scholarly journals Improved effectiveness and safety of flexible ureteroscopy for renal calculi (<2 cm): A retrospective study

2015 ◽  
Vol 9 (5-6) ◽  
pp. 273 ◽  
Author(s):  
Shuqiu Chen ◽  
Bin Xu ◽  
Ning Liu ◽  
Hua Jiang ◽  
Xiaowen Zhang ◽  
...  
Keyword(s):  
Success Rate ◽  
Preoperative Evaluation ◽  
Surgical Techniques ◽  
Renal Calculi ◽  
Flexible Ureteroscopy ◽  
Efficacy And Safety ◽  
Stone Free Rate ◽  
Prevention And Treatment ◽  
Post Operation ◽  
Free Rate

Introduction: We discuss the efficacy and safety of flexible ureteroscopy for renal calculi with a burden of <2 cm, as well as the prevention and treatment of complications.Methods: A total of 108 renal calculi with flexible ureteroscopy and holmium laser treatment were retrospectively analyzed. The stone-free rate was evaluated. The effectiveness, safety, surgical technique, incidence of complications, and relevant treatments were analyzed.Results: All patients underwent only one lithotripsy procedure. The success rate of flexible ureteroscopy was 97.2% (105/108). Among the 105 cases, the total lithotripsy success rate was 97.1% (101/105). The total stone-free rate after 8 weeks post-operation was 94.3% (99/105), the stone-free rate of the lower calyx was 85.7% (30/35); it was 98.6% (69/70) in the middle‒upper calyceal and renal pelvis. The incidence of complications was 12.9% (14/108). None of the patients had serious adverse outcomes.Conclusion: Flexible ureteroscopy represents an optimal treatment option for selected renal calculi with burden of <2 cm. The effectiveness and safety of flexible ureteroscopy can be further improved through reasonable preoperative evaluation and advances in surgical techniques, as well as a better understanding of the inducement and treatment of complications.

Factors that affect Stone Free Rate in flexible ureteroscopy in large renal calculi lithotripsy

2018 ◽  
Vol 17 (4) ◽  
pp. e2016
Author(s):  
G. Dellis ◽  
E. Patili ◽  
J. Varkarakis ◽  
A. Papatsoris ◽  
M. Berdebes ◽  
...  
Keyword(s):  
Renal Calculi ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Free Rate

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 A Comparative Study between Holmium Laser, Pneumatic Lithotripsy and Shock Pulse in Terms of Efficacy and Safety in Percutaneous Nephrolithotomy (PCNL) : A Prospective Randomised Study.

2020 ◽  
Vol 3 (1) ◽  
pp. e1-e8
Author(s):  
Rajeev T P ◽  
Sarbartha Kumar Pratihar ◽  
Debanga Sarma ◽  
Saumar Jyoti Baruah ◽  
Sasanka Kumar Barua ◽  
...  
Keyword(s):  
Success Rate ◽  
Holmium Laser ◽  
Shock Pulse ◽  
Efficacy And Safety ◽  
Stone Clearance ◽  
Pneumatic Lithotripsy ◽  
Stone Fragmentation ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Free Rate

