scholarly journals Usage of Forceps and Dormia basket in the Management of Ureteric Stone: Comparison between Holmium: YAG Laser and Pneumatic Lithotripsy in a Referral Hospital, Bangladesh

2019 ◽  
Vol 48 (1) ◽  
pp. 26-30
Author(s):  
Md Ashif Chowdhury ◽  
Shahidul Islam ◽  
SM Shameem Waheed ◽  
Faruk Hossain ◽  
AKM Mashiul Munir ◽  
...  
Keyword(s):  
Laser Lithotripsy ◽  
Military Hospital ◽  
Video Monitor ◽  
Ureteric Stone ◽  
Yag Laser ◽  
Pneumatic Lithotripsy ◽  
Dormia Basket ◽  
Proximal Migration ◽  
Wide Range

Now lithoclast has become more popular tool than various intracorporeal lithotripters for the treatment of ureteric stones. Recently the Holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of ureteric stones. This study was conducted to compare the use of Forceps and Dormia basket in the management of ureteric stone between Holmium: YAG Laser and Pneumatic Lithotripsy. It was a longitudinal follow-up comparative study conducted at Combined Military Hospital, Dhaka. All the respondents were admitted patients in Combined Military Hospital Dhaka, under Urology Ward. A total of 100 patients were enrolled for this study under convenient purposive sampling method. They all were admitted with the complaints of upper ureteric stone who underwent ureteroscopic lithotripsy from October 2010 to September 2012. In 50 patients, Laser Lithotripsy (LL) was used and in other 50 patients Pneumatic Lithotripsy (PL) was used. Same ureteroscope, video monitor, baskets and irrigation devices were used in both the samples. Patients were followed up after 1st and 3rd months interval. Lithotripsy follow-up was done with radiograph and ultrasonography of kidney, ureter and bladder.  Patients with migrated fragments or incomplete clearance were underwent an auxiliary procedure such as shock wave lithotripsy. Mean stone size was 1.36 ± 0.36 cm in group Laser lithotripsy (LL) and 1.37± 0.36 cm in group Pneumatic lithotripsy (PL). The immediate stone clearance rate was significantly higher in Group LL (94.0%) than Group PL (76.0%). Proximal migration of fragments were 6.0% in LL group and 24.0% in PL group. Use of stone retrieval equipment (baskets, forceps) was 16.0% and 64.0% in LL and PL group respectively (p<0.05). On the other hand stone fragments clearance requiring auxiliary procedures were 6% and 24% in LL and PL group respectively. The mean lithotripsy time was 40.46 ± 19.25 min and 36.86 ± 14.83 min the LL and PL group respectively. Use of stone retrieval equipment(baskets, forceps) was significantly lower in Holmium: YAG assisted ureteroscopy than pneumatic lithotripsy group. Bangladesh Med J. 2019 Jan; 48 (1): 26-30

scholarly journals Comparative Study Between Holmium: Yag Laser and Pneumatic Lithotripsy in the Management of Upper Ureteric Stone

2020 ◽  
Vol 22 (2) ◽  
pp. 160-165
Author(s):  
Md Ashif Chowdhury ◽  
Md Shahidul Islam ◽  
SM Shameem Waheed ◽  
Md Abdur Rakib ◽  
Faruk Hossain ◽  
...  
Keyword(s):  
Clearance Rate ◽  
Ureteric Stone ◽  
Yag Laser ◽  
Stone Clearance ◽  
Pneumatic Lithotripsy ◽  
Proximal Migration ◽  
Intracorporeal Lithotripsy ◽  
Wide Range ◽  
Group A ◽  
Group B

