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 Mini percutaneous nephrolithotomy versus retrograde flexible ureterorenoscopy in the treatment of renal calculi in anomalous kidneys

2021 ◽  
Vol 93 (2) ◽  
pp. 167-172
Author(s):  
Hussein M. Abdeldaeim ◽  
Omar El Gebaly ◽  
Mostafa Said ◽  
Abdel Rahman Zahran ◽  
Tamer Abouyoussif
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Hemoglobin Concentration ◽  
Renal Stones ◽  
Renal Calculi ◽  
Flexible Ureterorenoscopy ◽  
Single Center Experience ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate

Objectives: To report our single center experience in comparing mini-percutaneous nephrolithotomy versus flexible ureterorenoscopy for management of renal stones up to 2 cm in anomalous kidneys. Materials and methods: Records of the last 30 patients with stones less than 2 cm in anomalous kidney treated by mini-percutaneous nephrolithotomy were reviewed and compared to last 30 patients treated by flexible ureterorenoscopy. Results: Mean stone size was significantly higher in the minipercutaneous nephrolithotomy group (17.90 mm) than in flexible ureterorenoscopy group (14.97mm) (p < 0.001). Mean operative time (80.33 min vs 56.43 min) and fluoroscopy exposure time (4.49 min vs 0.84 min) were significantly higher in the mini-percutaneous nephrolithotomy group than in the flexible ureterorenoscopy group (p < 0.001). The mean post-operative drop in hemoglobin concentration was significantly higher in the mini-percutaneous nephrolithotomy group (0.47 gm versus 0.2 gm) (p < 0.001). Stone free rate after 12 weeks follow up was not statistically significant between the 2 groups (90% in minipercutaneous nephrolithotomy vs 80% in flexible ureterorenoscopy) (FEp = 0.472).Conclusions: Both modalities were found to be safe and effective for treatment of stones less than 2 cm in anomalous kidneys.

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.

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 Treatment of upper urinary tract stones with flexible ureteroscopy in children

2018 ◽  
Vol 13 (3) ◽  
Author(s):  
Jing Xiao ◽  
Xiangyu Wang ◽  
Jun Li ◽  
Miaomiao Wang ◽  
Tiandong Han ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Flexible Ureteroscopy ◽  
Holmium Laser Lithotripsy ◽  
Stone Free Rate ◽  
Urinary Tract Stones ◽  
Free Rate

Introduction: This single-centre, retrospective study aimed to assess the efficacy and safety of flexible ureteroscopy (FURS) combined with holmium laser lithotripsy in treating children with upper urinary tract stones. Methods: From June 2014 to October 2015, a total of 100 children (74 boys and 26 girls) with upper urinary tract stones were treated using FURS. A 4.7 Fr double-J stent was placed two weeks before operation. Patients were considered stone-free when the absence of residual fragments was observed on imaging studies. The preoperative, operative, and postoperative data of the patients were retrospectively analyzed. Results: A total of 100 pediatric patients with a mean age of 3.51±1.82 years underwent 131 FURS and holmium laser lithotripsy. Mean stone diameter was 1.49±0.92 cm. Average operation time was 30.8 minutes (range 15–60). The laser power was controlled between 18 and 32 W, and the energy maintained between 0.6 and 0.8 J at any time; laser frequency was controlled between 30 and 40 Hz. Complications were observed in 69 (69.0 %) patients and classified according to the Clavien system. Postoperative hematuria (Clavien I) occurred in 64 (64.0 %) patients. Postoperative urinary tract infection with fever (Clavien II) was observed in 8/113 (7.1%) patients. No ureteral perforation and mucosa avulsion occurred. The overall stone-free rate of single operation was 89/100 (89%). Stone diameter and staghorn calculi were significantly associated with stone-free rate. Conclusions: FURS and holmium laser lithotripsy is effective and safe in treating children with upper urinary tract stones.

scholarly journals Management of upper ureteral stones exceeding 15 mm in diameter: Shock wave lithotripsy versus semirigid ureteroscopy with holmium:yttrium–aluminum–garnet laser lithotripsy

2016 ◽  
Vol 4 ◽  
pp. 205031211668518 ◽  
Author(s):  
Hamdy Aboutaleb ◽  
Mohamed Omar ◽  
Shady Salem ◽  
Mohamed Elshazly
Keyword(s):  
Shock Wave ◽  
Shock Wave Lithotripsy ◽  
Perioperative Complications ◽  
Operation Time ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Complication Rates ◽  
Stone Free Rate ◽  
Free Rate

