scholarly journals Outcomes of Retrograde Intra-Renal Surgery

2019 ◽  
Vol 2 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Samir Shrestha ◽  
Pukar Maskey
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Renal Stone ◽  
Operative Time ◽  
Renal Calculi ◽  
Renal Surgery ◽  
Surgical Morbidity ◽  
Retrograde Intrarenal Surgery ◽  
Stone Clearance ◽  
The Mean

Introduction: Miniaturization of endoscopic instruments has gained wide popularity in the treatment of renal calculi. Retrograde intra-renal surgery and holmium laser in combination has already proven its superiority when compared to other modalities in the treatment of renal calculi. This study was conducted to assess the outcome of retrograde intra-renal surgery in renal stone disease.Materials and Methods: This retrospective study analyzed the outcome of retrograde intra-renal surgery in renal stone less than 2 cm size in the adults above 18 years of age from September 2018 to August 2019 at Patan Hospital, Nepal. The outcome was assessed descriptively on postoperative pain and fever, stone localization, stone size, stone clearance, urosepsis, operative time, hospital stay, mortality, need of the second procedure.Results: A total of 62 patients underwent retrograde intrarenal surgery, out of which 48 cases were included. The mean age of the study population was 32.4± 14 years (19-68 years). Similarly, the mean operative time was 68± 12 (48-124 minutes) and mean hospital-stay was 3.2± 1.1 days. Postoperative pain and fever were observed in 14 (29.16%) & 4(8.33%) patients respectively. Hematuria occurred in 6(12.50%) and urosepsis in 2(4.16%) of the patients. Complete stone clearance was achieved in 34(70.83%) and residual stones were present in 8(16.66%) and clinically insignificant radiological fragments were present in 6(12.50%) patients.Conclusions: Retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal calculi, with minimal post-surgical morbidity.

scholarly journals Retrograde Intrarenal surgery- Our experience

2020 ◽  
Vol 3 (1) ◽  
pp. 88-92
Author(s):  
Nand Kumar B. Madhekar ◽  
A. Nischal Prasad
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Tertiary Care ◽  
Renal Stones ◽  
Tertiary Care Centre ◽  
Renal Surgery ◽  
Retrograde Intrarenal Surgery ◽  
Residual Stone ◽  
Stone Clearance ◽  
Residual Stones

Background: RIRS has become an important treatment option for kidney stones in pediatric patients with the development of new-generation ureteroscopy and holmium laser. The present study was conducted to assess cases of retrograde intrarenal surgery. Subjects and Methods: The present study was conducted in a tertiary care centre over a period of one year on 120 cases of retrograde intra renal surgery (RIRS) performed in both genders. Renal stone location and stone clearance, laterality, stone size, operative time, hematuria, postoperative pain & fever, urosepsis, hospital stay, residual stones and need of an adjunctive procedure to achieve residual stone clearance. Results: Out of 120 patients, males were 70 and females were 50. Stones were detected in upper calyx in 50 cases, middle calyx in 40, lower calyx in 20 and pelvis in 10 cases. The mean size of stones was 8.1 mm, operative time was 62.1 minutes, hospital stay was 3.6 days, clinically insignificant radiological fragments were seen in 35 cases and residual stones were seen in 20 cases. Maximum cases of CIRF were seen in middle calyx (15) and residual stones were seen in lower calyx (7). The difference was significant (P< 0.05). Common complications were fever in 7, hematuria in 3, flank pain in 4 and urosepsis in 2 cases. Conclusion: Authors found that retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal stones.

scholarly journals Laparoscopic cholecystectomy in Jordan

2001 ◽  
Vol 7 (4-5) ◽  
pp. 838-840
Author(s):  
A. Al Raymoony
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Safe Procedure ◽  
Short Hospital Stay ◽  
Early Return ◽  
The Mean ◽  
Mean Time

This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. The success rate was 87% and the procedure was completed using the conventional method in 13 patients. The mean operative time was 60 minutes, complication rate was 5% and there were no deaths. The mean hospital stay was 1 day and mean time to return to work was 10 days. This study showed that laparoscopic cholecystectomy is a safe procedure with reasonable operative time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality rate.

scholarly journals Comparative Study Between Mini PCNL and RIRS in the Treatment of Renal Stones <20mm : Our Experience in CMH Dhaka

