Long Term Results of Percutaneous Treatment of Caliceal Diverticular Calculi

Landry, Jean Luc; Colombel, Marc; Rouvière, Olivier; Lezrek, M.; Gelet, A.; Dubernard, Jean‐Michel; Martín, Xavier

doi:10.1016/s0302-2838(02)00039-8

Cited by 28 publications

(20 citation statements)

References 23 publications

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“…Several groups have reported opacifying the diverticular cavity by instillation of contrast material through a ureteral catheter placed in retrograde fashion prior to PCNL. [3][4][5] We have reported a novel singlestage procedure that obviates ureteral catheter placement and instead involves placement of the access needle directly onto the targeted diverticular calculi. 6 However, neither of these techniques is possible if the stones cannot be seen fluoroscopically, and if the caliceal diverticulum does not opacify when contrast is instilled.…”

Section: Introductionmentioning

confidence: 99%

Pre-percutaneous Nephrolithotomy Opacification for Caliceal Diverticular Calculi

Matlaga

Kim

Watkins

et al. 2006

Journal of Endourology

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Caliceal diverticula harbor calculi in as many as 50% of cases. Such stones rarely pass spontaneously. Various stone-removal techniques have been used, with percutaneous techniques generally having the best results. In patients with nonradiopaque stones or in whom the diverticulum does not opacify when contrast is instilled retrograde or by intravenous urogram, contrast can be instilled directly into the cavity with CT or ultrasound guidance. Three such cases are described, with good results.

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Section: Introductionmentioning

confidence: 99%

Pre-percutaneous Nephrolithotomy Opacification for Caliceal Diverticular Calculi

Matlaga

Kim

Watkins

et al. 2006

Journal of Endourology

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“…Ureteral access sheath (Boston Scientific Corporation, Massachusetts, USA) was placed after ureteroscopic examination and dilation of the ureter. If the diverticulum was not found under FURS (Olympus, Tokyo, Japan) or the Blue Spritz technique, which involved instillation of methylene blue (Jumpcan, Jiangsu, China) into the collecting system,[45810] a G18 puncture needle (Bard, Covington, GA, USA) was used for diverticular puncture under ultrasound guidance. Calyceal diverticula and stones were identified under ultrasound.…”

Section: Methodsmentioning

confidence: 99%

“…It is most commonly located at the upper pole of the kidney, with up to 50% of diverticula containing calculi. [34567] Patients with symptomatic calculi may present with flank pain, repeat urinary tract infection, and gross hematuria. [567] Surgical intervention is required for symptomatic calculi.…”

Section: Introductionmentioning

confidence: 99%

“…[567] However, PCNL is associated with disadvantages of massive trauma, long hospital stay, and multiple complications. [67] In recent years, flexible ureteroscopy (FURS) has been used for the treatment of calyceal diverticula.…”

Section: Introductionmentioning

confidence: 99%

“…Despite its advantages, many diverticular necks are narrow and concealed with atresia and obstruction, thus warranting PCNL treatment. [24567891011]…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Analysis of Ultrasound-guided Flexible Ureteroscopy in the Management of Calyceal Diverticular Calculi

Zhang

Wang

Zhang

et al. 2016

Chinese Medical Journal

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Background:Percutaneous nephrolithotomy (PCNL) is the most widely recommended treatment for calyceal diverticular calculi, providing excellent stone-free results. However, its invasiveness is not negligible considering its major complication rates. Flexible ureteroscopy (FURS) is currently used to treat calyceal diverticula. However, the greatest drawback of FURS is locating the diverticulum since its neck is narrow and concealed. In such a case, the FURS procedure must be converted to PCNL. The aim of this study was to evaluate ultrasound-guided flexible ureteroscopy (UFURS) identifying diverticulum and the management of calyceal diverticular calculi.Methods:A retrospective analysis was conducted on 24 patients who had calyceal diverticular calculi. In all 12 patients in the UFURS group, direct FURS failed to find evidence of calyceal diverticula but were confirmed with imaging. The other 12 patients in the PCNL group received PCNL plus fulguration of the diverticular walls.Results:Puncture of calyceal diverticulum was successful in all 12 UFURS patients. Two patients in this group had postoperative residual calculi and two patients developed fever. In the PCNL group, percutaneous renal access and lithotomy were successful in all 12 patients. One patient in this group had residual calculi, one had perirenal hematoma, and two patients developed fever. No significant difference was found in the operating time (UFURS vs. PCNL, 91.8 ± 24.2 vs. 86.3 ± 18.7 min), stone-free rate (UFURS vs. PCNL, 9/12 vs. 10/12), and rate of successful lithotripsy (UFURS vs. PCNL, 10/12 vs. 11/12) between the two groups (all P > 0.05). Postoperative pain scores in the FURS group were significantly lower than that in the PCNL group (2.7 ± 1.2 vs. 6.2 ± 1.5, P < 0.05). Hospital stay in the UFURS group was significantly shorter than that in the PCNL group (3.4 ± 0.8 vs. 5.4 ± 1.0 days, P < 0.05). All patients were symptom-free following surgery (UFURS vs. PCNL, 10/10 vs. 12/12).Conclusion:Ultrasound-guided puncture facilitates identification of calyceal diverticula during FURS and improves the success rate of FURS surgery.

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Indications for Surgical Removal, Including Asymptomatic Stones

Young¹,

Keeley²

2010

Urinary Tract Stone Disease

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Long Term Results of Percutaneous Treatment of Caliceal Diverticular Calculi

Cited by 28 publications

References 23 publications

Pre-percutaneous Nephrolithotomy Opacification for Caliceal Diverticular Calculi

Pre-percutaneous Nephrolithotomy Opacification for Caliceal Diverticular Calculi

Retrospective Analysis of Ultrasound-guided Flexible Ureteroscopy in the Management of Calyceal Diverticular Calculi

Indications for Surgical Removal, Including Asymptomatic Stones

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