period between January 2014 and March 2017 were included in our study. Out of the sixty-seven patients, 37 patients had semirigid ureteroscopy and holmium laser lithotripsy (Group A) and 30 patients had laparoscopic ureterolithotomy (Group B). Both groups were compared regarding operative time, intraoperative complications, need for auxiliary procedures, hospital stays, postoperative complications and stone-free rate. Results The mean stone size was 1.84 ± 0.12 cm in Group A and 1.79 ± 0.17 cm in Group B, P value = 0.2. The mean operative time was 61.5 ± 3.5 min in Group A and 63 ± 4.2 min in Group B, P value = 0.13. Stone migration was recorded in five cases (14%) in Group A while no cases in Group B had stone migration. Flexible ureteroscope was used as an auxiliary measure in five patients (14%) in Group A at the same session. No auxiliary measures were used in the LU group. Conclusion The stone-free rates after semirigid URS and laser lithotripsy are comparable to those following LU, especially when flexible URS is used to manage migrating stone fragments at the same session.

scholarly journals Complex pulmonary aspergilloma treated by cavernostomy

2014 ◽  
Vol 41 (6) ◽  
pp. 406-411 ◽  
Author(s):  
Paula dos Santos Marsico Pereira da Silva ◽  
Giovanni Antonio Marsico ◽  
Marcell Alex Ferraz Araujo ◽  
Fernando Soares Vannucci Braz ◽  
Heron Teixeira Andrade dos Santos ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Records ◽  
Operative Time ◽  
Lung Resection ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Treatment Alternative ◽  
Pulmonary Aspergilloma ◽  
The Mean ◽  
Pulmonary Bleeding

Objective: To evaluate the effectiveness of cavernostomy in patients with complex fungal balls.Methods: We analyzed the medical records of patients undergoing cavernostomy between January 2005 and May 2013, evaluating: age, gender, preoperative signs and symptoms, predisposing disease, preoperative tests, location of the aspergilloma, etiologic agent, cavernostomy indication, postoperative outcome.Results: Ten patients were male. The mean age was 42.9 years (34-56). The most frequent symptom was repeated pulmonary bleeding. Cavernostomy was proposed for patients at high risk for lung resection. It was performed in 17 patients and all of them had pulmonary tuberculosis sequelae, with cavitations. The indication in all cases was hemoptysis and elimination of phlegm. The cavernostomies were performed in a single surgical procedure. In all 17 patients the cavity was left open after the withdrawal of the mycetoma. In all patients hemoptysis ceased immediately. Operative mortality was 9.5% (1).Conclusion: cavernostomy is an effective treatment alternative in patients at high risk. It may be useful in some patients with complex aspergilloma, irrespective of lung function or bilateral disease. It is technically easy, has low-risk, saves parenchyma, and may be performed in a single operative time.

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