Background:Among various intracorporeal lithotripters, Pneumatic lithotriptorhas become the widely used tool for the treatment of ureteric stones. Recently the Holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of ureteric stones. Objective: To compare the treatment of upper ureteric stone between laser and pneumatic lithotripsy. Materials and methods: One hundred patients with upper ureteric stone who underwent ureteroscopic lithotripsy in the Department of Urology, CMH, Dhakafrom October 2012 to September 2015 were enrolled in this study. Patients were divided into two groups. Group A (LL) were treated with holmium: YAG laser and Group B (PL) were treated with pneumatic lithotripsy. Two procedures were compared in term of stone fragmentation, stone clearance rate, duration of lithotripsy, complications and duration of post operativehospital stay. Patients were monitored as outpatients after one month and after three months with a kidney ureter and bladder radiograph and ultrasonograph. Patients with migrated fragments or incomplete clearance underwent an auxiliary procedure such as Extra Corporeal shock wave lithotripsy (ESWL). Results: Mean stone size was 1.36 ± 0.36 cm in group A (LL) and 1.37± 0.36 cm in group B (PL). The immediate stone clearance rate was significantly higher inGroup A (94.0%) than Group B (76.0%). Fragments proximal migration were 6.0% in LL group and 24.0% in PL group. Use of stone retrieval equipments (baskets, forceps) was 16.0% and 64.0% in LL and PL group respectively (p<0.05) and stone fragments clearance requiring auxiliary procedures were 6% and 24% (p<0.05) in LL and PL group respectively. The mean lithotripsy time 40.46 ± 19.25 min and 36.86 ± 14.83 min and mean period of post operative hospital stay was 2.32 ± 1.22 days and 2.44 ± 1.18 days in the LL and PL group respectively. Periprocedural complications like hemorrhage, mucosal disruption/ perforation were almost same in both groups. Conclusion: In this study stone clearance and fragmentation of stone in Holmium:YAG assisted ureteroscopy was significantly higher than pneumatic lithotripsy group. The need for auxiliary procedure like ESWL for proximally migrated fragments was significantly less inHolmium:YAG assisted ureterocopy compared with pneumatic lithotripsy. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.160-165

scholarly journals Outcome of Uretero Renoscopic Lithotripsy (URSL) with Holmium LASER Vs Pneumatic Lithotripter for Lower Ureteric Stones, Experience from University Hospital of Nepal

2020 ◽  
Vol 18 (1) ◽  
pp. 49-53
Author(s):  
H.N. Joshi ◽  
A.K. Singh ◽  
N. Koirala ◽  
R.M. Karmacharya
Keyword(s):  
Operation Time ◽  
Laser Lithotripsy ◽  
University Hospital ◽  
Ureteric Stone ◽  
Pneumatic Lithotripsy ◽  
Stone Free Rate ◽  
Stone Migration ◽  
And Gender ◽  
Free Rate

Background There are various methods of endoluminal ureteral stone fragmentation. Among various modalities Laser lithotripsy and Pneumatic lithotripsy are commonly used and have shown comparable outcomes. Objective To compare the efficacy and outcome of laser and pneumatic lithotripsy in a patient with lower ureteric calculi. The comparison will be done in stone free rate, migration of stone and complication of the procedure. Method This is a prospective comparative study in a cohort of patients at University Hospital with Lower Ureteric stone. Ninety patients were randomized in to two groups (Laser Lithotripsy Vs Pneumatic Lithotripsy) during the study period. The purpose of this study was to measure the immediate stone free rate, intra-operative complications, mean operative time, post-operative complication and if any stone retention after six weeks follow up. Result Both the groups were similar in Age and Gender. Immediate stone free rate was slightly higher in Laser lithotripsy group (97.77%) in comparison to Pneumatic lithotripter group (84.44%) with p=0.507 which is not statistically significant. There was statistical difference in terms of stone migration rate, mean operation time in favor of Laser Lithotripsy group (p<0.01, in both parameters). There were no immediate complications in both the group however there were three cases of short segment ureteric strictures (6.66%) in case of Pneumatic lithotripsy on six weeks follow up which was managed conservatively. Conclusion Both LASER lithotripter and Pneumatic lithotripter are equally efficacious modality of endoluminal URSL in lower ureteric stone with similar Stone Free Rate. Laser lithotripsy showed lower frequency of stone migration and had shorter procedure time.

scholarly journals Outcome of Lower Ureteric Stone Fragmentation by Laser in Comparison with Pneumatic Lithotripsy

2020 ◽  
Vol 23 (2) ◽  
pp. 169-175
Author(s):  
SA Anowar Ul Quadir ◽  
Khan Nazrul Islam ◽  
Md Mostafizur Rahman ◽  
Md Shafiqul Alam Chowdhury ◽  
SM Mahbub Alam
Keyword(s):  
Laser Lithotripsy ◽  
Medical College Hospital ◽  
Ureteric Stone ◽  
College Hospital ◽  
Operation Theatre ◽  
Medical College ◽  
Pneumatic Lithotripsy ◽  
Stone Fragmentation ◽  
Group A ◽  
Group B

