scholarly journals Flexible ureteroscopic renal stone extraction during laparoscopic ureterolithotomy in patients with large upper ureteral stone and small renal stones

2014 ◽  
Vol 8 (9-10) ◽  
pp. 591 ◽  
Author(s):  
Myung Ki Kim ◽  
Jae Hyung You ◽  
Young Gon Kim
Keyword(s):  
Renal Stone ◽  
Ureteral Stone ◽  
Length Of Hospital Stay ◽  
Renal Stones ◽  
Treatment Modalities ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Stone Extraction ◽  
Mean Size ◽  
The Mean

Introduction: We describe laparoscopic ureterolithotomy with renal stone extraction using a stone basket under flexible ureteroscopy. We describe its efficacy through a laparoscopic port and a ureterotomy site in patients with large upper ureteral stone and small renal stones.Methods: Between January 2009 and February 2012, we performed laparoscopic ureterolithotomy with renal stone extraction using a stone basket under flexible ureteroscopy in 11 patients who had upper ureteral and renal stones. The retroperitoneal approaches were used in all patients using 3-4 trocars.Results: All procedures were performed successfully without significant complications. Mean operative time was 78.5 minutes (range: 52-114 minutes). The mean size of ureteral stone was 19.91 mm (range: 15-25 mm). In addition, 25 renal stones (mean size 7.48 mm, range: 2-12 mm) were removed from 11 patients. The mean length of hospital stay was 3.5 days (range: 2-6 days).Conclusions: Laparoscopic ureterolithotomy with renal stone extraction using a stone basket under flexible ureteroscopy can be considered one of treatment modalities for patients with large upper ureteral stones accompanied by renal stones who are indicated in laparoscopic ureterolithotomy.

scholarly journals Experiences of Renal Stone Fragmentation with the Use of the Ultrasound-guided Mini-percutaneous Nephrolithotipsy in 650 Patients

2021 ◽  
Vol 9 (B) ◽  
pp. 36-41
Author(s):  
Trung Duong ◽  
Trinh Hoang Hoan ◽  
Hoang Nguyen ◽  
Quan Tran
Keyword(s):  
Renal Stone ◽  
Ultrasound Guidance ◽  
Renal Stones ◽  
Lateral Position ◽  
Ureteral Stones ◽  
Ultrasound Guided ◽  
Stone Fragmentation ◽  
Results Of Treatment ◽  
The Mean ◽  
Tract Infections

AIM: This study assesses the results of treatment using the mini-percutaneous nephrolithotipsy (PCNL) procedure on renal stone patients in a lateral position under ultrasound guidance, performed at the Ha Noi Hospital of Post and Telecommunications. METHODS: The study was conducted with 650 kidney stone patients who were treated using the ultrasound-guided mini-PCNL procedure in a lateral position, at the Ha Noi Hospital of Post and Telecommunications, over the period from June 2018 to June 2019. RESULTS: For the 650 patients, the mean age was 47.3 ± 7.6 (from 21 to 91 years old); the mean size of stones: 19.4 ± 1.2 mm (from 12 mm to 60 mm); the mean operative time: 49.3 minutes (from 37 to 90 min); the mean period of hospitalization: 3.9 days (from 3 to 12 days); the mean stone-free rate (SFR): 90.6%; the rate of second surgery: 1.07%; hemorrhage complication: 0.8%; urinary tract infections: 7.7%; septicemia: 0.6%; administered open surgery: 0.46%; and administered other methods: 0.76%. CONCLUSION: Renal stone fragmentation using the mini-PCNL procedure, performed on patients placed in lateral position under ultrasound guidance, is a method that is effective, beneficial, and safe for patients with renal stones and upper ureteral stones.

scholarly journals Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Size ◽  
Intraoperative Complication ◽  
Safety And Efficacy ◽  
Single Center Experience ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

Surgery for Pediatric Ureteropelvic Junction Obstruction—Comparison of Outcomes in Relation to Surgical Technique and Operating Discipline in Germany

2018 ◽  
Vol 29 (01) ◽  
pp. 033-038 ◽  
Author(s):  
M. Klora ◽  
J. Zeidler ◽  
S. Eberhard ◽  
S. Bassler ◽  
S. Mayer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Ureteropelvic Junction Obstruction ◽  
Length Of Hospital Stay ◽  
Ureteropelvic Junction ◽  
Treatment Modalities ◽  
Complication Rates ◽  
Laparoscopic Pyeloplasty ◽  
Small Children ◽  
The Mean ◽  
Open Pyeloplasty

