Holmium Laser Lithotripsy for Ureteral Calculi: Predictive Factors for Complications and Success

Leijte, Joost A.P.; Oddens, Jorg R.; Lock, Tycho

doi:10.1089/end.2007.0299

Cited by 91 publications

(66 citation statements)

References 17 publications

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“…The edematous and inflamated mucosa surronding and partly covering the stone or fibroepithelial polyp results impede visualization of the stone and make it difficult to perform the lithotripsy. 10,11 The increment of irrigation fluid pressure to obtain a clear image may result in stone migration into the renal collecting system.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive surgical treatment for large impacted upper ureteral stones: Ureteroscopic lithotripsy or percutaneous nephrolithotomy?

Bozkurt

Yonguç

Arslan

et al. 2015

CUAJ

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Introduction:The management of patients with large impacted upper ureteral stones is difficult; there is no standard treatment. We compared the outcomes of percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (UL) to treat large (≥1.5 cm), impacted, upper ureteral stones. Methods: In total, 86 patients with large impacted upper ureteral stones were included in this study. Of these patients 41 underwent UL and 45 underwent PCNL. The inclusion criteria were: longest diameter of stone ≥1.5 cm, the localization of stone between the lower border of L4 spine and ureteropelvic junction and impacted stone. Results: In the UL group, we were unable to reach the stone in 3 patients because of ureteral stricture and edema despite balloon dilation. Of these 3 patients, we were unable to optimally visualize the stone in 2 patients due to bleeding and mucosal injury following balloon dilation. The stricture was too firm and could not be passed in the third patient. Also in the UL group, 15 patients had stones or big fragments which migrated into the renal collecting system. In the PCNL group, 21 patients had concurrent renal stones <1 cm and stones were successfully removed in all patients. No statistically significant difference was found between groups in terms of operation time. Mean hospital stay was significantly shorter in the UL group. Success rates were 82.3% in the UL group and 97.6% in the PCNL group (p = 0.001). Conclusion:The recent study confirms that PCNL is a safe and effective minimally invasive procedure with acceptable complication rates in the treatment of patients with large, impacted upper ureteral stones.

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Section: Discussionmentioning

confidence: 99%

Minimally invasive surgical treatment for large impacted upper ureteral stones: Ureteroscopic lithotripsy or percutaneous nephrolithotomy?

Bozkurt

Yonguç

Arslan

et al. 2015

CUAJ

View full text Add to dashboard Cite

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“…Grade 4a [20] comparing surgical outcomes between experts and trainees, the surgical outcome in terms of stone-free rate and complication rate was superior in the supervised trainees group than in the least experienced expert group. In another series, Netsch et al [21] evaluated the impact of surgical experience on the outcome of ureteroscopy done for a single upper ureteric stone and found that the supervised trainees had a similar overall outcome to their mentor consultants.…”

Section: Grade 3bmentioning

confidence: 93%

Evaluation of ureteroscopy outcome in a teaching hospital

Al‐Naimi¹,

Alobaidy²,

Majzoub³

et al. 2016

Turkish Journal of Urology

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Objective: To evaluate factors affecting semi-rigid ureteroscopy (URS) results highlighting the influence of teaching on its outcomes. Material and methods:We reviewed the files of 891 adult patients who had undergone 1182 ureteroscopies at our institute during the period from July 2008 to June 2011. The outcomes of all URSs were evaluated. Outcomes were measured by stone-free rate and presence of complications, which were assessed using the Clavien-Dindo system. Patients were divided into 2 groups; Group 1 (favorable outcome) became stone-free after the first URS and had no documented complications, while Group 2 (unfavorable outcome) had residual stones and/or complications. Group 2 was subdivided according to the skill level of the operating surgeon into two subgroups. Patients belonging to subgroup A had their procedures performed by urology trainees under direct supervision of expert urologists, while those in subgroup B had their procedures performed by the expert urologists themselves. All groups were compared using univariate (chi-square and t tests) and multivariate (logistic regression) statistical tests to identify significant risk factors. All data was analyzed using SPSS.Results: A total of 1182 URSs were evaluated. 958 patients had a favorable outcome (Group 1) while 224 patients had an unfavorable outcome (Group 2). Factors associated with an unfavorable outcome include location of the presenting stone (p<0.001) and presence of stone impaction (p<0.001). No statistically significant differences were detected in the overall complication rate between trainees and expert urologists. Trainees stone-free rate was comparable to that of experts; 90.3% vs. 91.1%, respectively, p=0.6. Conclusion:Factors such as stone impaction and proximal location are associated with an unfavorable surgical outcome. In a high-volume teaching hospital, semi-rigid URS done by trainees under direct supervision is safe and their outcome is comparable to literature findings.

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“…Accumulated literature data have well demonstrated that the as the stone gets buried into the ureteric wall, this condition (often being called as "impaction") may affect not only the spontaneous passage rates; but also the ultimate success as well as procedure related complications of endourological stone removal methods [1,[12][13][14][15][16].…”

Section: Assessment Of Ureteral Stone Impaction Into the Ureteric Wallmentioning

confidence: 99%

Radiological non-invasive assessment of ureteral stone impaction into the ureteric wall: A critical evaluation with objective radiological parameters

Elibol¹,

Sabuncu²,

Erdem³

et al. 2017

European Urology Supplements

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Holmium Laser Lithotripsy for Ureteral Calculi: Predictive Factors for Complications and Success

Cited by 91 publications

References 17 publications

Minimally invasive surgical treatment for large impacted upper ureteral stones: Ureteroscopic lithotripsy or percutaneous nephrolithotomy?

Minimally invasive surgical treatment for large impacted upper ureteral stones: Ureteroscopic lithotripsy or percutaneous nephrolithotomy?

Evaluation of ureteroscopy outcome in a teaching hospital

Radiological non-invasive assessment of ureteral stone impaction into the ureteric wall: A critical evaluation with objective radiological parameters

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