scholarly journals COMPARISON OF STONE FREE RATE OF STAGHORN STONE, RENAL PELVIC STONE, AND INFERIOR CALYX STONE FOLLOWING PCNL

2016 ◽  
Vol 23 (1) ◽  
Author(s):  
Pande Made Wisnu Tirtayasa ◽  
Ponco Birowo ◽  
Nur Rasyid
Keyword(s):  
General Hospital ◽  
Kidney Stones ◽  
Medical Records ◽  
Incomplete Data ◽  
Inclusion Criteria ◽  
Stone Free Rate ◽  
Staghorn Stone ◽  
Free Rate ◽  
Free Status ◽  
Staghorn Stones

Objective: To compare the stone free rates on patients with staghorn, renal pelvic, and inferior calyx stones with stone burden < 20 mm, 21-30 mm, and > 30 mm following percutaneous nephrolithotomy (PCNL) in Cipto Mangunkusumo General Hospital Jakarta. Material & methods: The data were collected retrospectively from PCNL medical records in Cipto Mangunkusumo General Hospital Jakarta between January 2000 and March 2011. Six hundred and twenty-three patients with 651 kidney stones underwent PCNL. The inclusion criteria were staghorn stones, renal pelvic stone, and inferior calyx stone. All cases outside these three criteria and incomplete data were excluded. Stone free status was defined as no residual fragment on radiography or ultrasonography. Results: As many as 364 kidney stones from 344 patients were included, with 47.8% cases of staghorn stones, 31.9% cases of renal pelvic stones, and 20.3% cases of inferior calyx stones. Overall, 273 (75%) cases were defined as stone free. In group < 20 mm, 4 staghorn stones (100%), 18 renal pelvic stones (81.8%), and 34 inferior calyx stones (94.4%) were cleared (p = 0.811). In group 21-30 mm, 20 staghorn stones (95.2%), 52 renal pelvic stones (91.2%), and 26 inferior calyx stones (92.9%) were cleared (p = 1.000). In group > 30 mm, 83 staghorn stones (55.7%), 28 renal pelvic stones (75.7%), and 8 inferior calyx stones (80%) were cleared (p = 0.037). Conclusion: PCNL is an important tool for treating various kinds and sizes of kidney stones with high stone free rate.

scholarly journals STONE FREE RATES OF KIDNEY STONE WAS LOWER THAN THE ONE OF URETER STONE PATIENTS MANAGED BY ESWL AND THE ONE OF URETER STONE MANAGED BY URETEROLITHOTRIPSY

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Zuhirman Zamzami
Keyword(s):  
Kidney Stones ◽  
Medical Records ◽  
Kidney Stone ◽  
Shockwave Lithotripsy ◽  
Ureter Stone ◽  
Stone Free Rate ◽  
Ureter Stones ◽  
Male Patients ◽  
The One ◽  
Free Rate

Objective: To evaluate the stone free rates of kidney and ureter stone patients managed by Extracorporeal Shockwave Lithotripsy (ESWL), and the ureter stone free rate managed by ureterolithotripsy. Material & method: We reviewed the medical records of kidney and ureter stone patients managed by ESWL and ureter stone patients managed by ureterolithotripsy in Arifin Achmad Regional General Hospital Pekanbaru Riau Province, Indonesia, from January 2010 - December 2016. ESWL and ureterolithotripsy stone free rates were examined by the control of KUB röngents. Results: There were 891 kidney and ureter stone patients consisting of 325 (36.5%) were kidney stone patients and 566 (63.5%) were ureter stone patients. The pyelum stones were the most (78.2%) in kidney stones and the lower ureter stones were the most (57.2%) in ureter stones. There were more male patients than the female ones in which most of the patients were in the group age of 49-59 years. The amount of patients increased each year. The kidney stone free rate managed by ESWL was lower (71.7%) than ureter stone free rate (84.1%) by ESWL, while the stone free rate of ureter stone patients managed by ureterolithotripsy was 100%. Conclusion: The ESWL stone free rate of the kidney stone patients was lower than the one in ureter stone patients while the ureterolithotripsy stone free rate was 100%.

scholarly journals Outcome and safety of upper pole versus non-upper pole single puncture PCNL for staghorn stones: a systematic review and meta-analysis