Background and ObjectivesPercutaneous nephrolithotomy (PCNL) occupies an essential place in the treatment of upper urinary tract calculi. PCNL also accomplishes higher stone-free rates and requires fewer auxiliary procedures than shock wave lithotripsy (SWL) and ureterorenoscopy (URS) for renal stones between 1–2 cm. There are different intracorporeal lithotripter devices available. This study aims to compare the efficacy and safety of holmium laser, pneumatic lithotripsy and Shock Pulse in PCNL. Materials and MethodsA prospective randomized study was performed in Gauhati Medical College & Hospital, Guwahati, Assam, India, between October 2016 to November 2018. Patients of renal calculi and upper ureteric calculi less than or equal to 2.5cms and functioning kidney on the ipsilateral side were included. 300 patients were randomized according to a random number generator. In the holmium laser, pneumatic and Shock Pulse groups’ number of patients was 96, 102, 102 respectively. Stone disintegration time (SDT), stone-free rate, failure rate, success rate, irrigant used, mean hematocrit drop were evaluated. Statistical analysis was done to compare and predict any significant difference. ResultsPatients were divided into groups depending on the lithotripter used: group A (n=96), group B (n=102), group C (n=102) were holmium laser, pneumatic lithotripsy, and Shock Pulse respectively. No significant difference in stone location (p=0.785),Hounsfield unit (p=0.115),complication rates between the groups. Stone free rate in laser, pneumatic lithotripter, and Shock Pulse were 81.25%, 67.65%, 82.35% (highest in Shock Pulse and lowest in the Pneumatic group) and failure rate were 6.25%, 14.7%, 5.89% respectively. A significant difference was found in terms of stone-free, success rate, clinically insignificant residual fragments(CIRF)and failure rates between the groups(p<0.001). Irrigant requirement (litre/mm3) between the groups is statistically significant (p<0.001) with the highest in Shock Pulse and lowest in the Pneumatic group. Mean hematocrit drop: 4.19%, 4.20%, 5.46% in Laser, Pneumatic and Shock Pulse respectively. No significant difference between Laser and Pneumatic group (p=0.907), but in Shock Pulse group it is significantly higher. (p< 0.001) ConclusionEfficacy of energy sources used in PCNL for stone fragmentation vary in terms of stone clearance, failure rates, SDT, irrigant requirement and mean hematocrit drop. In our study, we found stone clearance signifi-cantly higher in Shock Pulse than Pneumatic and Laser groups. Stone fragmentation volume per unit time highest in Shock Pulse and lowest in Laser. Irrigant requirement highest in Shock Pulse group and compa-rable between Laser and Pneumatic group. The higher irrigant requirement in the Shock Pulse group may be the cause for higher hematocrit drop in this group. Complications between the groups are comparable.  

scholarly journals Rigid and flexible ureteroscopy (URS/RIRS) management of paediatric urolithiasis in a not endemic country

2021 ◽  
Vol 93 (1) ◽  
pp. 26-30
Author(s):  
Stefania Ferretti ◽  
Monica Cuschera ◽  
Davide Campobasso ◽  
Claudia Gatti ◽  
Riccardo Milandri ◽  
...  
Keyword(s):  
Success Rate ◽  
Urinary Stone ◽  
Urinary Stones ◽  
Flexible Ureteroscopy ◽  
Residual Stone ◽  
Reliable Technique ◽  
Endoscopic Procedures ◽  
Stone Free Rate ◽  
Free Rate ◽  
Free Status

Introduction: In the last years due to miniaturization of endoscopic instruments and percutaneous surgery, endourology has become very popular in paediatric urinary stone managment. We reported our single-centre experience in retrograde endoscopic procedures in children. Results and complications of URS/RIRS are discussed. Materials and methods: We retrospectively reviewed our experience in patients ≤ 16 years old affected by urinary stones who underwent URS/RIRS procedures performed by two surgeons with expertise in endourology. A total of 30 renal Units (RUs) underwent endoscopic procedures (URS, RIRS or both). Surgical complications according to the ClavienDindo’s classification and stone-free rate were evaluated at 3 months follow-up. Success of URS was defined as stone-free status after single procedure while RIRS success rate was considered as presence of residual stone fragments smaller than 4 mm at first procedure. Results: The mean age of our patients was 8 years, range 2- 16 years. A total of 30 renal units (RUs) underwent 40 endourological procedures (23 URS and 17 RIRS; 10 children underwent both procedures at the same time). 17/30 (56.6%) RUs were pre-stented before surgery. The stone-free status was achieved in 23/30 renal units treated, with a 76.6% success rate. The remaining 7 patients had residual stones greater than 4 mm and underwent further treatments. After a second surgery the stone-free rate turned out to be 93.3% (28/30 renal units). Conclusions: Rigid and flexible ureteroscopy (URS/RIRS) is a reliable technique for treatment of < 2 cm urinary stones in paediatric age group. It shows low rate of major complications and promising results in terms of stone-free rate.

Efficacy of flexible ureteroscopy and laser lithotripsy for lower pole renal calculi

2014 ◽  
Vol 7 (6) ◽  
pp. 389-393 ◽  
Author(s):  
A Sahai ◽  
F Khan ◽  
F Anjum ◽  
IK Dickinson ◽  
H Marsh ◽  
...  
Keyword(s):  
Renal Calculi ◽  
Laser Lithotripsy ◽  
Flexible Ureteroscopy ◽  
Lower Pole ◽  
Invasive Treatment ◽  
Flexible Ureterorenoscopy ◽  
Stone Free Rate ◽  
Operation Rate ◽  
The Mean ◽  
Free Rate

