Clinical effects of FURL and PCNL with holmium laser for the treatment of kidney stones

Li, Zhigang; Zhao, Yan; Fan, Tao; Hao, Lin; Han, Conghui; Zang, Guanghui

doi:10.3892/etm.2016.3835

“…PCNL still plays a vital role in urology surgery, which protects a large number of KS sufferers against open surgery [9]. Although PCNL has a high stone-free rate, patients need massive transfusions during operations, and the duration is long, which will inevitably increase the occurrence of complications such as vital organ injury and hemopneumothorax [10]. As efficacy develops, super-mini-PCNL (SMP) has been generalized in clinical practice [11].…”

Section: Progress In the Treatment Of Renal Calculimentioning

confidence: 99%

Efficacy of Super-Mini-PCNL and Ureteroscopy in Kidney Stone Sufferers and Risk Factors of Postoperative Infection

Yuan

¹

,

Li

²

,

Dai

³

et al. 2022

Journal of Healthcare Engineering

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To investigate the efficacy of super-mini-PCNL (SMP) and ureteroscopy in kidney stone (KS) sufferers and learn the risk factors of postoperative infection. A retrospective analysis was performed on 180 KS sufferers who were diagnosed and treated in our hospital from May 2019 to May 2021. They were enrolled into an observation group (OG, n = 104) and a control group (CG, n = 76) based on different treatment methods. Therein, the former was treated with SMP, while the latter was treated with ureteroscopy. The operation time, blood loss, hospital stay, recent stone-free rate (one week after operation), changes of serum creatinine (SCr), blood urea nitrogen (BUN), and cystatin C (CysC) levels before and after operation and complications were compared. Those sufferers were assigned to infected and uninfected groups based on their postoperative infection. The risk factors were assessed through logistic regression, and the model formula was established. The predictive value of this model for infection was tested through RO. Compared with CG, the operation time of the OG was longer, the blood loss and hospital stay were lower P < 0.05 , and the stone-free rate was higher P < 0.05 . Renal function indexes before and after treatment P > 0.05 and postoperative complications revealed no significant difference P > 0.05 . Logistic regression analysis manifested that preoperative urinary tract infection (OR: 4.690, 95% CI: 1.170–18.802), preoperative blood glucose level (OR: 11.188, 95% CI: 2.106–59.442), positive urine culture (OR: 10.931, 95% CI: 2.453–48.705), and infectious stones (OR: 3.951, 95% CI: 1.020–15.300) were independently related to infection. The risk prediction equation is logit p = − 8.913 + 1.545 × X 1 + 2.415 × X 2 + 2.392 × X 3 + 1.374 × X 4 , with a goodness-of-fit value of 0.545. The AUC is 0.930, so SMP is superior to ureteroscopy in KS sufferers. Preoperative urinary tract infection, preoperative blood glucose level, positive urine culture, and infectious stones are independently related to infection.

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“…However, a statistically significant decrease was revealed in the functional volume at the PCNL site of entry for the regional assessment. Li et al [ 8 ] mentioned that the cystatin C level of the FURL group was significantly higher than that of the PCNL group at three and seven days after the operation. KIM-1 was expressed in the early stage of renal function damage, which was positively correlated with the severity of renal tissue pathology and Cystatin C was a recognized index for the early evaluation of renal function injury.…”

Section: Discussionmentioning

confidence: 99%

“…It is extremely effective for stones that are ≤2 cm in diameter and complex kidney stones. [ 8 ] FURL could also be considered for elderly patients, patients with hemorrhagic disorders, which were not suitable for ESWL or PCNL. [ 9 , 10 ] The purpose of this study was to evaluate and compare the efficacy and safety of FURL and MPCNL for the treatment of renal and proximal ureteral calculi of ≤20 mm…”

Section: Introductionmentioning

confidence: 99%

The efficacy of flexible ureteroscopy lithotripsy and miniaturized percutaneous nephrolithotomy for the treatment of renal and proximal ureteral calculi of ≤2 cm