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 537
Author(s):  
Steven Gunawan ◽  
Ponco Birowo ◽  
Nur Rasyid ◽  
Widi Atmoko
Keyword(s):  
Meta Analysis ◽  
Direct Access ◽  
Risk Of Bleeding ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Complications Rate ◽  
Staghorn Stone ◽  
Review Manager ◽  
Free Rate ◽  
Staghorn Stones

Background: Staghorn stones are mostly treated by percutaneous nephrolithotomy (PCNL), either with an upper-pole (UP) or non-upper (lower- or middle-) pole (NP) approach. NP access has a lower risk of bleeding and thoracic complications but may not be sufficient for complete stone clearance. UP access is advocated as the preferred approach, because of direct access to the collecting system. However, it is associated with a higher complications rate, including pneumothorax and hydrothorax, and a higher risk of bleeding. This meta-analysis aimed to describe the outcomes and safety of PCNL for staghorn stones using UP and NP approaches. Methods: A systematic literature review was conducted using several databases such as: PubMed; EBSCO; Science Direct; Cochrane and Google Scholar. Data from all selected articles were extracted by two independent reviewers. Relevant parameters explored using Review Manager V5.3. Results: Five comparative studies of staghorn stones involving 384 renal units were analyzed; 176 cases used the UP approach and 208 the NP approach. There was no significant difference in stone-free rate between these approaches, with 74.4% undergoing the UP approach and 71.1% the NP approach considered stone-free (OR: 1.55; 95% CI: 0.92-2.63; P=0.10). The rate of thoracic complications (hydrothorax and pneumothorax) did not differ significantly (OR: 3.14; 95% CI: 0.63-15.62; P=0.16). However, we noted that 5 of 176 patients that underwent the UP approach experienced thoracic complications. The incidence of post-procedural fever and sepsis is similar (OR: 1.18; 95% CI: 0.52-2.64; P=0.69). Neither post-procedural urine leakage (OR: 2.03; 95% CI: 0.70-5.85; P=0.19) nor requirement of blood transfusions (OR: 0.49; 95% CI: 0.14-1.76; P=0.27) differed significantly. Conclusion: PCNL with UP access for staghorn stone has a similar stone-free rate to the NP approach. Thoracic complication rate which was believed to be higher in the UP group is also deemed similar with NP access.

scholarly journals PERCUTANEOUS NEPHROLITOTOMY ON THE MANAGEMENT OF CALYX INFERIOR STONES

2014 ◽  
Vol 21 (2) ◽  
Author(s):  
Pande Made Wisnu Tirtayasa ◽  
Ponco Birowo ◽  
Nur Rasyid
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Medical Records ◽  
Renal Ultrasonography ◽  
Abdominal Radiography ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Plain Abdominal Radiography ◽  
Free Rate ◽  
Free Status ◽  
Residual Fragments

Objectives: To compare the stone free rates of inferior calyceal stones with stone burden < 20 mm, 21-30 mm, and > 30 mm on post-percutaneous nephrolithotomy (PCNL) patients in Cipto Mangunkusumo Hospital. Material & method: The data was collected retrospectively from PCNL medical records in Cipto Mangunkusumo Hospital between January 2000 until May 2012. Patients were followed-up with plain abdominal radiography (BNO) or renal ultrasonography (USG). Stone free status was defined as no residual fragments on radiography or USG. Results: As many as 88 patients with inferior calyceal stones who underwent PCNL were included. Forty-three cases had stone burden < 20 mm, 34 cases with stone burden 21-30 mm, and 11 cases with stone burden > 30 mm. Overall, 81 (92%) cases were defined as stone free. On group < 20 mm, 21-30 mm, and > 30 mm; 41 (95%), 32 (94%), and 8 (73%) cases defined as stone free respectively (p = 0.485). Conclusion: PCNL is the primary modalityon the management of calyx inferior stones with high stone free rate. The stone free rate of these three groups showed no statistically significant difference.Keywords: Percutaneous nephrolithotomy, inferior calyx stone, stone free rate.

scholarly journals Differences Effectiveness of Percutaneous Nephrolithotomy and Open Surgery in Staghorn Stone Patients: Systematic Review