Objective: Our aim was to determine whether flexible ureterorenoscopy and laser lithotripsy is efficacious and safe in treating lower pole renal calculi. Materials and methods: Patient, procedure and stone data of patients who underwent flexible ureterorenoscopy and laser lithotripsy at our referral centre were collected prospectively between November 2005 and November 2011 and entered into a designated database. In all, 242 procedures were performed in 198 patients. Results: The mean age was 51.2 years. The mean calculi size was 10.51 mm (range 4–27 mm). Thirty seven patients had more than one stone in the lower pole. An access sheath was used in 19 patients (9.6%), 171 (86.4%) had a ureteric stent inserted after the procedure, and 165 patients had a single procedure. Re-operation rate was 16.7%. Stone-free rates after one procedure were 89%, 80% and 41%, respectively, for calculi measuring 4–10 mm ( n=107), 11–20 mm ( n=76) and > 20 mm ( n=15). The overall stone-free rate was 83%, 91% and 95% after one, two and three procedures, respectively. Conclusion: Flexible ureterorenoscopy and laser lithotripsy is a safe and effective minimally invasive treatment option for patients with 4–20 mm lower pole calculi. Staged procedures, however, become necessary as the size of the stone increases greater than 20 mm, and this should be mentioned when counselling patients for their primary procedure.

A Novel Clinical-Radiomics Model Preoperatively Predicted the Stone-Free Rate of Flexible Ureteroscopy Strategy in Kidney Stone Patients

2020 ◽  
Author(s):  
Yang Xun ◽  
Mingzhen Chen ◽  
Ping Liang ◽  
Pratik Tripathi ◽  
Huchuan Deng ◽  
...  
Keyword(s):  
Kidney Stone ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Free Rate

scholarly journals Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098313
Author(s):  
Tie Mao ◽  
Na Wei ◽  
Jing Yu ◽  
Yinghui Lu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Efficacy And Safety ◽  
Complementary Treatment ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Free Rate

Background We aimed to compare the efficacy and safety of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) for treating renal stones larger than 2 cm. Methods We searched the PubMed, Embase, Web of Science, SinoMed, and Chinese National Knowledge Infrastructure databases for studies that compared the surgical outcomes of LPL and PCNL. We conducted a meta-analysis of the retrieved studies, expressed as weighted mean difference or risk ratios with 95% confidence intervals. Results We included 25 studies (1831 patients). LPL was associated with a significantly higher stone-free rate, lower rates of blood loss, complementary treatment, blood transfusion, and complications, and less reduction in hemoglobin level compared with PCNL. LPL and PCNL were similar in terms of duration of hospital stay, conversion rate, changes in glomerular filtration rate and creatinine level, and mean time of postoperative analgesia. However, LPL was associated with a longer operation time than PCNL. Conclusion LPL appears to be more effective and safer than PCNL in patients with large renal stones, by increasing the stone-free rate and reducing blood loss, complementary treatment, blood transfusion, and complications compared with PCNL. LPL may thus be a useful modality for treating patients with large renal stones.

scholarly journals Predictors of Success after Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal Calculi Between 20—30 mm: A Multivariate Analysis Model

2006 ◽  
Vol 6 ◽  
pp. 2388-2395 ◽  
Author(s):  
Ahmed El-Assmy ◽  
Ahmed R. El-Nahas ◽  
Mohamed E. Abo-Elghar ◽  
Ibrahim Eraky ◽  
Mahmoud R. El-Kenawy ◽  
...  
Keyword(s):  
Surface Area ◽  
Renal Stones ◽  
Renal Calculi ◽  
Analysis Model ◽  
Stone Surface ◽  
Chi Square ◽  
Renal Anomalies ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Free Rate

The first-line management of renal stones between 20—30 mm remains controversial. The Extracorporeal Shock Wave Lithotripsy (ESWL) stone-free rates for such patient groups vary widely. The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL in such controversial groups. Between January 1990 and January 2004, 594 patients with renal stones 20—30 mm in length underwent ESWL monotherapy. Stone surface area was measured for all stones. The results of treatment were evaluated after 3 months of follow-up. The stone-free rate was correlated with stone and patient characteristics using the Chi-square test; factors found to be significant were further analyzed using multivariate analysis.Repeat ESWL was needed in 56.9% of cases. Post-ESWL complications occurred in 5% of cases and post-ESWL secondary procedures were required in 5.9%. At 3-month follow-up, the overall stone-free rate was 77.2%. Using the Chi-square test, stone surface area, location, number, radiological renal picture, and congenital renal anomalies had a significant impact on the stone-free rate. Multivariate analysis excluded radiological renal picture from the logistic regression model while other factors maintained their statistically significant effect on success rate, indicating that they were independent predictors. A regression analysis model was designed to estimate the probability of stone-free status after ESWL. The sensitivity of the model was 97.4%, the specificity 90%, and the overall accuracy 95.6%.Stone surface area, location, number, and congenital renal anomalies are prognostic predictors determining stone clearance after ESWL of renal calculi of 20—30 mm. High probability of stone clearance is obtained with single stone ≤400 mm2 located in renal pelvis with no congenital anomalies. Our regression model can predict the probability of the success of ESWL in such controversial groups and can define patients who would need other treatment modality.