Introduction Surgery for ureteropelvic junction obstruction (UPJO) is performed by both pediatric surgeons (PS) and urologists (URO). The aim of this study was to analyze treatment modalities for UPJO and results in relation to the surgical technique and the operating discipline in Germany. Materials and Methods Data of patients aged 0 to 18 years were extracted from a major public health insurance (covering ∼5.7 million clients) during 2009 to 2016 and were analyzed for sociodemographic variables, surgical technique, and treating discipline. Logistic regression analysis was performed for the risk of a complication within the first postoperative year. Results A total of 229 children (31.0% female) were included. Laparoscopic pyeloplasty (LP) was performed in 58 (25.3%) patients (8.6 ± 6.4 years), and open pyeloplasty (OP) was applied in 171 (74.7%; 4.6 ± 5.9 years). LP was the dominant technique in females (p < 0.02); males preferentially underwent OP (p < 0.02). Length of hospital stay was 4.3 days (p = 0.0005) shorter in LP compared with that in OP, especially in children ≤ 2 years (6.7 days, p = 0.007). PS operated on 162 children (70.7%), and URO performed surgery on 67 patients (29.3%). The mean age of children operated by PS (3.5 ± 4.7 years) was significantly younger compared with that operated by URO (10.8 ± 6.5 years, p < 0.0001). Complication rates were independent of surgical technique or treating specialty. Conclusion In Germany, UPJO was treated by LP in 25.3% of patients, which was associated with a shorter length of stay, especially in children ≤ 2 years. Complication rates were independent of the operating specialty and surgical technique. Therefore, LP should be further promoted for the treatment of UPJO in small children.

scholarly journals Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2728 ◽  
Author(s):  
Jiaqiao Zhang ◽  
Chuou Xu ◽  
Deng He ◽  
Yuchao Lu ◽  
Henglong Hu ◽  
...  
Keyword(s):  
Renal Stone ◽  
Operation Time ◽  
Renal Stones ◽  
Renal Calculi ◽  
Good Prognosis ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Ureteral Stenting ◽  
Free Rate

Purpose To clarify the outcome of flexible ureteroscopy (fURS) for management of renal calculi without preoperative stenting. Methods A total of 171 patients who received 176 fURS procedures for unilateral renal stones were reviewed. All procedures were divided into two groups depending on whether they received ureteral stenting preoperatively. Baseline characteristics of patients, stone burden, operation time, stone-free rates, and complications were compared between both groups. Results Successful primary access to the renal pelvis was achieved in 104 of 114 (91.2%) patients without preoperative stenting, while all procedures with preoperative stenting (n = 62) were successfully performed. A total of 156 procedures were included for further data analysis (56 procedures in stenting group and 100 in non-stenting group). No significant differences was found regardless of a preoperative stent placement in terms of stone-free rate (73.2% with stenting vs. 71.0% without, P = 0.854), operative time (70.4 ± 32.8 with stenting vs. 70.2 ± 32.1 without, P = 0.969). Conclusions fURS for management of renal stone without preoperative ureteral stenting are associated with well outcome in short term follow-up. Our study may help patients and doctors to decide if an optional stent is placed or not.

scholarly journals Endourological Evaluation and Management of Leukoplakia of the Renal Pelvis

1996 ◽  
Vol 2 (3) ◽  
pp. 167-174
Author(s):  
Hidehiro Kakizaki ◽  
Katsuya Nonomura ◽  
Tomohiko Koyanagi ◽  
Masami Nantani ◽  
Kotaro Taniguchi ◽  
...  
Keyword(s):  
Renal Pelvis ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Renal Stones ◽  
Endoscopic Evaluation ◽  
Stone Extraction ◽  
Retrograde Pyelography ◽  
Cytological Examination ◽  
Extracorporeal Shock Wave ◽  
Pelvic Lesions

Since August 1989, we have seen 4 patients with leukoplakia of the renal pelvis associated with a longstanding renal stone. In 2 of them, excretory or retrograde pyelography revealed multiple filling defects in the left renal pelvis as well as a renal stone, although urine cytological examination was negative. One of the other 2 patients underwent extracorporeal shock wave lithotripsy (ESWL) for the renal stone, but this was not followed by the passage of stone fragments. The renal stone in the remaining patient was associated with staghorn calculi. For stone extraction as well as endoscopic evaluation of the intrapelvic lesion, percutaneous nephroscopy was performed. A small to large amount of tissue-like white debris in sheets characteristic of leukoplakia was found in the renal pelvis with stones embedded in it and was removed directly by forceps or suction and then by irrigating with saline. We propose that 1) the endourological approach should be recommended for patients with renal pelvic lesions associated with longstanding renal stones or for patients who show difficulty in passing stone fragments after ESWL and 2) this entity of leukoplakia should be kept in mind for the differential diagnosis of renal pelvic lesions associated with renal stones.