Objectives: We conducted a retrospective study to evaluate the efficacy and outcome of shock wave lithotripsy versus semirigid ureteroscopy in the management of the proximal ureteral stones of diameter exceeding 15 mm. Methods: During the 2009−2014 study period, 147 patients presenting with the proximal ureteral stones exceeding 15 mm in diameter were treated. Both shock wave lithotripsy and ureteroscopy with laser lithotripsy were offered for our patients. A 6/8.9 Fr semirigid ureteroscope was used in conjunction with a holmium:yttrium–aluminum–garnet laser. The stone-free rate was assessed at 2 weeks and 3 months post-treatment. All patients were evaluated for stone-free status, operation time, hospital stay, perioperative complications, and auxiliary procedures. Results: Of the 147 patients who took part in this study, 66 (45%) had undergone shock wave lithotripsy and 81 (55%) underwent ureteroscopy. At the 3-month follow-up, the overall stone-free rate in the shock wave lithotripsy group was 39/66 (59%) compared to 70/81 (86.4%) in the ureteroscopic laser lithotripsy group. Ureteroscopic laser lithotripsy achieved a highly significant stone-free rate ( p = 0.0002), and the mean operative time, auxiliary procedures, and postoperative complication rates were comparable between the two groups. Conclusion: In terms of the management of proximal ureteral stones exceeding 15 mm in diameter, ureteroscopy achieved a greater stone-free rate and is considered the first-line of management. Shock wave lithotripsy achieved lower stone-free rate, and it could be used in selected cases.

Flank Suspended Supine Position for Percutaneous Nephrolithotomy

2012 ◽  
Vol 79 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Pan Tie-jun ◽  
Li Gong-cheng ◽  
Ye Zhang-qun ◽  
Wen Han-dong ◽  
Shen Guo-qiu ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Renal Stone ◽  
Pleural Cavity ◽  
Operation Time ◽  
Bleeding Rate ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Positioning Method ◽  
Free Rate

Aims Prone and supine positions for percutaneous nephrolithotomy are widely used but have their drawbacks. We report a new positioning method called “flank suspended supine position” (FSSP) for PCNL and describe our experience with PCNL in this position to evaluate its safety and efficacy. Methods Retrospective study of 150 cases of renal stone patients treated with PCNL in a new position called flank suspended supine position (FSSP) from June 2009 to July 2010. All patients were treated with PCNL in FSSP under epidural anesthesia. Operation time, bleeding rate, stone free rate, and complications were recorded. Results All patients tolerated FSSP. Mean operation time was 78.29±26.13 min. Initial stone-free rate was 83%. For those with residual stones (26 cases), 18 were stone-free after a second PCNL, 8 after extracorporeal shock wave lithotripsy (ESWL). Mean hospital stay was 7.63±2.39 days. No penetrating injury of the pleural cavity or injury to visceral organs was reported. Summary FSSP is an effective and safe position for PCNL in our hands and its effectiveness relative to traditional prone position needs to be determined in future randomized studies.

scholarly journals Clinical effects of Poly- Flexible Ureteroscopy combined with ultrasound guided all seeing needle Microperc to treatment of Lower Pole Renal Calculi larger than 2cm with infundibulopelvic angle less than 60 degrees

1969 ◽  
Vol 1 (3) ◽  
Author(s):  
Jingyang Guo
Keyword(s):  
Postoperative Complications ◽  
Operation Time ◽  
Renal Calculi ◽  
Flexible Ureteroscopy ◽  
Clinical Effects ◽  
Lower Pole ◽  
Ultrasound Guided ◽  
Retrograde Intrarenal Surgery ◽  
Stone Free Rate ◽  
Male Patients

Objective: To observation on Poly- Flexible Ureteroscopy(FURS) retrograde intrarenal surgery (RIRS) combined with ultrasound guided all seeing needle Microperc to treatment of Lower Pole Renal Calculi larger than 2cm stone with infundibulopelvic angle（IPA）less than 60 degrees. Method: From January 2016 to January 2017, 63 patients with IPA angle less than 60 degrees in our hospital were treated with Poly-FURS retrograde intrarenal surgery combined with ultrasound guided all seeing needle Microperc, the patients stone sized more than 2 mm and located in the lower-pole calyx were retrospectively reviewed. Multiple stones were found in 37 cases and solitary stones in 26. Male patients used 70cm Poly-FURS, and the female 42cm.The clinical data including the operation time, the amount of bleeding, the stone free rate(SFR), the incidence of postoperative complications. Results: The operation time was 30~60min, mean 45min, FURS lithotripsy time was 20~35min, ultrasound guided all seeing needle puncture time was 3~5min, and lithotripsy time was 8~12min. 48 cases mainly lithotripsy with FURS and 15cases with micro-Percutaneous nephrolithotomy(micro-perc), 3 cases of fever as postoperative complications, 2 cases of pain; In non blood transfusion patients. The postoperative hospital stay was 2~3 days, with an average of 2 days. Postoperative residual stones were observed in 3 cases(SFR 95.2%) and treated with ESWL after 2 weeks. The stone clearance rate was 98.4% (62/63)after one month. Conclusion: The results of our study demonstrated that Poly- FURS retrograde intrarenal surgery combined with ultrasound guided all seeing needle Microperc had a significant effect on the success rate of lower Pole Renal Calculi larger than 2cm.

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