Background: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. Aims: To see the outcome of lower ureteric stone fragmentation by laser in comparison with pneumatic lithotripsy. Methods: The prospective clinical study was conducted during the period from July 2012 to June 2014 in Dhaka Medical College Hospital. From the patient admitted in Dhaka medical college hospital a total of 60 patient were selected using purposive sampling methods. Selected patients were numbered chronologically and odd number group as group A (laser lithotripsy) and even number group B (pneumatic lithtripsy). Cystoscopy followed by ureterescopy with the help of guide wire was done and stone fragmentation done by either laser lithotripsy (done in general operation theatre in Dhaka Medical College Hospital) or pneumatic lithotripsy (done in Urology operation theatre in Dhaka Medical College Hospital). Collected data were processed and analyzed using computer software SPSS (statistical package for social science), version-18. Un-pair t-test, chisquare test and Fishers Exact probability test were used to analyze the data. The findings of the study showed age and sex are almost identically distributed in both groups. Results: The mean age of group A and group- B were 35.63±11.66 and 38.90±11.21 years respectively. A male predominance was observed in both groups with 70% male in group- A and 53.3% in group-B. Stone size was also observed identically in both groups. 43% of stone are larger than 10mm in group- A and 47% stone are larger than 10mm. None of other baseline variable found very between groups. Immediate stone clearance was much higher in group-A (96.7%) then that in group- B (80%). Although both the groups demonstrated 100% clearance after 1 month. Immediate complications were higher in group B then those of group- A. Ureteral perforation in group B was found 6.7% as opposed to none in group-A. Fever in group A (6.7%) was observed to be more than 3 times higher than in group- B (23.3%). Comparison of complications after 1 and 3 months shows some differences (higher in group-B) but that is not significant. Ureteral stricture developed in 3 patients in group- B compared to nil in group- A. More than 90% of patients of group-A were released from the hospital within 3 days after operation, in contrast about 40% in group-B left the hospital within 3 days. Conclusion: So, laser lithotripsy is better option for the management of lower ureteric stone by using semi rigid ureteroscope, in term of stone migration, rate of stone fragmentation and clearance, operation time, hospital stay and complication. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.169-175

scholarly journals Retrograde-Assisted Percutaneous Cystolitholapaxy Versus Transurethral Cystolithotripsy With Holmium-YAG Laser: A Retrospective Study

2019 ◽  
Vol 10 (5) ◽  
pp. S54-S58
Author(s):  
Shahrokh Sakhaei ◽  
Morteza Fallah-Karkan ◽  
Mohammadreza Razzaghi ◽  
Babak Kazemzadeh Azad ◽  
Fereshteh Aliakbari
Keyword(s):  
Operation Time ◽  
Laser Lithotripsy ◽  
Yag Laser ◽  
Stone Free Rate ◽  
Cord Injury ◽  
Stone Treatment ◽  
Group A ◽  
Male Patients ◽  
The Mean

Introduction: The retrograde approach is a modification that makes the percutaneous cystolitholapaxy (PCCL) a more trendy method, especially in operating rooms with limited facilities. The transurethral approach for bladder calculi lithotripsy by a laser has become popular among urologists. In this study, we investigate the feasibility and safety of retrograde assisted access for PCCL in comparison with transurethral cystolithotripsy by the holmium-YAG laser (Ho: YAG). Methods: According to the type of intervention, the patients were stratified to two matched groups. In the retrograde-assisted percutaneous cystolitholapaxy (RPCCL) group, a Benique was conducted through the urethra into the bladder; palpating the suprapubic region, an about 1.5 cm incision was done over the tip, then an Amplatz sheath was placed over it, treading into the bladder; further cystolitholapaxy was done by a routine order. In transurethral Ho: YAG laser lithotripsy (TULL) via 200 µm fiber vaporize the stone. Results: A total of 124 male patients with the mean age of 50.33±9.64 years and the average stone burden of 3.35±1.07 cm were included in the study. The most common cause of vesical calculi was spinal cord injury. Statistically significant differences were found in terms of the mean operation time in favor of the RPCCL group (P≤0.05) and the mean hospital stay in favor of the TULL group (P≤0.05). The stone-free rate (SFR) was 100% in both methods after a onemonth follow-up. None of the interventions changed to open surgery. There were not any major complications in both methods. Conclusion: RPCCL is a safe and effective method in bladder stone treatment and is applicable in medical centres without Ho: YAG equipment.

scholarly journals Comparison of mean operative time in patients undergoing Ho: YAG laser lithotripsy and pneumatic lithotripsy in ureterorenoscopy for ureteric calculus

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Muhammad Tanveer Sajid ◽  
Mohammad Ameen ◽  
Badar Murtaza ◽  
Muhammad Sarwar Alvi ◽  
Zakir Khan ◽  
...  
Keyword(s):  
Operative Time ◽  
Linear Regression Analysis ◽  
Randomized Study ◽  
Sampling Technique ◽  
Armed Forces ◽  
Laser Lithotripsy ◽  
Yag Laser ◽  
Ureteric Calculus ◽  
Pneumatic Lithotripsy ◽  
Group I