2020 ◽  
Vol 23 (2) ◽  
pp. 199-204
Author(s):  
Md Abdur Rakib ◽  
Md Shahidul Islam ◽  
SM Shameem Waheed ◽  
Md Ashif Chwdhury ◽  
Mohammad Shafiul Alam ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Renal Stones ◽  
Renal Calculi ◽  
Hemoglobin Level ◽  
Clearance Rates ◽  
Open Label ◽  
Stone Clearance ◽  
Level Data ◽  
The Mean ◽  
Study Participants

Aim: The aim of this study is to compare the outcomes of miniaturized percutaneous nephrolithotomy (mini-perc) and retrograde intrarenal surgery (RIRS) in management of renal stones with a diameter <15 mm. Materials and Methods: This was an open-label prospective study that included a total of 80 cases underwent mini-perc (n = 40) and RIRS (n = 40) between July 2014 and August 2017. The primary outcome objective was stone-free rate, retreatment rate, complications, hospital stay, operative time, and reduction in hemoglobin level. Data were analyzed using SPSS version 16.0 Software. Results: Overall, 80 patients were enrolled in this study. The mean age was 40.12 and 38.20 years, and the mean stone size was 1.15 and 1.30 cm in mini-perc and RIRS group, respectively. Majority of the study participants were males. Overall, mini-perc and RIRS had stone clearance rates of 100% and 95.4%, respectively. Two patients required retreatment in RIRS group. The duration of hospital stay and the rate of complication was similar in both the groups. Operative duration was more in RIRS group. Decrease in hemoglobin level was more in mini-perc group. Conclusions: Results demonstrated that both modalities were associated with high stone clearance rates with minimal complications. RIRS was associated with less reduction in hemoglobin and could be used as standard treatment modality for small renal calculi. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.199-204

scholarly journals Three Years Experience of Bilateral Simultaneous Percutaneous Nephrolithotomy – A Single Center Study in Pakistan

2020 ◽  
Vol I (2) ◽  
pp. 31-34
Author(s):  
Shakeel Haseeb Uddin Siddique
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Adult Population ◽  
Data Entry ◽  
Retrospective Chart Review ◽  
Renal Calculi ◽  
Normal Activity ◽  
Transfusion Rate ◽  
Early Return ◽  
The Mean

Objective To study the outcomes of simultaneous bilateral PCNLs in adult population and discussing therapeutical benefits and complications. Design A Retrospective Study. Setting The Kidney Centre ( The Post Graduate Training Institute, Karachi). Duration of Study Three years from January 2017 to December 2019. Methodology A retrospective chart review at one of the large urology institute in Karachi was conducted. The aim was to document the demographics, operation dynamics, outcomes and complications of simultaneous bilateral PCNL in adult population. Record of 60 patients who underwent simultaneous bilateral PCNL between January 2017 and December 2019 in our hospital were evaluated. Preoperative, post-operative laboratory values, operative time, stone clearance, complications and hospital stay were recorded. SPSS IBM version 20 was used for data entry and analysis. Results The mean age was 40.0±15.1 years. The mean hospital stay was 3.5 days and mean operative time was 144 minutes. The transfusion rate was observed 16.7% and infracostal approach was most frequently used approach. Conclusion Simultaneous bilateral PCNL is a safe, efficacious, and cost-effective option in cases of bilateral renal calculi and should be considered an acceptable treatment option for patients with bilateral stones due to low morbidity, overall short hospital stays, comparable stone free rates, cost effectiveness and early return-to-normal activity time.

Laparoscopic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction: Our Preliminary Experience

2020 ◽  
Vol 19 (2) ◽  
pp. 59-63
Author(s):  
Md Mahfuzur Rahman Chowdhury ◽  
AKM Khurshidul Alam ◽  
AKM Anwarul Islam ◽  
Md Sajid Hasan ◽  
Tms Hossain ◽  
...  
Keyword(s):  
Renal Function ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Ureteropelvic Junction Obstruction ◽  
Clinical Symptoms ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
The Mean ◽  
Urine Leakage

