Combined Retrograde Flexible Ureteroscopic Lithotripsy with Holmium YAG Laser for Renal Calculi Associated with Ipsilateral Ureteral Stones

Cocuzza, Marcello; Colombo, José R.; Ganpule, Arvind; Turna, Burak; Cocuzza, Antonio; Dhawan, Divya R; Santos, Bruno; Mazzucchi, Eduardo; Srougi, Miguel; Desai, Mahesh; Desai, Mihir

doi:10.1089/end.2008.0368

Cited by 22 publications

(16 citation statements)

References 25 publications

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“…[16][17][18] With marked technology advances in instrumentation and energy sources, endo-luminal retrograde ureteric (and intra-renal) stone clearance is becoming more recognized. [19][20][21] Our stone-free rates calculated over 4 weeks (91.5%) is comparable to international rates. 15 Better results with Values are presented as mean ± standard deviation or number (%); p < 0.05 is significant.…”

Section: Discussionsupporting

confidence: 60%

Emergency versus elective ureteroscopic treatment of ureteral stones

Matani

Al-Ghazo

Al-Azab

et al. 2013

CUAJ

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Introduction: This retrospective study investigates the role of the emergency ureteroscopic (URS) approach in the definitive treatment of ureteric stones. Methods: We reviewed all patients admitted for ureteric stones from May 2003 to December 2010. Those who underwent URS stone treatment were selected and stratified into emergency (EMG) and elective groups (ELG). Emergency URS is defined as URS being performed within 24 hours of admission to the emergency room. The main indication for emergency treatment was refractory ureteric colic in spite of narcotic analgesia. Both groups were statistically compared in terms of their patient-, stone-and outcome-related variables. The overall success rate was defined by the clearance of the stone and/or presence of residual fragments (<3 mm) at the end of 4-week follow-up period. Results: In total, 903 patients were suitable for analysis with 244 and 659 patients in the EMG and ELG, respectively. Age, sex and comorbidities were comparable in both groups. Average ages were 43.4 ± 15.31 and 45.6 ± 13.24 years among EMG and ELG, respectively. Stones had an average size of 0.92 ± 0.49 (in the EMG group) and 0.96 ± 0.53 cm (in the ELG group). We found that 61.1% and 65.7% of stones were distally located in the EMG and ELG, respectively. EMG had a longer operative time (69 ± 21.03 vs. 57 ± 13.45 minutes) with comparable average hospital stays (1.9 days). Intra-operative double-J stents or ureteric catheter insertion was noted in 72.5 and 67.7% of EMG and ELG, respectively. The overall complication rates were reported in 13.1% in EMG and 14.4% in ELG. A higher rate of ureteric injuries (early and late) was documented in the EMG group (7% vs. 5.6%). Most of these injuries were minor and manageable without additional procedure and/or general anesthesia. Success was achieved in 90.6% and 91.8% of the EMG and ELG groups, respectively. Conclusion: With recent advances in technology, the growing trend toward one-stage definitive treatment, patient acceptability and rising concerns over financial aspects, emergency URS treatment of ureteric stones is evolving as a standard initial management option.

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Section: Discussionsupporting

confidence: 60%

Emergency versus elective ureteroscopic treatment of ureteral stones

Matani

Al-Ghazo

Al-Azab

et al. 2013

CUAJ

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“…In RIRS procedures, X-ray fluoroscopy is usually used for initial ureteral access to navigate and provide a "roadmap" during URS and stent placement [7,8]. Despite many advantages for endourology, ionizing radiation exposure from X-ray screening poses potential risks to both patients and procedure providers deterministically and stochastically [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Advances in optical systems and miniaturization of ureteroscopes also facilitate navigation of the ureter and renal pelvis and calyces with excellent visualization [7]. The use of UAS facilitates ureteral entry and re-entry [8,13], thus making flexible URS increasingly safe and feasible. In addition, technological advancement in modern flexible ureteroscopes allows the access to the entire pyelocaliceal system [14].…”

Section: Discussionmentioning

confidence: 99%

Retrograde intrarenal surgery for the treatment of renal stones: is fluoroscopy-free technique achievable?

Peng

Zhang

et al. 2015

Urolithiasis

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The aim of this study was to present the safety and efficacy of retrograde intrarenal surgery (RIRS) procedures that minimize the intraoperative radiation exposure. The totally endoscopy-guided RIRS technique included the following steps: (a) preoperative assessment of pelvicaliceal system anatomy and stone characteristics, (b) thorough evaluation of the ureters by rigid ureteroscopy, (c) a step-wise approach of introducing the ureteral sheath, (d) gathering stones in the more accessible renal calyx before fragmenting them, and (e) a modified holmium laser technique. The RIRS procedures performed by a single surgeon between October 2012 and October 2013 in consecutive patients with renal stones were retrospectively reviewed. The mean stone size was 1.4 ± 0.4 (range 0.8-2.0) cm. The median operative time was 74.5 min. Fluoroscopy was only used in one patient who had a double collecting system with two ureters. The stone-free status was achieved in 134 (95.7%) patients one month after surgery. Five (3.6%) patients had minor complications, including hematuria and fever. No major intraoperative complication was observed. We believe that with appropriate preparation, RIRS without fluoroscopic guidance can be safely and efficiently performed by experienced urologists in selected patients with renal stones.

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“…11 Renal stones were associated with collecting system obstruction in 15 (34%) patients, failed extracorporeal SWL in 14 (32%) patients, unilateral multiple stones in 18 (41%) patients, and multiple bilateral stones in three patients (7%). In 29 (66%) patients, the stone was in the inferior calyx.…”

Section: Discussionmentioning

confidence: 95%

Efficacy of flexible fibreoptic ureteroscopy and Holmium laser in retrograde intrarenal surgery for calyceal calculi

Doddamani

Sinha

Talwar³

2011

Medical Journal Armed Forces India

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Combined Retrograde Flexible Ureteroscopic Lithotripsy with Holmium YAG Laser for Renal Calculi Associated with Ipsilateral Ureteral Stones

Abstract: Combined ureteroscopic treatment for ureteral and ipsilateral renal calculi is a safe and attractive option for patients presenting for symptomatic ureteral stone and ipsilateral renal calculi smaller than 15 mm.

Cited by 22 publications

References 25 publications

Emergency versus elective ureteroscopic treatment of ureteral stones

Emergency versus elective ureteroscopic treatment of ureteral stones

Retrograde intrarenal surgery for the treatment of renal stones: is fluoroscopy-free technique achievable?

Efficacy of flexible fibreoptic ureteroscopy and Holmium laser in retrograde intrarenal surgery for calyceal calculi

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