Objective: To compare the mean operative time (MOT) in patients undergoing Ho: YAG laser lithotripsy (LL) and pneumatic lithotripsy (PL) for ureteric stones. Methods: This randomized study was conducted at Armed Forces Institute of Urology (AFIU) Rawalpindi, Pakistan from July 2016 to November 2018. Non probability consecutive sampling technique utilized to enroll 60 patients of both gender aged 18-60 years, having ureteric calculus ≤1.5cm. Randomization was done into group I (LL) and II (PL) via computer generated number tables. Six Consultant Urologists performed surgeries under spinal anesthesia utilizing Swiss Lithoclast® Master (EMS+ S.A. Switzerland) in group II and holmium laser fiber (365μm, 8-10Hz, 9.6-16W, 2100nm wavelength) in group I respectively. MOT was noted from insertion of cystoscope till removal out of meatus. Data obtained was analyzed through IBM SPSS 24.0. Results: Analysis involved 60 patients (30 each group) having similar baseline characteristics (age, gender, laterality, location). There was statistically significant different MOT between LL & PL (25.48±6.99 vs 34.83±7.47 minutes, p < 0.001). Data stratification with respect to age, gender, laterality and stone location revealed similar trend. Lithotripsy technique significantly affected MOT (p < 0.001) on Multiple Linear Regression Analysis. Conclusions: Ho: YAG LL is an efficient technique when compared with PL in terms of MOT for ureteric stones. doi: https://doi.org/10.12669/pjms.37.2.3049 How to cite this:Sajid MT, Ameen M, Murtaza B, Alvi MS, Khan Z, Kiani F. Comparison of mean operative time in patients undergoing Ho: YAG laser lithotripsy and pneumatic lithotripsy in ureterorenoscopy for ureteric calculus. Pak J Med Sci. 2021;37(2):---------.  doi: https://doi.org/10.12669/pjms.37.2.3049 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.

Holmium: YAG Laser Lithotripsy Versus Pneumatic Lithotripsy for Treatment of Distal Ureteral Calculi: A Meta-Analysis

2013 ◽  
Vol 27 (4) ◽  
pp. 408-414 ◽  
Author(s):  
Xiangrui Yin ◽  
Ziwei Tang ◽  
Bei Yu ◽  
Yarong Wang ◽  
Yuehua Li ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Laser Lithotripsy ◽  
Ureteral Calculi ◽  
Yag Laser ◽  
Pneumatic Lithotripsy

Cerebellotrigeminal Dermal Dysplasia (Gómez-López-Hernández Syndrome)

2018 ◽  
Vol 16 (05) ◽  
pp. 362-368 ◽  
Author(s):  
Federica Sullo ◽  
Agata Polizzi ◽  
Stefano Catanzaro ◽  
Selene Mantegna ◽  
Francesco Lacarrubba ◽  
...  
Keyword(s):  
De Novo ◽  
Chromosomal Rearrangements ◽  
Number Of Patients ◽  
Wide Range ◽  
Visual Problems ◽  
Neurodevelopmental Abnormalities ◽  
Clinical Triad ◽  
High Degree ◽  
Motor Handicap

Cerebellotrigeminal dermal (CTD) dysplasia is a rare neurocutaneous disorder characterized by a triad of symptoms: bilateral parieto-occipital alopecia, facial anesthesia in the trigeminal area, and rhombencephalosynapsis (RES), confirmed by cranial magnetic resonance imaging. CTD dysplasia is also known as Gómez-López-Hernández syndrome. So far, only 35 cases have been described with varying symptomatology. The etiology remains unknown. Either spontaneous dominant mutations or de novo chromosomal rearrangements have been proposed as possible explanations. In addition to its clinical triad of RES, parietal alopecia, and trigeminal anesthesia, CTD dysplasia is associated with a wide range of phenotypic and neurodevelopmental abnormalities.Treatment is symptomatic and includes physical rehabilitation, special education, dental care, and ocular protection against self-induced corneal trauma that causes ulcers and, later, corneal opacification. The prognosis is correlated to the mental development, motor handicap, corneal–facial anesthesia, and visual problems. Follow-up on a large number of patients with CTD dysplasia has never been reported and experience is limited to few cases to date. High degree of suspicion in a child presenting with characteristic alopecia and RES has a great importance in diagnosis of this syndrome.

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