scholarly journals Providing Several Skills to Treat Complex Infectious Stones of Solitary Kidney in a Patient Failed to Undergo Percutaneous Nephrolithotomy: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Dechao Feng ◽  
Wuran Wei
Keyword(s):  
Cost Effectiveness ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Solitary Kidney ◽  
Laser Lithotripsy ◽  
High Frequency Oscillation ◽  
Flexible Ureteroscopy ◽  
Renal Deterioration ◽  
Holmium Laser Lithotripsy ◽  
Staghorn Stones

Conservative treatment is closely associated with renal deterioration for patients with renal staghorn stones. It is well-recognized that percutaneous nephrolithotomy (PCNL) is recommended as the first-line treatment of renal stones larger than 2 cm due to its higher stone clearance and cost-effectiveness when compared with other treatment alternatives, such as shockwave lithotripsy and flexible ureteroscopy (FURS). Besides, our findings indicated that miniaturized PCNL could be served as an alternative to PCNL with a higher stone-free rate and a lower hemorrhage risk. Despite the higher cost-effectiveness of PCNL, the management of staghorn stones are still controversial in some special situations, such as a solitary kidney. Herein, we present a case with complex infectious stones of a right-sided solitary kidney, complaining of persistent pain in the right waist. The rarity of this case is that it is difficult to encounter these cotton-like staghorn stones which are clinically resistant to holmium laser lithotripsy, and the particularity is that the patient with solitary kidney failed to undergo PCNL. We found that the combination of intermittently high-frequency oscillation and flexible ureteroscopy forceps might contribute to treat the complex infectious stones in a patient with solitary kidney. Our surgical experience might be beneficial to such patients undergoing flexible ureteroscopy in clinical practice.

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

Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients

2014 ◽  
Vol 94 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Chen Xu ◽  
Ri-jin Song ◽  
Min-jun Jiang ◽  
Chao Qin ◽  
Xiao-lan Wang ◽  
...  
Keyword(s):  
Renal Stones ◽  
Laser Lithotripsy ◽  
Flexible Ureteroscopy ◽  
Stone Fragment ◽  
Stone Burden ◽  
Holmium Laser Lithotripsy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Free Rate ◽  
Free Status

Objective: To evaluate the efficiency and safety of flexible ureteroscopy (FURS) and holmium lithotripsy for intrarenal stones and to stratify the efficiency and safety by stone burdens of ≤20, 20-40, and ≥40 mm. Methods: Five hundred eighty-two patients with intrarenal stones were treated with FURS and holmium lithotripsy at a single department from August 2008 to October 2013. Stone size was evaluated by calculating the cumulative stone diameter of all intrarenal stones, and stone-free status was defined as the absence of any stone or stone fragment <1 mm in the kidney. Results: Data analysis revealed a mean stone burden of 21.8 ± 7.6 mm. The overall primary stone-free rate (SFR) was 65.3%, which increased to 89.0% 6 months after the first surgery. Complications developed in 6.7% of patients. A significant difference was found between lower-calyx stones and other stones (p < 0.001; p = 0.006), while noncalcium stones had a much higher SFR than calcium stones (p < 0.001; p = 0.04). Conclusion: Our study showed that the overall renal SFR with the use of FURS and holmium lithotripsy was satisfactory, with a relatively low complication rate. We believe that FURS with holmium lithotripsy could be a valuable choice for patients with renal stones, especially for patients with a cumulative stone burden ≤40 mm.

scholarly journals A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2 cm

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Janak Desai ◽  
Guohua Zeng ◽  
Zhijian Zhao ◽  
Wen Zhong ◽  
Wenzhong Chen ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Urinary Calculi ◽  
Renal Stones ◽  
Laser Lithotripsy ◽  
Complication Rates ◽  
Modified Technique ◽  
Average Operative Time ◽  
Grade Ii ◽  
The Mean ◽  
Metal Sheath

Objectives. To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6 Fr mininephroscope through an 11–13 Fr metal sheath to perform holmium: YAG laser lithotripsy.Methods. The medical records of 36 patients with moderate-sized (<20 mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status.Results. The mean stone size was 14.9 ± 4.1 mm (rang: 6–20). The average operative time was 59.8 ± 15.9 (30–90) min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2–5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion.Conclusions. UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

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