scholarly journals Prevention of Renal Stone Recurrence: Knowledge and Practice Patterns Among Medical Officers of DHQ Hospital, Faisalabad

Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Muhammad Saifullah ◽  
Hanan Noor ◽  
Muhammad Waqas Iqbal ◽  
Nauman Khalid ◽  
Muhammad Sohail ◽  
...  
Keyword(s):  
Renal Stone ◽  
Practice Patterns ◽  
Medical Officer ◽  
Renal Stones ◽  
Cross Sectional Study ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Stone Recurrence ◽  
The Mean ◽  
Knowledge And Practice

Objective: To assess the knowledge and practice patterns among medical officers of DHQ Hospital, Faisalabad in the prevention of recurrent renal stones. Cross sectional study. DHQ hospital, Faisalabad during 01-01-2019 to 30-09-2019. Methods: In this study the medical officers of either gender and age more than 25 years and working in DHQ Hospital, Faisalabad were included. They were assessed on the basis of a designed questionnaire regarding their general practice and knowledge in order to prevent renal stone recurrence. The paper based questionnaire was circulated to medical officers in different departments of the hospital. Results: In this study total 225 medical officers that were included. 135 (60%) of these participants were males and 90 (40%) were females. The mean age of the participants was 29.70±3.21 years. The mean working experience was 4.40±2.18 years. On assessment, 65.67% medical officers had adequate knowledge regarding recurrent renal stone prevention according to latest practice guidelines. Unfortunately 62.22% respondents were not practicing their knowledge adequately. Conclusion: The knowledge regarding the clinical practices in light of recent guidelines was optimal, however the practice regarding the preventive strategies was below power. Keywords; Renal stone, Recurrence, Medical officer, prevention.

Efficacy of Tamsulosin with Extracorporeal Shock Wave Lithotripsy for Passage of Renal and Ureteral Calculi

2008 ◽  
Vol 42 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Ryan L Losek ◽  
Laurie S Mauro
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stone ◽  
Data Extraction ◽  
Renal Stones ◽  
Ureteral Stones ◽  
Control Group ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave

Objective: To review the evidence for the safety and efficacy of adjunctive tamsulosin in enhancing the efficacy of renal and ureteral stone clearance when used with extracorporeal shock wave lithotripsy (ESWL). Data Sources: A search of MEDLINE (1950-January 2008), PubMed (1950-January 2008), and the Iowa Drug Information System (1966-January 2008) was performed using the search terms tamsulosin and extracorporeal shock wave lithotripsy. MeSH headings included lithotripsy and adrenergic α-antagonists. Additional references were found by searching bibliographic references of resulting citations. Study Selection and Data Extraction: All studies utilizing tamsulosin therapy after a single session of ESWL or after the development of steinstrasse, an accumulation of stone fragments that obstructs the ureter, were included. Data Synthesis: To date, 5 prospective studies have evaluated the efficacy of tamsulosin combined with ESWL in enhancing the passage of renal and ureteral stones. in one trial, 12-week renal stone clearance was 60% in the control group compared with 78.5% in the tamsulosin group (p = 0.037). Among trials that evaluated overall ureteral stone clearance, efficacy rates were 33.3-79.3% in the control groups compared with 66.6-96.6% in the tamsulosin groups. Reports of pain and supplemental analgesic dosing were consistently lower with tamsulosin, but data on the incidence of subsequent retreatment with ESWL or ureteroscopy was rarely reported. Adjunctive tamsulosin particularly enhanced the passage of renal stones 10-24 millimeters in diameter. Overall, tamsulosin was well tolerated. Conclusions: Overall, evidence suggests that adjunctive tamsulosin therapy combined with ESWL is safe and effective in enhancing stone clearance in patients with renal stones 10-24 millimeters in diameter. Evidence regarding ureteral stone clearance is inconclusive, although adjunctive tamsulosin has been reported to reduce painful episodes. Larger prospective trials evaluating different dosages and stone locations, as well as the ability of tamsulosin to reduce repeat ESWL or more invasive methods such as ureteroscopy should be performed.

scholarly journals Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

2019 ◽  
Author(s):  
Zhuohang Li ◽  
Cong Lai ◽  
Arvind K. Shah ◽  
Weibin Xie ◽  
Cheng Liu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Renal Stones ◽  
Postoperative Hospital Stay ◽  
Lithotomy Position ◽  
Base Line ◽  
Retrograde Intrarenal Surgery ◽  
The Mean ◽  
Stone Characteristics ◽  
Illness Condition

Abstract Purpose To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n= 33) or modified UMP (n= 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p< 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p< 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p< 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p< 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p< 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p= 0.504, p= 0.675). There were no significant differences between the two groups in complications (p= 0.228). Conclusion For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.