Objective: To evaluate prospectively the results obtained in 16 patients undergoing laparoscopic pyeloplasty through transperitoneal access. Materials and Methods: The study was conducted in the department of urology, BSMMU, Dhaka between the periods of March 2013 and June 2014, sixteen patients between 15 and 48 years old, were treated for ureteropelvic junction obstruction (UPJO) via a transperitoneal laparoscopy. All patients had clinical symptoms of urinary obstruction and hydronephrosis were confirmed by imaging methods. Anderson-Hynes dismembered pyeloplasty was performed in all patients. Patients were clinically and imaging evaluated in the postoperative period at 6 and 12 weeks. Results: Most of the patients were male (68.75%) and female were 31.25%. The mean operative time was 127.37 (±15.67) minutes ranged from 95 to 240 minutes. Pain score in first postoperative day and third postoperative day following pyeloplasty were 20.87 (±6.83) and 4.75 (±3.34) respectively. The mean hospital stay was 4.25 (±1.34) days. Anomalous vessels were identified in 4 patients, intrinsic stenosis in 12 patients. Postoperative urine leakage and UTI were seen 18.75%, 12.50% subject respectively. Split renal function and GFR were significantly improved (p<0.05) and improvement of renal functional outcome was 87.50%. Conclusion: Laparoscopic pyeloplasty had the advantages like less postoperative pain and shorter hospital stay. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.59-63

scholarly journals Retrograde Intrarenal Surgery (RIRS) vs Percutaneous Nephrolithotomy (PCNL) in Treatment of Lower Pole Renal Stone

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S I Ragy ◽  
A A Elshorbagy ◽  
M A Alzqzouq
Keyword(s):  
Hospital Stay ◽  
Renal Stone ◽  
Operative Time ◽  
Randomized Study ◽  
Alternative Therapy ◽  
Renal Calculi ◽  
Stone Free Rate ◽  
Group 2 ◽  
Free Rate ◽  
Group 1

Abstract Objective Compare the outcomes of RIRS and PCNL for the treatment of 1 to 2 cm lower calyceal renal calculi regarding the stone free rate, operative time, fluoroscopy time, hospital stay and complication rate. Materials and Methods Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were enrolled in this randomized study. Patients were randomized into two groups: group 1: underwent RIRS (20pts); group 2: underwent PCNL (20 pts). Patients were evaluated with KUB and CT after one month. Results Mean fluoroscopy times and Hospital stay were significantly greater in the PCNL group than in RIRS group, In the RIRS group, the stone-free rate was 85% (17/20 patients); this rate increased to 95% after a second intervention. After a single PCNL procedure, 19 of 20 (95%) patients were completely stone free and For complications, there were minimal differences in both procedures, except for hemorrhage three patients who were treated with PCNL need blood transfusion Conclusions PCNL and RIRS are safe and effective methods for medium-sized LP calculi. For selected patients, RIRS may represent an alternative therapy to PCNL, with acceptable efficacy and low morbidity., RIRS compared to PCNL offers the best outcome in terms of radiation exposure and hospital stay.

Uniportal Videothoracoscopic Surgery: Our Indications and Limits

2015 ◽  
Vol 10 (5) ◽  
pp. 309-313 ◽  
Author(s):  
Alessandro Gonfiotti ◽  
Massimo Osvaldo Jaus ◽  
Daniel Barale ◽  
Domenico Viggiano ◽  
Natalia Battisti ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Pain Score ◽  
Chest Wall ◽  
Pulmonary Nodule ◽  
Operative Time ◽  
Chest Wall Tumor ◽  
Wide Range ◽  
The Mean ◽  
Videothoracoscopic Surgery

