Current Indications for Open Stone Surgery in the Treatment of Renal and Ureteral Calculi

Paik, Michael L.; Wainstein, Mark A.; Spirnak, J. Patrick; Hampel, Nehemia; Resnick, Martin I.

doi:10.1016/s0022-5347(01)63922-3

Cited by 147 publications

(79 citation statements)

References 23 publications

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“…[26] In open surgery stone-free rate has been reported to range between 69, and 93 percent. [23,27] In our study, stone-free rate of 69.3% was detected in 13 patients. However, complex stone burden which is one of the indications of open surgery, inadequacy of other minimally invasive methods, presence of anatomical abnormalities or comorbidies all decrease stone-free rates in this group.…”

Section: Discussionsupporting

confidence: 49%

Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones

Aydemi̇r

Budak

Kumsar

et al. 2014

Turkish Journal of Urology

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Objective: In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery. Material and methods:Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded. Results:The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm 2 in the PNL, 1.4±0.1 cm 2 in the RIRS, and 3.1±0.9 cm 2 in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups.Conclusion: PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity.

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Section: Discussionsupporting

confidence: 49%

Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones

Aydemi̇r

Budak

Kumsar

et al. 2014

Turkish Journal of Urology

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“…The introduction of effective methods of endoscopic stone fragmentation, such as electrohydraulic, pneumatic lithotripters and the laser has rendered the indications for open surgery more limited. 4,5 In our locality, Upper Egypt, urolithiasis is an endemic disease. We are approaching 15 000 cases of SWL since 1991, more than 300 ureteroscopies per year and 150 cases of PNL annually.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic ureterolithotomy: Our experience with 74 cases

et al. 2008

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Objectives:We retrospectively evaluated our experience with a relatively uncommon procedure, the laparoscopic ureterolithotomy, for the treatment of ureteral stones. Methods: Between April 2002 and October 2006, a total of 74 patients (56 males, 18 females) with upper (54 cases), middle (18 cases) and lower (two cases) ureteral stones underwent laparoscopic ureterolithomy. The mean age was 39.4 years (range, 19-74). The stones were in the right side in 44 cases (59.5%) and in the left side in 30 (40.5%) cases. The mean stone size was 1.8 cm (range 1.5-2.8). The procedure was retroperitoneal in 66 cases (89.2%) and transperitoneal in eight (10.8%) cases. Laparoscopic guided flexible ureterorenoscopic extraction of kidney stone was carried out in one case as an adjuvant procedure. The ureter was stented and not sutured in 64 cases (86.5%). Results:The procedure was successfully completed in 94.6% of cases and an open conversion was carried out in four (5.4%) patients. The mean operative time was 58.7 min, and the mean blood loss was 90.6 mL. No major complications were encountered. Prolonged urinary leakage occurred in one patient. The mean hospital stay was 6.4 days. One patient developed ureteral stricture during follow up and was treated by endoscopic dilatation and stenting. Conclusion: In our experience laparoscopic ureterolithotomy represents a safe and effective treatment option for ureteral stones either as primary for large impacted stones or as a salvage procedure after failed shock wave lithotripsy or ureteroscopy. This procedure fulfills the advantages of minimal blood loss and analgesia requirements, good cosmetic appearance, short hospital stay and convalescence period.

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“…In the light of these limiting factors, open stone surgery will probably remain a viable option in those countries for some time. 5 With 1% of open surgery in the stone service, our data, therefore, compare with the literature.…”

Section: Discussion the Current Role Of Open Stone Surgerymentioning

confidence: 61%

The (Soon Forgotten) Art of Open Stone Surgery: To Train or Not To Train?

Buchholz

Hitchings

Albanis

2006

annals

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To date, open stone surgery is now performed in a very limited number of selected cases. A review of our own cases revealed that open surgery constituted 1% of all procedures. These procedures were mostly ablative, or operations to deal with complications of failed minimally invasive therapies. Given two continuing trends towards sub-specialisation in urology on the one hand, and minimally invasive therapy on the other, the question arises whether and how sub-specialised stone surgeons should and can learn open stone surgery. Is it merely a lost art not to be bothered with, or is it something worthwhile preserving? This article discusses the pros and cons of the argument and suggests centralisation of complex stone cases as a possible way out of the dilemma.

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Current Indications for Open Stone Surgery in the Treatment of Renal and Ureteral Calculi

Abstract: While most patients with renal and ureteral stones can be treated with less invasive techniques, open stone surgery continues to represent a reasonable alternative for a small segment of the urinary stone population.

Cited by 147 publications

References 23 publications

Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones

Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones

Laparoscopic ureterolithotomy: Our experience with 74 cases

The (Soon Forgotten) Art of Open Stone Surgery: To Train or Not To Train?

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