2020 ◽  
Vol 4 (11) ◽  
pp. 381-385
Author(s):  
Ramandita Duta Dewangga ◽  
Tarmono Djojodimedjo ◽  
Dyah Erawati
Keyword(s):  
Systematic Review ◽  
Percutaneous Nephrolithotomy ◽  
Open Surgery ◽  
Meta Analysis ◽  
Number Of Patients ◽  
Stone Free Rate ◽  
Additional Therapy ◽  
Staghorn Stone ◽  
Free Rate ◽  
Staghorn Stones

This study purpose to analyze the differences in the effectiveness of PCNL and open surgery in patients with staghorn stones. We searched the literatures from PubMed and ScienceDirect from year 2005 until 2020. The method used in this study was a systematic review with a quantitative statistical approach (meta-analysis) using primary research data. From 4 studies there were 148 cases of PCNL and 98 cases of open surgery. PCNL had lower postoperative stone-free rate than open surgery (OR 0.168). PCNL had a lower final stone-free rate than open surgery (OR 0.603). The number of patients who had complications with PCNL was lower than open surgery (OR 0.451). The number of patients receiving blood transfusions on PCNL was lower than for open surgery (OR 0.494). Patients who received PCNL procedure required a shorter hospital stay than open surgery (MD -3,234). The number of patients who received additional therapy modalities on PCNL was lower than open surgery (OR 1.917). The conclusions obtained in this study indicate that there are differences in the effectiveness of PCNL and open surgery for patients with staghorn stones. Keywords: percutaneous nephrolithotomy; open surgery; staghorn stone

scholarly journals ESWL EFFECTIVENESS FOR LOWER POLE KIDNEY STONES

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Riza Mazidu Sholihin ◽  
Soetojo Soetojo ◽  
Haviv Muris
Keyword(s):  
General Hospital ◽  
Kidney Stones ◽  
Clearance Rate ◽  
Kidney Stone ◽  
Lower Pole ◽  
Stone Size ◽  
Chi Square ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Free Rate

Objective: To describe the profile of lower pole kidney stone patients who underwent Extracorporeal Shock Wave Lithotripsy (ESWL) and the clearance rate of ESWL for lower pole kidney stones at Soetomo General Hospital from 2012 to 2016. Material & Methods: This research design was analytical retrospective, lower pole kidney stone patients who underwent ESWL in Soetomo General Hospital from 2012 to 2016 who fulfill inclusion criteria become samples in this research. Samples were divided into two group, stone size <15 mm and 15-20 mm. Results: Total samples in this study were 128, consist of 81 males and 47 females. The age average was 48 ± 11.124. The stone size average was 9.5 ± 4.5 mm consisted of 109 patients with stone size <15 mm and 19 patients with stone size 15-20 mm. There were 119 single lower pole kidney stones and 9 multiple ones. From all patients, 77 patients (60.2%) were stones free and the rest (39.8%) were not. Stone free rate for lower pole kidney stones was higher in stone size <15 mm compared with 15-20 mm, 65.2% and 31.5% respectively. Statistical analysis with Chi-square showed significant ESWL clearance rate difference between lower pole kidney stone size <15mm group and 15-20 mm (p<0.05). Conclusion: ESWL was a safe option for lower pole kidney stones with high success rate. There was significant relationship between stone size and stone clearance rate. ESWL was effective for lower pole kidney stones size <15 mm. 

scholarly journals Middle calyx access in complete supine percutaneous nephrolithotomy

2013 ◽  
Vol 7 (5-6) ◽  
pp. 306 ◽  
Author(s):  
Siavash Falahatkar ◽  
Ehsan Kazemnezhad ◽  
Keivan Gholamjani Moghaddam ◽  
Majid Kazemzadeh ◽  
Ahmad Asadollahzade ◽  
...  
Keyword(s):  
Operative Time ◽  
P Value ◽  
Inclusion Criteria ◽  
Renal Anomalies ◽  
Safety And Efficacy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Hemoglobin Drop ◽  
Free Rate ◽  
Staghorn Stones