Objective We present our experience with uniportal videothoracoscopic surgery (VATS-U), examining its indications, limits, and results. Methods Since January 2009, 66 patients underwent VATS-U for the following indications: pneumothorax (n = 25), lung nodule (n = 15; n = 10 with preoperative radiolocalization), wedge biopsy (n = 15), hyperhidrosis (n = 10), and chest wall schwannoma (n = 1). The conversion rate to conventional video-assisted thoracic surgery (VATS), postoperative pain, complications, residual paraesthesia, and hospitalization were analyzed. Operative time, postoperative pain, and paraesthesia were retrospectively compared with a cohort of 172 cases of conventional multiportal VATS, performed in the same period. Results Conversion to traditional VATS was necessary in two cases (pulmonary nodule, n = 1; pneumothorax, n = 1). The mean pain score was 0.8, the mean operation time was 42 minutes, and 10 patients had postoperative paraesthesia that lasted a mean of 7 days. No postoperative complications were reported, and the mean postoperative hospital stay was 3 days (range, 1–6 days). The comparison between the VATS-U and the standard multiportal VATS group showed in the VATS-U group a lower but not statistically significant pain score and paraesthesia as well as a lower and statistically significant operative time. Conclusions Uniportal videothoracoscopic surgery has a wide range of indications: lung apex resections and pleurodesis for spontaneous pneumothorax treatment; pulmonary nodule assessment with or without preoperative localization; lung biopsy for interstitial diseases; unilateral or bilateral sympathectomy to treat hyperhidrosis; benign chest wall tumor evaluation. The limits of this technique are linked to pleural adhesions or lung nodules in difficult positions. In our experience, VATS-U results in minimal postoperative pain, allowing for fast functional recovery and a consequent short hospital stay; thus, we suggest that VATS-U is a valid alternative to traditional multiportal VATS for indications beyond cosmetic benefits. Prospective randomized trials are necessary to validate the advantages of uniportal VATS.

scholarly journals Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery (RIRS) in the management of renal calculi ≤ 2 cm: a propensity matched study

2021 ◽  
Author(s):  
Sunil Bhaskara Pillai ◽  
Arun Chawla ◽  
Jean de la Rosette ◽  
Pilar Laguna ◽  
Rajsekhar Guddeti ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pain Score ◽  
Final Analysis ◽  
High Volume ◽  
Renal Calculi ◽  
Complication Rates ◽  
Retrograde Intrarenal Surgery ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Objective To compare the effectiveness and safety of Super-Mini PCNL (SMP) and Retrograde Intrarenal Surgery (RIRS) in the management of renal calculi ≤ 2 cm. Patients and methods A prospective, inter-institutional, observational study of patients presenting with renal calculi ≤ 2 cm. Patients underwent either SMP (Group 1) or RIRS (Group 2) and were performed by 2 experienced high-volume surgeons. Results Between September 2018 and April 2019, 593 patients underwent PCNL and 239 patients had RIRS in two tertiary centers. Among them, 149 patients were included for the final analysis after propensity-score matching out of which 75 patients underwent SMP in one center and 74 patients underwent RIRS in the other. The stone-free rate (SFR) was statistically significantly higher in Group 1 on POD-1 (98.66% vs. 89.19%; p = 0.015), and was still higher in Group 1 on POD-30 (98.66% vs. 93.24%, p = 0.092) SFR on both POD-1 and POD-30 for lower pole calculi was higher in Group 1 (100 vs. 82.61%, p = 0.047 and 100 vs 92.61% p = 0.171). The mean (SD) operative time was significantly shorter in Group 1 at 36.43 min (14.07) vs 51.15 (17.95) mins (p < 0.0001). The mean hemoglobin drop was significantly less in Group 1 (0.31 vs 0.53 gm%; p = 0.020). There were more Clavien–Dindo complications in Group 2 (p = 0.021). The mean VAS pain score was significantly less in Group 2 at 6 and 12 h postoperatively (2.52 vs 3.67, 1.85 vs 2.40, respectively: p < 0.0001), whereas the mean VAS pain score was significantly less in Group 1 at 24 h postoperatively (0.31 vs 1.01, p < 0.0001). The mean hospital stay was significantly shorter in Group 1 (28.37 vs 45.70 h; p < 0.0001). Conclusion SMP has significantly lower operative times, complication rates, shorter hospital stay, with higher stone-free rates compared to RIRS. SMP is associated with more early post-operative pain though.

scholarly journals A Single Surgeon’s Experience of Total Extra Peritoneal Repair Vs Transabdominal Preperitoneal Repair- A Prospective Cohort Study

2021 ◽  
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Koshy Mathew Panicker ◽  
Jeyakumar Sundaraj ◽  
Sidhu Rajasekhar ◽  
Pradeep Joshua Christopher
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Pain Score ◽  
Operative Time ◽  
P Value ◽  
Tep Repair ◽  
Duration Of Hospital Stay ◽  
Tapp Repair ◽  
The Mean

