Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of analgesic consumption and treatment-related patient satisfaction in patients with renal stones 10–35 mm

Wilhelm, Konrad; Hein, Simon; Adams, Fabian; Schlager, Daniel; Miernik, Arkadiusz; Schoenthaler, Martin

doi:10.1007/s00345-015-1585-5

Cited by 41 publications

(51 citation statements)

References 15 publications

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“…All studies expect Wilhelm [24] indicated that RIRS resulted in shorter hospital stays compared with MIPPs. Again, reasons underlying this may be similar to those proposed for the analysis of hemoglobin levels.…”

Section: Discussionmentioning

confidence: 99%

“…All studies included were full-text articles. Among all the studies, RIRS was compared with mini-PCNL in six studies [14][15][16][17][18][19], micro-PCNL in three studies [20][21][22], ultra-mini PCNL in two studies [23,24], and mixture of mini and micro PCNL in one study [25]. Agreement between the two reviewers was 91.67% for quality assessment of articles.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…All studies excluded Kiremit's [25] take age, gender, and stone sizes into considerations, and there is no signification difference between each group. During our research, there were only two small sampled RCTs [16,22] (level of evidence: 2b); eight retrospective studies [14,15,17,19,20,[23][24][25] discussed contemporary series of patients (LE: 3b); three were two prospective studies [18,21], and one of them was matchedpair study [18] (LE: 2b), and the rest [21] was prospective data collection (LE: 3b). As for surgical indications, six studies were about mini-PCNL, three studies about micro-PCNL, two about ultra-mini PCNL, and one study discuss mini-PCNL and micro-PCNL at the same time.…”

Section: Characteristics Of Eligible Studiesmentioning

confidence: 99%

“…Matching criteria in trails were variable expect for one study [25], which had no declarations. Ten studies [14][15][16][17][18][19][20][21][22]24] talked about the detail length of followup. Methods for handling missing data were declared in the majority, but not for intention-to-treat.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

Li¹,

Zheng²,

Zang³

et al. 2018

biomedicalresearch

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Percutaneous Nephrolithotomy (PCNL) and Retrograde Intrarenal Surgery (RIRS) are widely used in the management of kidney stones. But the safety and efficiency between these two technologies is still a mystery. This meta-analysis was performed to compare the efficacy as well as safety of Minimally Invasive Percutaneous Procedures (MIPPs) including ultra mini-PCNL, mini-PCNL, and micro-PCNL with RIRS. PubMed, Embase and Scopus were searched, and twelve studies included data on 1207 cases (613 for MIPPs and 594 for RIRS) satisfied the inclusion criteria and were included in this research finally. MIPPs were found to be associated with higher stone-free rate but longer hospital stays, and a larger drop in hemoglobin levels. Difference between MIPPs and RIRS in complication rate, operative time, and total cost were not notable. Given no obvious difference in the complication rate and higher efficacy, our findings suggest that mini-PCNL should be recommended over RIRS for stones>2 cm, and that for stones<2 cm any of MIPPs or RIRS are reasonable.

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Section: Discussionmentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Characteristics Of Eligible Studiesmentioning

confidence: 99%

Section: Quality Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

Li¹,

Zheng²,

Zang³

et al. 2018

biomedicalresearch

View full text Add to dashboard Cite

show abstract

“…This new treatment modality seems to be promising for the management of middle-sized stones; however, up to now only a few studies have been published from certain centers reporting the limited number of experiences of the same few surgeons. [10][11][12][13][14][15][16] We report herein the outcomes of the prospective clinical study of UMP compared with the findings cited in the literature. With the surgeons' increased experience using UMP and presentation of series, the role of UMP in the management of renal stones will be more clearly understood.…”

Section: Introductionmentioning

confidence: 99%

The role of ultra-mini percutaneous nephrolithotomy in the treatment of kidney stones

Tepeler

Basibuyuk

Tosun

et al. 2016

Turkish Journal of Urology

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Objective: In our study we aimed to evaluate outcomes of ultra-mini-percutaneous nephrolithotomy (UMP) performed for the treatment of kidney stones. Material and methods:Between October 2014 and September 2015, a single surgeon performed UMP on a total of 49 consecutive patients with symptomatic kidney stones at our center. Pregnants, anticogulant users, patients with bleeding diathesis pyonephrosis, and partial/complete staghorn stones were excluded from the study. Patient characteristics, operative data and postoperative outcomes were assessed in detail. Results:The UMP was performed on 50 (34 right/16 left) renal units of the 48 (28 male/20 female) patients included in this study. The mean age and body mass index was 36.5 (2-83) years and 26.2 (17.6-32.8) kg/m 2 , respectively. Mean stone size was calculated as 22.2 (10-55) mm. The mean durations of the operations and fluoroscopic examination were calculated as 65.4 (20-120) minutes and 89.4 (9-322) seconds, respectively. The mean duration of hospitalization was 1.4 (1-5) days. In 52% of the patients the procedure was terminated tubeless. Mean hemoglobin drop was 0.6 (0-3) g/dL. Our series experienced a 10% complication rate. The UMP procedure was successful in 96% of the renal units at the 1 st month control visit assessment. Conclusion:The outcomes of our study have demonstrated that UMP is an effective and safe treatment modality, especially in the treatment of medium-sized renal calculi.

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Clinical outcomes and costs of reusable and single-use flexible ureterorenoscopes: a prospective cohort study

et al. 2018

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The purpose of this study is to analyze clinical outcomes and costs of single-use flexible ureterorenoscopes in comparison with reusable flexible ureterorenoscopes in a tertiary referral center. Prospectively, 68 flexible ureterorenoscopies utilizing reusable (Flex-X2S, Flex-X, Karl Storz) and 68 applying single-use flexible ureterorenoscopes (LithoVue, Boston Scientific) were collected. Clinical outcome parameters such as overall success rate, complication rates according to Clavien-Dindo, operation time and radiation exposure time were measured. Cost analysis was based on purchase costs and recurrent costs for repair and reprocessing divided by number of procedures. In each group 68 procedures were available for evaluation. In 91% of reusable and 88% of single-use ureterorenoscopies stone disease was treated with a mean stone burden of 101 ± 226 and 90 ± 244 mm and lower pole involvement in 47 and 41%, respectively (p > 0.05). Comparing clinical outcomes of reusable vs. single-use instruments revealed no significant difference for overall success rates (81 vs. 87%), stone-free rates (82 vs. 85%), operation time (76.2 ± 46.8 vs. 76.8 ± 40.2 min), radiation exposure time (3.83 ± 3.15 vs. 3.93 ± 4.43 min) and complication rates (7 vs. 17%) (p > 0.05). A wide range of repair and purchase costs resulted in total to $1212-$1743 per procedure for reusable ureterorenoscopy whereas price of single-use ureterorenoscopy was $1300-$3180 per procedure. The current work provided evidence for equal clinical effectiveness of reusable and single-use flexible ureterorenoscopes. Partially overlapping ranges of costs for single-use and reusable scopes stress the importance to precisely know the expenses and caseload when negotiating purchase prices, repair prices and warranty conditions.

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Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of analgesic consumption and treatment-related patient satisfaction in patients with renal stones 10–35 mm

Cited by 41 publications

References 15 publications

Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

The role of ultra-mini percutaneous nephrolithotomy in the treatment of kidney stones

Clinical outcomes and costs of reusable and single-use flexible ureterorenoscopes: a prospective cohort study

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