scholarly journals Ureteral stricture formation after removal of proximal ureteral stone: retroperitoneal laparoscopic ureterolithotomy versus ureteroscopy with holmium: YAG laser lithotripsy

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3483 ◽  
Author(s):  
Henglong Hu ◽  
Lu Xu ◽  
Shaogang Wang ◽  
Xiao Yu ◽  
Huan Yang ◽  
...  
Keyword(s):  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Ureteral Stricture ◽  
Stricture Formation ◽  
Yag Laser ◽  
Stricture Rate ◽  
Confounding Variables ◽  
Significant Difference ◽  
Retroperitoneal Laparoscopic Ureterolithotomy ◽  
The Difference

Objective To compare the risk of postoperative ureteral stricture formation following retroperitoneal laparoscopic ureterolithotomy (RPLU) and ureteroscopy with holmium: YAG laser lithotripsy (URSL) in patients with proximal ureteral stones. Materials and Methods We retrospectively reviewed the medical records of patients who underwent RPLU or URSL for proximal ureteral stones between April 2011 and May 2015. Patients were allocated into URSL group or RPLU group and the outcomes were compared. Results A total of 201 patients who underwent 209 procedures including 159 URSL and 50 RPLU with a median follow-up of 30 months were included. No significant difference was observed among the two groups in most baseline parameters, while the stone size was significantly larger in the RPLU group (11.37 ± 2.97 vs 14.04 ± 4.38 mm, p = 0.000). Patients in RPLU group had markedly longer operative time (p = 0.000) and longer postoperative hospital stay (p = 0.000). The initial and one-month stone-free rates were significantly higher in the RPLU group (78.6% vs 100%, p = 0.000 and 82.4% vs 100%, p = 0.001, respectively). Patients in the RPLU had a higher complication rate (18.0% vs 9.4%, p = 0.098) and lower ureteral stricture rate (2.5% vs 2.0%, p = 1.000), while the difference was not significant. Further logistic regression model identified RPLU and female sex as independent risk factors for postoperative complication (Odds Ratio[OR] = 3.57, p = 0.035 and OR = 3.57, p = 0.025, respectively); however, URSL was not an independent risk factor for the formation of postoperative ureteral stricture after adjusting confounding variables (OR = 0.90, p = 0.935). Conclusion RPLU and URSL have similar postoperative ureteral stricture formation risks. RPLU can provide significantly higher stone clearance rate, but relates with more postoperative complications.

scholarly journals A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hikmet Topaloglu ◽  
Nihat Karakoyunlu ◽  
Sercan Sari ◽  
Hakki Ugur Ozok ◽  
Levent Sagnak ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operation Time ◽  
Ureteral Stones ◽  
Surgical Equipment ◽  
Duration Of Hospital Stay ◽  
Stone Free Rate ◽  
Surgical Expertise ◽  
Significant Difference ◽  
History Of ◽  
Retroperitoneal Laparoscopic Ureterolithotomy

Purpose. To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones.Methods. Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed.Results. Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6 ± 1.1 g/dL versus 0.5 ± 0.3 g/dL, resp.;P=0.022). RLU group had longer operation time (for PAU group and RLU group 80.1 ± 44.6 min versus 102.1 ± 45.5 min, resp.;P=0.039).Conclusions. Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment.

Negative-Pressure Ureteroscopic Holmium-YAG Laser Lithotripsy for Ureteral Stones

2020 ◽  
Vol 104 (9-10) ◽  
pp. 752-757 ◽  
Author(s):  
Zhong-Hua Wu ◽  
Tong-Zu Liu ◽  
Xing-Huan Wang ◽  
Yong-Zhi Wang ◽  
Hang Zheng ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Yag Laser

S112 Comparative evaluation of pneumatic versus holmium: YAG laser lithotripsy for impacted ureteral stones

2009 ◽  
Vol 8 (8) ◽  
pp. 644
Author(s):  
M. Binbay ◽  
A. Tepeler ◽  
E. Yuruk ◽  
O. Sarilar ◽  
U. Ozkuvanci ◽  
...  
Keyword(s):  
Comparative Evaluation ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Yag Laser

scholarly journals Ureteral Stenting after Uncomplicated Ureteroscopy for Distal Ureteral Stones: A Randomized, Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Y. El Harrech ◽  
N. Abakka ◽  
J. El Anzaoui ◽  
O. Ghoundale ◽  
D. Touiti
Keyword(s):  
Urinary Tract ◽  
Ureteral Stent ◽  
Ureteral Calculi ◽  
Ureteral Stones ◽  
Ureteral Stricture ◽  
Stent Group ◽  
Bladder Pain ◽  
Significant Difference ◽  
Group 3 ◽  
Group 1

