scholarly journals Treatment of Complex Whole Liver Intrahepatic Ductal Stones Using a Patented Stone-Clearance Sheath Combined with Nephroscopic Holmium Laser Lithotripsy

2021 ◽  
pp. 1-4
Author(s):  
Yuancai Xie ◽  
Dingwen Zhong ◽  
Yanda LU ◽  
Donghua Xie ◽  
Xianjin Cheng ◽  
...  
Keyword(s):  
Operative Time ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Control Group ◽  
Observation Group ◽  
Clearance Rates ◽  
Stone Clearance ◽  
Second Stage ◽  
Holmium Laser Lithotripsy ◽  
One Year

Purpose: To investigate the clinical efficacy of nephroscopic laser lithotripsy with the aid of a patented suctioning sheath in treating complicated whole-liver dispersed intrahepatic ductal stones. Methods: From September 2013 to September 2017, 150 patients who were diagnosed with whole-liver dispersed intrahepatic ductal stones were included in this study and were divided into two groups randomly. The control group consists of 75 patients who were treated by traditional surgery combined with choledochoscopic laser lithotripsy. The observation group consists of the other 75 patients who were treated by traditional surgery combined with nephroscopic laser lithotripsy with the aid of the patented sheath. Related treatment outcome parameters were compared. Results: There were no significant differences in first surgery operative time, first surgery bleeding amount, complication and stone clearance rates (P>0.05). However, the second surgery operative time was (63.58±9.84) min while the complication rate was 7.5% in the observation group, significantly less than that of control group (P<0.05). There were significantly higher first-stage and second stage sinus ductal stone clearance rates and final stone clearance rate in the observation group compared to that of control group (P<0.05), while operative times, hospitalization duration and cost, and one year stone recurrent rate were significantly lower (P<0.05). Conclusion: The efficacy of using the patented stone-clearance sheath combined with nephroscopic holmium laser lithotripsy was significant, warrants more extensive clinical adoption.

scholarly journals Support Vector Machine-Based Analysis of Holmium Laser Lithotripsy in Treatment of Urinary Calculus from Ultrasound Images

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Hu Li ◽  
Zhijun Chen ◽  
Dezhi Kong ◽  
Zhiqiang Huang ◽  
Ningning Wang
Keyword(s):  
Support Vector Machine ◽  
Success Rate ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Support Vector ◽  
Control Group ◽  
Ultrasound Images ◽  
Observation Group ◽  
Holmium Laser Lithotripsy ◽  
Svm Algorithm

This study was to investigate the application value of ultrasound images optimized by support vector machine (SVM) algorithm in the efficacy analysis of holmium laser lithotripsy in the treatment of urinary calculi. 92 patients for treatment of UC were selected as research subjects, with 46 cases in each group. The control group received pneumatic lithotripsy for diagnosis and treatment. The observation group received holmium laser lithotripsy for calculus treatment. The perimeter and area of the defect and the length and width of the external distance of the most effective area of the defect were used as classification features, and a classifier based on SVM was constructed and applied to it. After treatment, the success rate, operation duration, stone clearance time, and hospital stay of the two groups were comprehensively evaluated. The results showed that the success rate of the observation group adopting holmium laser lithotripsy was 100%. The duration of operation in the observation group was (29.7 ± 7.65) min, and the time to clear calculus was (6.99 ± 5.29) days. The length of hospital stay was (3.67 ± 2.9) days. The probability of complications in the observation group was 3.11%. The observation group was superior to the control group in all surgical indicators (95%, 40.7 ± 8.36 minutes, 14.1 ± 7.21 days, and 5.12 ± 3.72 days), with considerable differences between groups ( P < 0.05 ). The strong support structure similarity information improved the detection and diagnostic analysis ability of ultrasonic images. In conclusion, after ultrasound image evaluation based on SVM algorithm, the adoption of holmium laser lithotripsy can effectively improve the success rate of patients with urinary system disease, which was worthy of clinical adoption and promotion.

Influence of Pelvicaliceal Anatomy on Stone Clearance After Flexible Ureteroscopy and Holmium Laser Lithotripsy for Large Renal Stones

2015 ◽  
Vol 29 (9) ◽  
pp. 998-1005 ◽  
Author(s):  
Takaaki Inoue ◽  
Takashi Murota ◽  
Shinsuke Okada ◽  
Shuzo Hamamoto ◽  
Kouei Muguruma ◽  
...  
Keyword(s):  
Renal Stones ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Flexible Ureteroscopy ◽  
Stone Clearance ◽  
Holmium Laser Lithotripsy

scholarly journals Semi-rigid Ureteroscopy and Holmium laser stone dusting for Proximal Ureteral Stones Does Adjuvant Tamsulosin Therapy Increase the Chance of Success?

