Intra-renal pressure and temperature during ureteroscopy: Does it matter?

Lopes, Antonio Corrêa; Dall'Aqua, Vinicius; Carrera, Raphael; Molina, Wilson; Glina, Sidney

doi:10.1590/s1677-5538.ibju.2020.0428

Cited by 19 publications

(9 citation statements)

References 45 publications

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“…However, only multiple incisions in the kidney can ensure stone removal, leading to greater trauma and more complications, which is not conducive to postoperative functional rehabilitation [ 8 , 9 ]. Extracorporeal shock wave lithotripsy plays a vital role in treating multiple renal calculi, but its therapeutic effect is affected by the stone size and location [ 10 ]. Therefore, a safe and effective treatment strategy for multiple renal calculi is still missing.…”

Section: Discussionmentioning

confidence: 99%

Flexible Ureteroscopy and Nephroscopy for Stone Removal in Patients with Multiple Renal Calculi

Zhu

Zhang

2022

Disease Markers

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Objective. Renal calculi are a common type of urological calculi and are associated with morbidity. This study was aimed at exploring the effect of flexible ureteroscopy and nephroscopy on stone removal in patients with multiple renal calculi. Method. This randomized controlled trial included a total of 78 cases with multiple renal calculi in our hospital. The patients were randomly divided into the study and control groups and treated with flexible ureteroscopy and percutaneous nephrolithotomy with pneumatic ballistics, respectively. The surgery condition, levels of prostaglandin F2α (PGF2α), prostaglandin E2 (PGE2), keratocyte growth factor (KGF), renal function indices, and the incidence of complications were analyzed before and after surgery in the two groups. Result. The operation time, the postoperative analgesia pump application time, one-time stone removal rate, the intraoperative blood loss, and hospital stay of the study group were significantly lower than those of the control group. Postsurgery, the levels of PGE2, PGF2α, and KGF in the study group were significantly lower than those in the control group. The serum levels of SCR, BUN, and NGAL in the study group were significantly lower than those in the control group. In addition, the incidence complications in the study group were significantly lower. Conclusion. Flexible ureteroscopy and laser lithotripsy under nephroscopy were equally effective against multiple renal calculi. Flexible ureteroscopy reduced surgical trauma without affecting renal function and had a low incidence of complications.

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Section: Discussionmentioning

confidence: 99%

Flexible Ureteroscopy and Nephroscopy for Stone Removal in Patients with Multiple Renal Calculi

Zhu

Zhang

2022

Disease Markers

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“…On the other hand, the dusting technique fragments stones into dust, resulting in the frequent poor vision field, especially for larger stones, and makes it difficult for surgeons to ensure that the stone is dusted small enough to pass spontaneously. In this situation, surgeons normally increase irrigation flow rates in order to get a better field view, which may increase intra-renal pressure and rise potential complications, especially sepsis risk ( 21 ). Furthermore, our results showed that basketing could not give an advantage in the complete SFR, while the immediate postoperative SFR and SFR observed 1 month postoperatively were significantly better in the basketing group.…”

Section: Discussionmentioning

confidence: 99%

A study comparing dusting to basketing for renal stones ≤ 2 cm during flexible ureteroscopy

et al. 2023

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Objectives To compare the dusting efficiency and safety with basketing for treating renal stones ≤ 2 cm during flexible ureteroscopy (fURS). Materials and methods This study included 218 patients with renal stones ≤ 2 cm treated with fURS. Among them, 106 patients underwent dusting, and 112 patients underwent fragmentation with basket extraction. All patients were followed up for 3 months postoperatively. The operating time, lasing time, stone-free rate (SFR) and complication rate were compared. Results The mean stone size in the dusting group was 1.3 cm, whereas 1.4 cm in the basketing group. The mean operative time was significantly lower in the dusting group than in the basketing group (43.1±11.7 minutes VS 60.5±13.4 minutes, P <0.05), but the lasing time was significantly longer for the dusting group than for the basketing group (17.7±3.9 minutes VS 14.1±3.6 minutes, P <0.05). SFR was signiﬁcantly higher in the basketing group immediately after the operation and follow-up after 1 month (76.8% vs 55.7%, P= 0.001 and 88.4% vs 78.3%, P = 0.045). However, the SFR was similar for both groups (88.8% in the dusting group vs. 90.2% in the basketing group) after 3 months postoperatively. There was no statistical difference in the complication rates between the two groups. Conclusions Dusting has advantages in shortening the operation time and reducing the operation cost, but the lasing time was longer compared with the basketing. Although there is no difference in long-term effect, basketing is superior to dusting in terms of short-term SFR. Moreover, dusting should be avoided in some special cases and basketing a better choice. Both techniques are effective for the treatment of renal stones ≤ 2 cm and choice depends on patient demographic and stone characteristics.

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“…15,17,35 The latter can serve to not only improve vision but reduce intra-renal temperatures. 36 In a recent prospective randomised trial comparing the clinical outcomes of URS lithotripsy using TFL and Ho:YAG, superior SFR (92% versus 67%, p = 0.001), less intraoperative adverse events (8% versus 27%, p = 0.011) and shorter operative time (49 minutes versus 57 minutes, p = 0.008) were achieved using TFL. 37 TFL may, therefore, evolve to take over as the preferred and recommended laser of choice for URS lithotripsy.…”

Section: Thulium Fibre Lasermentioning

confidence: 98%

Advances in Ureteroscopy: New technologies and current innovations in the era of Tailored Endourological Stone Treatment (TEST)

Juliebø‐Jones

Keller

Haugland

et al. 2022

Journal of Clinical Urology

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Ureteroscopy has undergone many advances in recent decades. As a result, it is able to treat an increasing range of patient groups including special populations such as pregnancy, anomalous kidneys and extremes of age. Such advances include Holmium laser, high-power systems and pulse modulation. Thulium fibre laser is a more recent introduction to clinical practice. Ureteroscopes have also been improved alongside vision and optics. This article provides an up-to-date guide to these topics as well as disposable scopes, pressure control and developments in operating planning and patient aftercare. These advances allow for a custom strategy to be applied to the individual patient in what we describe using a new term: Tailored endourological stone treatment (TEST). Level of evidence: 5

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Intra-renal pressure and temperature during ureteroscopy: Does it matter?

Cited by 19 publications

References 45 publications

Flexible Ureteroscopy and Nephroscopy for Stone Removal in Patients with Multiple Renal Calculi

Flexible Ureteroscopy and Nephroscopy for Stone Removal in Patients with Multiple Renal Calculi

A study comparing dusting to basketing for renal stones ≤ 2 cm during flexible ureteroscopy

Advances in Ureteroscopy: New technologies and current innovations in the era of Tailored Endourological Stone Treatment (TEST)

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