Objectives. We compared outcome and complications after uncomplicated ureteroscopic treatment of distal ureteral calculi with or without the use of ureteral stents.Materials and Methods. 117 patients, prospectively divided into three groups to receive a double j stent (group 1, 42 patients), ureteral stent (group 2, 37 patients), or no stent (group 3, 38 patients), underwent ureteroscopic treatment of distal ureteral calculi. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalization, stone-free rate, and late postoperative complications were all studied.Results. There were no significant differences in preoperative data. There was no significant difference between the three groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in the nonstented group. When comparing group 1 and group 3, patients with double j stents had statistically significantly more bladder pain (P=0.003), frequency/urgency (P=0.002), dysuria (P=0.001), and need of analgesics (P=0.001). All patients who underwent imaging postoperatively were without evidence of obstruction or ureteral stricture.Conclusions. Uncomplicated ureteroscopy for distal ureteral calculi without intraoperative ureteral dilation can safely be performed without placement of a ureteral stent.

scholarly journals Evaluating the effect of injecting triamcinolone acetonide in two sessions for preventing esophageal stricture after endoscopic submucosal dissection

2019 ◽  
Vol 07 (06) ◽  
pp. E764-E770 ◽  
Author(s):  
Satoru Hashimoto ◽  
Ken-ichi Mizuno ◽  
Kazuya Takahashi ◽  
Hiroki Sato ◽  
Junji Yokoyama ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Triamcinolone Acetonide ◽  
Esophageal Stricture ◽  
Control Group ◽  
Study Group ◽  
Stricture Formation ◽  
Endoscopic Injection ◽  
Submucosal Dissection ◽  
Stricture Rate ◽  
Significant Difference

Abstract Background and study aims Several previous reports indicate that endoscopic injection of triamcinolone acetonide (TA) after widespread endoscopic submucosal dissection (ESD) is effective for preventing esophageal stricture. We investigated the efficacy of injecting TA in two sessions for preventing stricture formation post-ESD. Patients and methods Sixty-six consecutive patients with widespread mucosal defects that affected more than three-fourths of the circumference of the esophagus were included. The study group (n = 40) received TA injections over two sessions: immediately after and 14 days after ESD. The control group (n = 26) did not receive a TA injection. This study was performed retrospectively against historical controls. The primary endpoint of this study was frequency of stricture after TA injection. The secondary endpoint was number of required endoscopic balloon dilations (EBDs) after TA injection. Results The post-ESD stricture rate among patients who had subcircumferential mucosal defects was 45.7 % in the study group (16/35 patients), which was significantly lower than the rate of 73.9 % in the control group (17/23 patients; P = 0.031). The number of EBD procedures required was significantly lower in the study group (median 0, range 0 – 7) than in the control group (median 4, range 0 – 20; P < 0.001). There was no significant difference between the study and control groups among the patients who had full circumferential mucosal defects. Conclusion This study showed that performing two sessions of TA injection is an effective and safe treatment for prevention of esophageal stricture following subcircumferential ESD.

scholarly journals Laser Versus Pneumatic Lithotripsy With Semi-Rigid Ureteroscope; A Comparative Randomized Study

2019 ◽  
Vol 10 (3) ◽  
pp. 185-188
Author(s):  
Seyed Mohammadreza Rabani ◽  
Seyedhossein Rabani ◽  
Najmeh Rashidi
Keyword(s):  
Randomized Study ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Female Ratio ◽  
Pneumatic Lithotripsy ◽  
Extracorporeal Shock Wave ◽  
Academic Center ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction: Ureteral stones are among the most common disorders in the urologic field. Miniaturization of endoscopic devices in urology and extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of ureteral stones. The aim of this study was to compare the efficacy and results of laser versus pneumatic lithotripsy (PL) with semi-rigid ureteroscope in a randomized prospective clinical trial in removing stones. Methods: 117 adult patients underwent transurethral lithotripsy (TUL) in a single academic center and by a single surgeon. The patients were randomized in 2 groups: In group 1, 58 patients with ureteral stones underwent ureteroscopy and stone fragmentation was done by Ho: YAG laser lithotripsy (LL) and in group 2, 59 patients underwent PL (Swiss LithoClast) by using the same ureteroscope. Results: Mean age was 41.77 years and 41.1years in group one and 2 respectively (P=0.79), there was no significant difference in male to female ratio and mean stone in both groups. The success rate for stone clearance was 79.31% and 77.96% in group 1 and 2 respectively (P=0.52). No difference between complications was seen in both groups, but the duration of operations was different (significantly lower in group 2). Conclusion: In both techniques, acceptable results were achieved. We have found a significant statistical difference in duration of operation between our results (P=0.001) and similar studies, while this was shorter in the pneumatic group in our study, it was longer in other similar ones. This might be a result of more experience in working with PL in our center.