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
P H Malky ◽  
A M Emam ◽  
H S Shaker
Keyword(s):  
Success Rate ◽  
Operative Time ◽  
Technical Problem ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Control Group ◽  
Stone Clearance ◽  
Alpha Blockers ◽  
Group 2 ◽  
Group 1

Abstract Background Alpha blockers decrease peristalsis above and below the stone, which increases the urine bolus and intraureteral pressure above it and lowers intraureteral pressure below it in association with the decrease in basal and micturition pressure, even at the bladder neck; thus, it increases the chance of stone expulsion.We aim to evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance. Since our aim in ureteroscopic treatment of upper ureteric stones is laser dusting rather than stone retrieval, its possible that alpha blockers can improve the access to upper ureter and clearance of fragmented stones. Objective To evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance. Patients and Methods This prospective, randomized, multicenter study included 60 patients and carried out between March 2018 and December 2018 in Police hospital Nasr City and Ain Shams University Hospitals included adult patients (at least 15 years) with proximal ureteral stones (≥ 5mm) scheduled for URS lithotripsy. Results In this study, the overall failure rate was 18.3%. In most cases 8/11(72.7%), failure of the procedure was due to the difficulty experienced in advancing the ureteroscope. We should mention that this technical problem was reported only in 2 (6.7%) patients receiving pre-URS tamsulosin but in 6 (20%) patients of the control group. The mean operative time in this series was significantly shorter operative time in Group 2(51.8min) compared to Group 1(58.8 min).At follow-up 4 weeks after URS, SFR was (86.7% for Group 2 and 66.7% for Group 1). Conclusion Adjunctive tamsulosin therapy prior to laser-assisted semi-rigid URS for the management of proximal ureteral stones improves ureteroscopic access, reduces the operative time and improves the SFR with an acceptable complication rate. Further research should be conducted on a larger scale to evaluate the various predictors of the outcome of URS and analyze the results with different pre-URS tamsulosin time periods in order to consolidate the results and to confirm the conclusion.

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 Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yue He ◽  
You-Gang Feng ◽  
Jun He ◽  
Bo Liang ◽  
Ming-Dong Jiang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Fluid Temperature ◽  
Postoperative Fever ◽  
Irrigation Fluid ◽  
Suspected Infection ◽  
Randomized Controlled ◽  
Holmium Laser Lithotripsy

Abstract Background Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications. Methods This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17 °C, 27 °C or 37 °C). Primary outcome was fever incidence (body temperature > 37.5 °C) within 48 h after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature > 38.5 °C and PCT > 0.5 µg/L). Results There were 108 patients, (17 °C group, n = 36; 27 °C group, n = 35; 37 °C group, n = 37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17 °C, 27 °C and 37 °C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p < 0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37 °C or 27 °C group compared with 17 °C group. One case each of flash pulmonary edema and bleeding occurred in 37 °C group. Conclusion Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature. Trial registration The trial was registered at the Chinese Clinical Trials Registry and allocated as ChiCTR2000031683. The trial was registered on 07/04/2020 and this was a retrospective registration.

Holmium Laser Lithotripsy for Ureteral Calculi: An Outpatient Procedure

1998 ◽  
Vol 12 (3) ◽  
pp. 241-246 ◽  
Author(s):  
K.H. YIP ◽  
C.W.F. LEE ◽  
P.C. TAM
Keyword(s):  
Laser Lithotripsy ◽  
Ureteral Calculi ◽  
Holmium Laser ◽  
Outpatient Procedure ◽  
Holmium Laser Lithotripsy

Size Distribution of Fragments by High-power Holmium Laser Lithotripsy in MiniPCNL with Suction

2021 ◽  
Vol 22 (12) ◽  
Author(s):  
Naveen K. Reddy ◽  
Abhijit P. Patil ◽  
Gopal R. Tak ◽  
Darshit Shah ◽  
Abhishek G. Singh ◽  
...  
Keyword(s):  
Size Distribution ◽  
High Power ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Holmium Laser Lithotripsy

Stone/tissue differentiation for holmium laser lithotripsy using autofluorescence

2015 ◽  
Vol 47 (9) ◽  
pp. 737-744 ◽  
Author(s):  
Birgit Lange ◽  
Jens Cordes ◽  
Ralf Brinkmann
Keyword(s):  
Laser Lithotripsy ◽  
Tissue Differentiation ◽  
Holmium Laser ◽  
Holmium Laser Lithotripsy
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