Percutaneous nephrolithotomy of staghorn renal stones in pediatric patients using adult-sized instrument

2019 ◽  
Vol 86 (4) ◽  
pp. 211-215
Author(s):  
Akbar Nouralizadeh ◽  
Hamid Pakmanesh ◽  
Abbas Basiri ◽  
Mohammad Hadi Radfar ◽  
Behzad Narouie ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Pediatric Patients ◽  
Renal Stones ◽  
Adult Size ◽  
Efficacy And Safety ◽  
Double J Stent ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate ◽  
Free Status

Introduction: In this study, we aimed to evaluate the safety and efficacy of the percutaneous nephrolithotomy procedure performed with adult-sized instruments in pediatric cases with staghorn kidney stone. Methods: We retrospectively evaluated the efficacy and safety of 94 percutaneous nephrolithotomy procedures performed during 15 years in a single center for 82 pediatric patients with staghorn calculi using adult-sized instruments (24-Fr nephroscope). Stone free status was defined as complete clearance of the stones or the presence of insignificant residual stones of <3 mm in diameter. Results: The mean age was 108 ± 53 months (range, 14–180 months). There were 39 patients (48%) with complete staghorn stones and 43 cases (52%) with partial staghorn. We fulfilled 91.4% of operations through a single access. The stone free rate was 86.6% after one percutaneous nephrolithotomy session. In total, seven patients referred for shock wave lithotripsy and four cases were scheduled for the second percutaneous nephrolithotomy session. Fever occurred in 18 patients (21%) and bleeding requiring transfusion in four children (5%). Prolonged leakage from nephrostomy site requiring anesthesia for double J stent placement occurred in one patient. No grade IV or V Clavien complication occurred. Conclusion: The success rate and complications of percutaneous nephrolithotomy with adult-size instruments in pediatric patients are acceptable.

scholarly journals COMPARISON OF THE EFFICACY AND SAFETY OF THE SUPINE AND PRONE POSITIONS IN PERCUTANEOUS NEPHROLITHOTOMIES FOR KIDNEY STONES

2019 ◽  
pp. 60-62
Author(s):  
RIO RAHMADI ◽  
NUR RASYID ◽  
PONCO BIROWO
Keyword(s):  
Kidney Stones ◽  
Controlled Trial ◽  
Similar Efficacy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Efficacy And Safety ◽  
Conversion To Open Surgery ◽  
Stone Free Rate ◽  
Student’S T ◽  
Free Rate

Objective: This study was designed to compare the efficacy and safety of the supine and prone positions in percutaneous nephrolithotomies (PCNLs) used for the treatment of kidney stones in Indonesian patients. Methods: This was a single-blinded randomized controlled trial of those patients undergoing PCNLs from February to May of 2018. There were 19 subjects in the supine group and 19 in the prone group for a total of 38 study subjects. The study outcomes that were compared included the operative time, hospital length of stay (LOS), stone-free rate, blood loss, conversion to open surgery, blood transfusion, and complications. These outcomes were evaluated using the Student’s t test and the chi-squared test. Results: There were no significant differences in the patient demographics or stone locations between the two groups. Additionally, the medians of the operative times, LOSs, blood losses, and blood transfusions were not statistically different. There was a higher stone-free rate in the supine group than in the prone group (70.0% vs. 47.4%, respectively, p = 0.151). More subjects were transfused in the supine group (30.0%) than in the prone group (15.8%), but this difference was not statistically significant (p = 0.292). The only complications were infundibular lacerations, which occurred in 20% of the subjects in the supine group and 15.8% of the subjects in the prone group (p = 0.732). Conclusion: This study showed that the supine and prone positions for PCNLs had similar efficacy and safety outcomes.

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