Background: Middle calyx access has been underused in percutaneousnephrolithotomy (PCNL), especially in the supine position.We compared the safety and efficacy outcomes between middlecalyx and lower calyx accesses in the complete supine PCNL in anon-randomized single-surgeon clinical study.Methods: Between February 2008 and October 2011, 170 patientsunderwent posterior subcostal single tract complete supine PCNLwith one-shot dilation and middle calyx (n = 48) and lower calyx(n = 122) accesses. Stone location and surgeon decision determinedtarget calyx for access. Inclusion criteria were pelvis stones,staghorn stones and multiple location stones. Exclusion criteriawere renal anomalies, only upper calyx stones, only middle calyxstones and only lower calyx stones. Important parameters werecompared between the two groups. A p value of <0.05 was consideredsignificant.Results: Two groups were similar in important patient- and stonerelatedparameters. Mean operative time (60.7 minutes), meanpostoperative hospital stay (1.84 days) and mean hemoglobin drop(0.67 g/dL) in the middle calyx group were significantly lesser thanin the lower calyx group (80.1 minutes, 2.19 days, 1.36 g/dL). Themiddle calyx group (89.6%; 79.6%) had a higher stone-free rate(p = 0.054) and efficiency quotient than the lower calyx group(76.2%; 61.6%). In the middle calyx group (10.4%; 2.1%), complicationand transfusion rates were lesser (p > 0.05) than lowercalyx group (14.8%; 7.4%). No significant difference (p = 0.40)was seen between two groups using the modified Clavien classificationof complications.Interpretation: Middle calyx can be an optimal access in PCNLwith the complete supine position for many of upper urinary tractstones due to its superior outcomes.

scholarly journals COMPARISON OF S.T.O.N.E. SCORE AND GUY SCORE IN PREDICTING STONE FREE RATES OF PERCUTANEOUS NEPHROLITHOTOMY PROCEDURES IN THE SOETOMO GENERAL HOSPITAL

2021 ◽  
Vol 28 (1) ◽  
pp. 91-97
Author(s):  
I Dewa Gede Reza Sanjaya ◽  
Doddy M. Soebadi ◽  
Tarmono Djojodimedjo ◽  
Bambang Soeprijanto
Keyword(s):  
General Hospital ◽  
Strong Relationship ◽  
Inclusion Criteria ◽  
Stone Size ◽  
Relationship Strength ◽  
X Ray ◽  
Stone Free Rate ◽  
Size Evaluation ◽  
The Relationship ◽  
Free Rate

Objective: To determine the effectiveness of Modified Guy's Stone Score (GSS) and S.T.O.N.E score (SS) as predictors of stone free rates in patients undergoing PCNL. Material & Methods: The design of this study was a prospective observational analytic. Samples were patients with kidney stones who came to the Urology Polyclinic of Soetomo0 General Hospital Surabaya, which was planned to undergo PCNL surgery, patients who met the inclusion criteria will have a CT stonographic examination then counted for the S.T.O.N.E score and Modified Guy's Stone Score before the PCNL procedure. Postoperative stone size evaluation used KUB X-ray (BOF) to assess Stone Free Rate (SFR). Results: In the ETA statistical test there was a strong relationship between GSS and SFR with a relationship strength value of 0.609, the direction of the relationship between these two variables was positive. This means that the greater the GSS, the less likely the SFR could be achieved. The relationship between these two variables was significant with p= 0.05. While between SS and SFR with a relationship strength value of 0.55, the strength of the relationship in these two variables was positive which indicated the higher the SS, the less likely the occurrence of SFR. But both of them were not statistically significant with p= 0.228. Conclusion: Guy Stone Score (GSS) gives a better predictive value than the STONE score (SS) on the stone free rates in patients undergoing PCNL procedures.

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.

Staghorn renal stone: Which therapeutic strategy?

1992 ◽  
Vol 59 (3) ◽  
pp. 53-55
Author(s):  
G. Mobilio ◽  
G. Bianchi ◽  
G. Malossini ◽  
P. Beltrami ◽  
G. Carluccio
Keyword(s):  
Kidney Stones ◽  
Therapeutic Strategy ◽  
Renal Stone ◽  
Adequate Treatment ◽  
Percutaneous Access ◽  
Free Status ◽  
Residual Fragments ◽  
Staghorn Stones

We report our experience in the treatment of renal staghorn stones. 74 patients were treated with PCNL followed, when necessary, by one or more ESWL treatments for residual fragments, achieving a stone-free status in 64/74 patients (86.5%). Treatment with ESWL monotherapy (6 cases) resulted in a stone-free status in 3 patients (50%). According to our experience, PCNL followed by ESWL, is the most adequate treatment for staghorn kidney stones. We reserve PCNL with multiple percutaneous access and ESWL monotherapy for selected patients.

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