Shockwave Lithotripsy in Patients with Horseshoe Kidney: Determinants of Success

Ray, A. Andrew; Ghiculete, Daniela; Honey, R. John D'a.; Pace, Kenneth T.

doi:10.1089/end.2010.0213

Cited by 22 publications

(13 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[10][11][12] Anatomic factors associated with concomitant metabolic disorders contribute to this condition, and make endoscopic treatment difficult. [13][14][15] PCNL is the chosen option for the treatment of anomalous kidney stones, especially for stones larger than 20 mm, with stone-free rates between 80 and 90%. [16][17][18][19][20] The success of the procedure is impaired by features such as renal pelvis and anteriorly positioned calyces, vascular abnormalities and different anatomical relationships with adjacent organs, which increases the risk of perioperative complications and the difficulty of the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…1 Tunc et al, 24 in turn, reported a rate of 92% for stones < 10 mm, but 34% for those greater than 30 mm. 3 Coupled with lower efficiency of ESWL in eliminating larger stones, Ray et al 13 has pointed out that 51% of their patients needed an additional procedure, but that little improvement occurred after the second session, revealing a limitation in the number of attempts that could be made.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

Astolfi

Freschi

Berti

et al. 2017

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

Objective: To analyze the results of flexible ureterorenoscopy (F-URS) with holmium laser in the treatment of kidney stones with ectopic and fusion anomalies (horseshoe kidney and rotation anomalies). Method: We reviewed data from 13 patients with fusion and ectopic renal anomalies that underwent F-URS from April 2011 to April 2017. We analyzed demographic and clinical data (age, gender, BMI, anatomical abnormality, location and dimension of the renal calculi) and perioperative data (method of treatment, stone-free rate, number of days with DJ catheter and perioperative complications). Results: The mean stone size was 12.23 +/-5.43 mm (range 6-22mm), located in the inferior (58.33%) and middle (16.76%) calyceal units, renal pelvis (16.67%) and multiple locations (8.33%). All 13 patients were treated with Ho-Yag laser, using dusting technique (25%), fragmentation and extraction of the calculi (58.33%) and mixed technique (16.67%). We did not have any severe perioperative complication. After 90 days, nine patients (75%) were considered stone free. Conclusion: Our data suggest that F-URS is a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

Astolfi

Freschi

Berti

et al. 2017

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

show abstract

“…Altered pyelocalyceal system anatomy and high ureteropelvic junction position lead to relatively poor results of SWL and retrograde intrarenal surgery. Some experts reported that PCNL had acceptable results in HSK with renal stones; its safety and efficacy resembled the anatomy of a normal kidney [4,7,8]. Desai et al [9] treated patients with staghorn calculi in a HSK by PCNL.…”

Section: Discussionmentioning

confidence: 99%

“…Retrograde in renal surgery (RIRS) had lower stone-free rate (SFR) than PCNL for the HSK's malformed anatomical structures; it was difficult for the stone fragments to complete drain and pass through the urinary tract. Some patients with complexity and large renal stones need second stage surgery [5,7]. In such cases, instead of open surgery, laparoscopic pyelolithotomy could be performed to deal with this clinical condition when ESWL and PCNL have both failed.…”

Section: Introductionmentioning

confidence: 99%

Retroperitoneoscopy Technique-Assisted Percutaneous Nephrolithotomy for Complexity Horseshoe Kidney with Renal Stones

Jiang

Tang²,

Xu³

et al. 2016

Urol Int

View full text Add to dashboard Cite

Objective: To assess the safety and efficacy of retroperitoneoscopy technique-assisted percutaneous nephrolithotomy (PCNL) used in the treatment of complexity horseshoe kidney (HSK) with renal stones. Methods: Between January 2012 and April 2015, 5 patients with renal stones in complexity HSK underwent retroperitoneoscopy technique-assisted PCNL. The perioperative data analyzed, included operation time, blood loss, incidence of complication rate, the stone-free rate (SFR), and so on. Results: All the patients successfully completed the operation without need for an open surgery. The mean operative time in which this procedure was done was 77.5 ± 20.6 min, the mean hemoglobin that was reduced was 2.5 ± 0.8 g/dl, the mean time to remove nephrostomy tube and retroperitoneal tube were 3.0 ± 1.0, 3.5 ± 1.0 days, respectively. The mean hospital stay was 7.0 ± 1.5 days. The SFR of all the patients was 80% (4/5). One patient who had residual stones (6 × 5 mm) in the middle pole underwent additional shock wave lithotripsy after the operation and no serious perioperative complications were noticed. Study limitations include small sample size and short follow-up time. Conclusions: Retroperitoneoscopy technique-assisted PCNL is a feasible, safe, and an effective alternative to laparoscopic pyelolithotomy for treating complexity HSK with renal stones, especially in a situation where the HSK is tightly wrapped by the surrounding organs.

show abstract

“…Failure of SWl has been associated with focusing difficulties due to anteriorly localized renal pelvis, medial calyces masked with vertebra, a requirement for the supine position, renal malrotations, ectopic renal pelvis, fused lower pole, high insertion ureter, stasis due to vascular variations, drainage disorders, stone size, stone localization and BMI [6][7][8].…”

Section: Horseshoe Kidneysmentioning

confidence: 99%

Outcomes of retrograde flexible ureteroscopy and laser lithotripsy for stone disease in patients with anomalous kidneys

et al. 2014

View full text Add to dashboard Cite

Due to the presence of structural and anatomical differences that accompany anomalous kidneys, currently available endourological modalities such as SWL and PNL may be insufficient, or additional laparoscopic assistance may be required. The present study aims to evaluate the efficacy and safety of retrograde flexible ureterorenoscopic stone treatment in patients with kidney anomalies. Over the last 3 years, 25 patients with renal stones in anomalous kidneys were consecutively treated by flexible ureterorenoscopy and holmium:YAG laser lithotripsy. Among the 25 patients, fiberoptic or digital flexible ureterorenoscopies were performed for the management of horseshoe kidneys (n = 3), cross-fused ectopic kidney (n = 1), renal ectopies [n = 13; associated with pelvic (n = 6) or lumbar kidneys (n = 7)], renal malrotations (n = 4), and duplicate ureters (n = 4). For lithotripsy, 200 or 273 µm probes were used, and for stone retraction 1.3-1.9 Fr ZeroTip baskets were used. Success was defined as the complete absence of stones as evaluated with a CT scan 1 month after the operation. The mean patient age was 39.4 ± 15.75 years, and the mean stone size was 194.64 ± 103.93 mm(2) (range 50-393). Complete stone clearance was achieved in 16 patients (64%) after a single session. Seven of the patients with residual stones underwent a second session and the remaining three patients were subsequently treated with SWL. The overall complete clearance rate was 88% (22 patients) with ancillary procedures. There were no serious postoperative complications except for one case (4%) of urosepsis. Flexible ureterorenoscopy with holmium laser lithotripsy is a safe option for the treatment of renal stones in anomalous kidneys with satisfactory success rates.

show abstract

Shockwave Lithotripsy in Patients with Horseshoe Kidney: Determinants of Success

Cited by 22 publications

References 30 publications

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

Retroperitoneoscopy Technique-Assisted Percutaneous Nephrolithotomy for Complexity Horseshoe Kidney with Renal Stones

Outcomes of retrograde flexible ureteroscopy and laser lithotripsy for stone disease in patients with anomalous kidneys

Contact Info

Product

Resources

About