Introduction: Hernia surgery has evolved over a period of 2500 years from the Bassini-Shouldice era to conventional Lichenstein’s meshplasty to the laparoscopic era. Since, inception of the laparoscopic approach 25 years ago, there were several advancements in the techniques of inguinal hernia repairs. The two most commonly practiced laparoscopic approaches are the Total Extra Peritoneal (TEP) and Transabdominal Preperitoneal (TAPP) repair. Aim: To compare the outcomes for TEP and TAPP approaches in laparoscopic inguinal hernia surgery in terms of operative time consumed, postoperative pain, duration of hospital stay, complications and recurrence rate when performed by a single surgeon. Materials and Methods: A prospective interventional cohort study was carried out among 70 patients with uncomplicated inguinal hernia. Patients were divided equally into two groups of 35 patients and underwent TAPP and TEP repairs depending on group randomisation. All surgeries were performed by the same surgeon. Factors including operative time, postoperative pain, duration of hospital stay, complications and recurrence were documented and compared for both the groups. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 21. Unpaired t-test was used to compare the mean between the two groups. The p-value of <0.05 was considered to be statistically significant. Results: The mean operative time measured in minutes for TEP repair was 31.03 minutes and TAPP repair was 42.26 showing a difference of 11.23 minutes which was statistically significant (p-0.001). The mean Standard Deviation (SD) pain score at 24 hours for TEP repair was 2.43 (1.195) and TAPP repair was 3.43 (0.917). The mean (SD) pain score at 48 hours for TEP repair was 1.31 (1.051) and TAPP repair was 2.20 (0.901). The mean (SD) pain score at one week for TEP repair was 0.37 (0.690) and TAPP repair was 0.91 (0.781). The mean (SD) duration of hospital stay in TEP repair was 2.60 days (0.553) when compared to 3.49 days (0.658) in TAPP repair. All the results were statistically significant with a p-value of 0.001. Conclusion: TEP repair had superior outcomes in terms of reduction in operative time, less postoperative pain and shorter hospital stay than TAPP repair.

scholarly journals Mini percutaneous nephrolithotomy: its role in the management of renal stone and our tertiary care centre experience

2020 ◽  
Vol 8 (2) ◽  
pp. 624
Author(s):  
Avinash Pratap Singh Thakur ◽  
Darsan S.
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Operative Time ◽  
Tertiary Care ◽  
Renal Calculi ◽  
Medium Size ◽  
Tertiary Care Centre ◽  
Excellent Outcome ◽  
Stone Fragmentation

Background: Miniaturized percutaneous nephrolithotomy (PCNL) procedures for urolithiasis have gained increased popularity in recent years. To decrease the complications of conventional PCNL by  reduced tract size led to the development of Mini PCNL, which makes the use of 15-18F sheaths in place of 24-30F of conventional PCNL. It has developed rapidly and become a popular technique of renal stone management with reduced morbidity and excellent outcome. Authors report our experience with Mini PCNL for the treatment of renal stone.Methods: In between his August 2015 and January 2018, sixty patients with the diagnosis of unilateral single medium size (8-20mm) renal stone were identified. Patient’s demographical, clinical, diagnostic and procedural data were recorded.  All patients were evaluated by history taking, physical examination and laboratory investigations. Radiological evaluation was done with X ray kidney, ureter and bladder region (KUB) and also with renal ultrasonography followed by computed tomography (CT). All patients underwent Mini PCNL using 12F nephroscope and 16.5/17.5F sheath. Holmium: YAG laser was used for stone fragmentation. No nephrostomy tube was used routinely. Treatment outcome was assessed in terms of operative time, haemoglobin drop, hospital stay and stone free rate.Results: Complete stone fragmentation was achieved in 41 out of 60 patients using Mini PCNL, so initial stone free rate was 68.3%. After 4 weeks of surgery total 53 patients were stone free (88.3%), 5 patients required some auxiliary procedure for complete clearance of stone and other 2 were managed conservatively. The mean operative time was 48.28 min, mean haemoglobin drop was 0.74gm/l and mean postoperative hospital stay was 54.22 hours. After 12 weeks postoperatively all patients were stone free. There were no significant postoperative complications, and all had good quality of life.Conclusion: Mini PCNL technique appears to be safe and effective alternative to conventional PCNL for moderate size renal calculi. It is usually related to less blood loss and shorter hospital stay than the standard method. It can achieve good stone-free rates with minimal complications and low morbidity. Mini PCNL can also be considered as a good alternative to retrograde intrarenal surgery and shockwave lithotripsy in selected cases. However, further high quality studies with larger sample size are required in future.

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