Changing Trends in the Treatment of Nephrolithiasis in the Real World

Chung, Kyung Jin; Kim, Jae Heon; Min, Gyeong Eun; Park, Hyoung Keun; Li, Shufeng; Giudice, Francesco Del; Han, Deok Hyun; Chung, Benjamin I.

doi:10.1089/end.2018.0667

Cited by 58 publications

(31 citation statements)

References 19 publications

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“…Frequently, urolithiasis treatment requires surgical intervention. Endoscopic approach is the gold standard and retrograde intra-renal surgery (RIRS) and semi-rigid ureteroscopy are the most common procedures performed for kidney and ureteral stones removal (8,9). New technology including digital and disposable flexible ureteroscopes, well designed guidewires, baskets, access sheaths and high-power laser systems with small fibers are particularly interesting devices to guarantee safety and attractivity for retrograde approach.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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“…There has been a shift in surgical modalities for treating kidney stones. The number of URSs and PCNLs has increased, 6,7 a trend confirmed to be of academic interest in the published literature. Between 2000 and 2015, a linear increase was observed in the publication rate of research on URS and PCNL.…”

Section: Introductionmentioning

confidence: 89%

Ureteroscopy‐assisted puncture for ultrasonography‐guided renal access significantly improves overall treatment outcomes in endoscopic combined intrarenal surgery

et al. 2021

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Objectives: To assess the impact and availability of ureteroscopy-assisted puncture for percutaneous renal access during ultrasonography-guided miniaturized (mini)-endoscopic combined intrarenal surgery for large volume renal and/or proximal ureteral stones. Methods: We conducted a multi-institutional retrospective cohort study for urolithiasis treatment. Data from a total of 313 patients who underwent mini-endoscopic combined intrarenal surgery to treat renal and/or ureteral stones between January 2016 and April 2020 were collected. We compared the outcomes between ultrasonography-guided miniendoscopic combined intrarenal surgery with and without ureteroscopy-assisted puncture (ureteroscopy-assisted puncture(+) group [n = 126] and ureteroscopy-assisted puncture(À) group [n = 187] group, respectively). The primary outcome was requirement for additional surgical intervention. Secondary outcomes were stone-free rate, complications and total procedure, fluoroscopy, hospital stay, and postoperative ureteral stent placement durations. Results: The ureteroscopy-assisted puncture(+) group had a lower additional surgical intervention rate and a higher stone-free rate immediately after and 3 months after surgery than the ureteroscopy-assisted puncture(À) group (5.6% vs 19.7%, P < 0.001; 82.5% vs 65.8%, P = 0.001; 59.5% vs 44.6%, P = 0.011). The median total procedure, fluoroscopy, and postoperative ureteral stent placement durations were 18 min, 3 min, and 5 days shorter, respectively, in the ureteroscopy-assisted puncture(+) group. Multivariate analyses showed that ureteroscopy-assisted puncture was associated with a decreased risk of additional surgical intervention (odds ratio 0.31, P = 0.011) and postoperative infection (odds ratio 0.34, P = 0.003) and decreased total procedure (estimate = À11 min; P = 0.011), fluoroscopy (estimate = À3 min; P = 0.034), and postoperative ureteral stent placement (estimate = À8 days; P = 0.011) durations. Female patients and those with smaller stone volumes or without hydronephrosis were identified as ideal ureteroscopy-assisted puncture candidates. Conclusions: Ureteroscopy-assisted puncture during mini-endoscopic combined intrarenal surgery could provide favorable surgical outcomes, especially in female patients without collecting system obstruction.

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“…While pyelolithotomy will continue to have a role in extremely limited situations, these aberrant cases are beyond the scope of standard practice and are perhaps best managed at a specialty center. Although PCNL carries a considerable learning curve to achieve excellence, the improved manipulation and visualization when compared to SWL and RIRS makes it an incredibly valuable tool in the management of lower pole stones (41)(42)(43).…”

Section: Percutaneous Nephrolithotomymentioning

confidence: 99%

Contemporary considerations in the management and treatment of lower pole stones

et al. 2021

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The presence of lower pole stones poses a unique challenge due to the anatomical considerations involved in their management and treatment. Considerable research has been performed to determine the optimal strategy when faced with this highly relevant clinical scenario. Standard options for management include observation, shock wave lithotripsy, retrograde intrarenal surgery, or percutaneous nephrolithotomy. Indeed, each approach confers a distinct set of risks and benefi ts, which must be placed into the context of patient preference and expected outcomes. The current state of practice refl ects a combination of lessons learned from managing calculi not only in the lower pole, but also from other locations within the kidney as well.

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Changing Trends in the Treatment of Nephrolithiasis in the Real World

Cited by 58 publications

References 19 publications

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

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

Ureteroscopy‐assisted puncture for ultrasonography‐guided renal access significantly improves overall treatment outcomes in endoscopic combined intrarenal surgery

Contemporary considerations in the management and treatment of lower pole stones

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