scholarly journals ESWL;

2017 ◽  
Vol 24 (05) ◽  
pp. 723-728
Author(s):  
Wasim Sarwar Bhatti ◽  
Aijaz Hussain Memon ◽  
Nauman Khalid
Keyword(s):  
Renal Stone ◽  
Renal Stones ◽  
Systemic Review ◽  
Ureteral Stones ◽  
Stent Insertion ◽  
Base Line ◽  
Female Ratio ◽  
Ureteric Stent ◽  
Urine Examination ◽  
Group B

Objectives: Objectives of the study are to evaluate extracorporeal shock waveslithotripsy (ESWL) with and without double-J-ureteric stent in 2-3 cm renal stone. Study Design:Comparative study. Place and Duration of Study: This study was out conducted at LithotripsyCenter, Department of Urology & Renal Transplantation, KEMU/ Mayo Hospital, Lahore, fromJune 2015to May 2016.”Methodology: This study consisted of 60 patients admitted. Allpatients were divided into two equal groups. Thirty patients of kidney stones were included ingroup A, who were treated by ESWL without double-j-ureteric stent. Group B, who were treatedby ESWL with prior double-j-ureteric stent insertion. Detailed History was taken from all thepatients with special regard to the renal stone pain. Detailed Clinical examination of the patientwas done and recorded in proforma. Systemic review was also done to see any co-morbidity.All patients underwent for base line and specific investigations” like Urinalysis Pre-ESWL andat monthly intervals post ESWL, mid-stream urine examination for Gram’s staining; culture andsensitivity were performed in selected patients, renal ultrasonography, Plain X-Ray KUB andintravenous Urography. Inclusion criteria were that all patients from both sexes between theages of 15-45 years suffering from renal stones 2-3cm will be included in the study. In Exclusioncriteria; patients are unfit for general anesthesia, advance cardiac diseases, bleeding disorders,pregnant women, lower ureteral stones, malignancy and severe urinary infection. Results: 60patients, there were 40 males and 20 females, with male to female ratio of 2:1. Minimum of 15year to 45 years in both group. Mean age was 32+ 2.1years. 38(63.33%) of patients has 2.5-3 cm stone and 22(36.66%) patients has 2-2.5cm stone. Commonest location of stone was34(57%) cases were lying in calyces followed by pelvis stones which accounted for 26(43%)stones. The average number of retreatment sessions was 2 to 3 sessions, ranged 1 to 5sessions. The majority 39 (65%) patients needed one & two sessions. Three & four sessionswere used in 17 (28.33%) and in five session 04(06%) cases needed. Stone clearance observed5 to 45days in 2 to 2.5 cm stone. Means clearance were seen 35+4.6 days in without Double-J-Ureteric Stent while 29+3.8 days in with Double-J-Ureteric Stent. Conclusion: In conclusionour study revealed that The extra corporeal shock waves lithotripsy with double-j-ureteric stentis safe, effective and with less complication rate then without double-j-ureteric stent.

scholarly journals LITOTRIPSI LASER HOLMIUM YAG UNTUK TERAPI BATU URETER

1970 ◽  
Vol 15 (2) ◽  
Author(s):  
Kuncoro Adi ◽  
Ferry Safriadi ◽  
Suwandi Sugandi ◽  
Zulhardi Haroen ◽  
Bambang S Noegroho ◽  
...  
Keyword(s):  
Ureteral Stone ◽  
Laser System ◽  
Intravenous Urography ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Holmium:Yag Laser ◽  
Stone Treatment ◽  
The Mean ◽  
Age Range

Objective: To assess the efficacy of pulsed holmium:YAG laser lithotripsy for ureteral stone therapy. Material and method: Ninety-one patients (70 males and 21 females) with age range 20 – 76 years underwent 93 ureteroscopic procedures for 101 ureteral stones. A preoperative diagnosis was established by ultrasound scanning and intravenous urography. An 8 F rigid Karl-Storz ureteroscope was used for a holmium:YAG laser (OmniPulse MaxTM 80 watt Holmium Laser System Model 1210-VHP, Trimedyne,Inc. Irvine CA, USA) as energy source for laser lithotripsy. The stone localization was mostly at the lower third of the ureter. The mean stone size was 9,6 mm, mean duration of procedure was 48,1 minutes, and the mean hospital stay was 2,1 days. Results: The overall stone clearance rate was 95,6% with the best results for stones in the middle third of the ureter (100%). At follow up we noted two patients with residual stones and two patients with a perforation of the ureteral wall. Conclusion: The Holmium:YAG laser is effective for ureteral stone treatment with a high success rate. Special attention and care should be afforded in impacted ureteral stones. 

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