Cranial crassicaudiasis in two coastal dolphin species from South Africa is predominantly a disease of immature individuals

2020 ◽  
Vol 139 ◽  
pp. 93-102 ◽  
Author(s):  
MF Van Bressem ◽  
P Duignan ◽  
JA Raga ◽  
K Van Waerebeek ◽  
N Fraijia-Fernández ◽  
...  
Keyword(s):  
South Africa ◽  
Bone Development ◽  
Bottlenose Dolphins ◽  
Fatal Outcome ◽  
Population Level ◽  
Cape Coast ◽  
Osteolytic Lesions ◽  
Immune Mediated ◽  
Significant Difference ◽  
The Difference

Crassicauda spp. (Nematoda) infest the cranial sinuses of several odontocetes, causing diagnostic trabecular osteolytic lesions. We examined skulls of 77 Indian Ocean humpback dolphins Sousa plumbea and 69 Indo-Pacific bottlenose dolphins Tursiops aduncus, caught in bather-protecting nets off KwaZulu-Natal (KZN) from 1970-2017, and skulls of 6 S. plumbea stranded along the southern Cape coast in South Africa from 1963-2002. Prevalence of cranial crassicaudiasis was evaluated according to sex and cranial maturity. Overall, prevalence in S. plumbea and T. aduncus taken off KZN was 13 and 31.9%, respectively. Parasitosis variably affected 1 or more cranial bones (frontal, pterygoid, maxillary and sphenoid). No significant difference was found by gender for either species, allowing sexes to be pooled. However, there was a significant difference in lesion prevalence by age, with immature T. aduncus 4.6 times more likely affected than adults, while for S. plumbea, the difference was 6.5-fold. As severe osteolytic lesions are unlikely to heal without trace, we propose that infection is more likely to have a fatal outcome for immature dolphins, possibly because of incomplete bone development, lower immune competence in clearing parasites or an over-exuberant inflammatory response in concert with parasitic enzymatic erosion. Cranial osteolysis was not observed in mature males (18 S. plumbea, 21 T. aduncus), suggesting potential cohort-linked immune-mediated resistance to infestation. Crassicauda spp. may play a role in the natural mortality of S. plumbea and T. aduncus, but the pathogenesis and population level impact remain unknown.

Quantitative Ratiometric pH Imaging Using a 1,2-Dioxetane Chemiluminescence Resonance Energy Transfer Sensor

2020 ◽  
Author(s):  
Lucas S. Ryan ◽  
Jeni Gerberich ◽  
Uroob Haris ◽  
ralph mason ◽  
Alexander Lippert
Keyword(s):  
Energy Transfer ◽  
Resonance Energy Transfer ◽  
Resonance Energy ◽  
Whole Body ◽  
Photon Flux ◽  
Ph Homeostasis ◽  
Ph Imaging ◽  
Confounding Variables ◽  
Significant Difference

<p>Regulation of physiological pH is integral for proper whole-body and cellular function, and disruptions in pH homeostasis can be both a cause and effect of disease. In light of this, many methods have been developed to monitor pH in cells and animals. In this study, we report a chemiluminescence resonance energy transfer (CRET) probe Ratio-pHCL-1, comprised of an acrylamide 1,2-dioxetane chemiluminescent scaffold with an appended pH-sensitive carbofluorescein fluorophore. The probe provides an accurate measurement of pH between 6.8-8.4, making it viable tool for measuring pH in biological systems. Further, its ratiometric output is independent of confounding variables. Quantification of pH can be accomplished both using common fluorimetry and advanced optical imaging methods. Using an IVIS Spectrum, pH can be quantified through tissue with Ratio-pHCL-1, which has been shown in vitro and precisely calibrated in sacrificed mouse models. Initial studies showed that intraperitoneal injections of Ratio-pHCL-1 into sacrificed mice produce a photon flux of more than 10^10 photons per second, and showed a significant difference in ratio of emission intensities between pH 6.0, 7.0, and 8.0.</p> <b></b><i></i><u></u><sub></sub><sup></sup><br>

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