Jiao

¹

,

Lai

²

,

Xu

³

et al. 2019

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To assess the clinical effect of miniaturized percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy lithotripsy (FURL) for the treatment of renal and proximal ureteral calculi of ≤2 cm.A retrospective analysis was carried out on clinical data of 106 patients with kidney or upper urethral calculi. Among these patients, 58 underwent the MPCNL, and 48 received FURL. Stone-free rates, operating time, blood loss, hemoglobin drop, length of hospital stay, complications, and renal damage indexes were compared.The stone removal rates of the FURL and MPCNL groups were 81.25% versus 87.93% (p > .05). Although operating time was significantly shorter in the MPCNL group, hospital stays were significantly shorter in the FURL group. In addition, pooled analysis showed that mean estimated blood loss was significantly higher in the PCNL group but the hemoglobin decline of the FURL group and PCNL group had no significant difference. The PCNL group had no significant difference in complications compared to the FURL group. Differences on the creatinine levels and urea nitrogen levels before the operation and after the operation were not statistically significant.FURL is an effective method for treating renal stone. FURL not only had a similar stone-free rate as compared to MPCNL but also was associated with less blood loss and more favorable recovery time. However, FURL had a longer operative time.

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“…En la búsqueda sistemática sólo se encontró una RS: la realizada para la GPC sobre el manejo de litiasis renal y urolitiasis del NICE (9) . Esta RS encontró 14 ensayos clínicos aleatorizados (10,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) en pacientes con litiasis renal de 10 a 20 mm, los cuales fueron meta-analizados. Si bien la evidencia demuestra cierta superioridad de NLP/URS frente a LEOCH, el GEG consideró que realizar NLP tendría un riesgo significativo de eventos adversos mayores debido a que es un procedimiento invasivo y operador dependiente en cuyo uso se tiene menor experiencia, comparada con los demás procedimientos.…”

Section: Pregunta 2: En Pacientes Con Litiasis Renal De 10 a 20 MM ¿unclassified

Guía de práctica clínica para el tratamiento quirúrgico de pacientes con urolitiasis en el Seguro Social del Perú (EsSalud)

Velásquez

¹

,

Hinostroza

²

,

Daza

³

et al. 2019

An Fac med

1

0

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Introducción. El presente artículo resume la guía de práctica clínica (GPC) para el tratamiento quirúrgico de pacientes con urolitiasis en el Seguro Social del Perú (EsSalud). Objetivo. Proveer recomendaciones clínicas basadas en evidencias para la para el tratamiento quirúrgico de los pacientes con urolitiasis en EsSalud. Método. Se conformó un grupo elaborador de la guía (GEG) constituido por médicos urólogos y metodólogos, los cuales formularon las preguntas clínicas que fueron respondidas dentro de la presente GPC. Para cada una de estas preguntas se realizó búsquedas de revisiones sistemáticas y de estudios primarios (cuando se consideró pertinente) en PubMed durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas, posteriormente se evaluó la certeza de la evidencia usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Se programaron reuniones de trabajo periódicas en las cuales el GEG revisó la evidencia y formuló recomendaciones, puntos de buenas prácticas clínicas y flujogramas usando la metodología GRADE. La GPC fue aprobada con Resolución N° 66–IETSI-ESSALUD-2018. Resultados. Se abordó 6 preguntas clínicas sobre el tema de tratamiento quirúrgico en urolitiasis. En base a dichas preguntas se formularon 5 recomendaciones (2 recomendaciones fuertes y 3 recomendaciones condicionales), 21 puntos de buena práctica clínica, y 3 flujogramas de manejo. Conclusión. El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el tratamiento quirúrgico de pacientes con urolitiasis en EsSalud.

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Clinical effects of FURL and PCNL with holmium laser for the treatment of kidney stones

Cited by 11 publications

References 18 publications

Efficacy of Super-Mini-PCNL and Ureteroscopy in Kidney Stone Sufferers and Risk Factors of Postoperative Infection

Efficacy of Super-Mini-PCNL and Ureteroscopy in Kidney Stone Sufferers and Risk Factors of Postoperative Infection

The efficacy of flexible ureteroscopy lithotripsy and miniaturized percutaneous nephrolithotomy for the treatment of renal and proximal ureteral calculi of ≤2 cm

Guía de práctica clínica para el tratamiento quirúrgico de pacientes con urolitiasis en el Seguro Social del Perú (EsSalud)

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