Which Is the Best Option to Treat Large (&gt;1.5 cm) Midureteric Calculi?

Khaladkar, Suparu; Modi, Jayesh; Bhansali, Manish; Dobhada, Satyen; Patankar, Suresh

doi:10.1089/lap.2008.0299

Cited by 22 publications

(20 citation statements)

References 11 publications

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“…The most common complication is perirenal, intrarenal, or subcapsular hemorrhage caused by direct tissue damage. [20] Acute pancreatitis is an additional, although rare, complication. [21] Hemorrhage manifested as hematuria in patients in the current study.…”

Section: Discussionmentioning

confidence: 99%

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

Dede¹,

Şener²,

Baş³

et al. 2015

Turkish Journal of Urology

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Objective: The aim of the current study was to investigate whether obesity influences the outcome of extracorporeal shockwave lithotripsy (ESWL) treatment for upper ureteral stones. Material and methods:This is a retrospective study of 134 patients who underwent ESWL between June 2011 and May 2014. Patients were divided into 2 groups. Group 1 comprised 94 patients of normal weight, and group 2 comprised 40 morbidly obese patients. Patients in both groups had upper ureteral stones. Results:The mean age of groups 1 and 2 was 45.6±12.1 and 45.3±15.5 years, respectively (p=0.98). There was no significant difference in demographic variables between the groups. The mean stone size in groups 1 and 2 was 81.7±25.7 mm² and 86.3±22.4 mm², respectively (p= 0.51), the mean body mass index (BMI) was 27.4±2.9 and 42.9±2.1, respectively (p<0.01), the mean number of ESWL sessions was 2.4±0.6 and 2.4±0.7, respectively (p= 0.97), and the mean follow-up time was 7.1±3.4 and 6.6±2.8 weeks, respectively (p= 0.67). The overall stone-free rate was 82% in group 1 and 67% in group 2 (p=0.01). Conclusion:It is well-known that morbidly obese patients have higher rates of anesthesia-related problems due to the comorbidities commonly observed in this population. In the current study, we found that ESWL is a safe and acceptable treatment option for morbidly obese patients with upper ureteral stones.

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Section: Discussionmentioning

confidence: 99%

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

Dede¹,

Şener²,

Baş³

et al. 2015

Turkish Journal of Urology

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“…The removal of double-J catheter was on average seven weeks after the procedure, which is near the four to six weeks recommended by most authors 25,29 . Finally, the group without catheter had prolonged drainage of urine through the wound on four of 16 of the patients (25%), which were considered as early complications.…”

Section: Results Results Results Resultsmentioning

confidence: 61%

“…Other authors have reported that large calculus (> 15 mm) and especially those who are impacted for long periods are prime candidates for this technique, due to the high failure rate of other methods 23,24,25 . The operative time was 133 minutes in the global average, not statistically different between groups (a = 130 min, 2 = 136 min).…”

Section: Results Results Results Resultsmentioning

confidence: 99%

O emprego do cateter duplo J diminui as complicações na ureterolitotomia retroperitoneoscópica

Cavalli

Filho

Slongo

et al. 2012

Rev. Col. Bras. Cir.

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OBJETIVO: Avaliar os resultados da ureterolitotomia retroperitoneoscópica no tratamento do cálculo ureteral e a necessidade do cateter duplo J para reduzir complicações relacionadas ao procedimento. MÉTODOS: Estudo retrospectivo comparativo de 47 pacientes operados pela técnica de ureterolitotomia retroperitoneoscópica, dos quais 31 foram selecionados e divididos em dois grupos: Grupo 1, cujos pacientes não receberam cateter duplo J, e Grupo 2, que foram submetidos ao implante de cateter duplo J transoperatório. Foram coletados dados de urografia excretora pré e pós-operatória, tempo cirúrgico, analgesia pós-operatória, tempo de internação e retirada do dreno. RESULTADOS: Os grupos foram semelhantes quando comparados na idade e sexo, grau de dilatação do trato urinário, posição e tamanho médio do cálculo (Grupo 1= 15,5 ± 6,6mm; Grupo 2= 16,3 ± 6,1mm). O tempo operatório também não teve diferença significativa (Grupo 1= 130 ± 40,3min; Grupo 2= 136,3 ± 49,3min). O Grupo 1 apresentou seis pacientes (37,5 %) com complicações precoces (quatro casos de fístula urinária) e tardias (um caso de estenose de ureter, um caso de exclusão funcional do rim operado), enquanto o Grupo 2 não teve complicações, sendo esta diferença estatisticamente significativa (p=0,011). CONCLUSÃO: O emprego do cateter duplo J foi associado a um número significativamente menor de complicações na ureterolitotomia retroperitoneoscópica. Tempo cirúrgico, analgesia pós-operatória e tempo de internação foram semelhantes entre os grupos com e sem cateter.

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“…A power analysis based on previous studies 2,3 showed that groups with an average of 48 patients each would be required to demonstrate the outcomes with a Type I error of 0.05.…”

Section: Methodsmentioning

confidence: 99%

“…Even though some researchers recommend extracorporeal shock wave lithotripsy (SWL) as first-line treatment, 1 it has a 40% success rate in larger proximal ureteral calculi. 2 With the common use of flexible devices in urology, ureteroscopy has gained popularity in the treatment of upper ureteral stones. For stones larger than 1 cm and fully obstructing the passage in the ureter, open or laparoscopic surgery may be an option with success rates up to 100%.…”

Section: Introductionmentioning

confidence: 99%

The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones

Öztürk

Şener

Göktuğ

et al. 2013

CUAJ

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Introduction: In this study we compare the success rates and complication rates of shock wave lithotripsy (SWL), laparoscopic, and ureteroscopic approaches for large (between 1 and 2 cm) proximal ureteral stones. Methods: In total, 151 patients with ureteral stones between 1 and 2 cm in diameter were randomized into 3 groups (52 SWL, 51 laparoscopy and 48 retrograde intrarenal surgery [RIRS]). The groups were compared for stone size, success rates, and complication rates using the modified Clavien grading system. Results: Stone burden of the groups were similar (p = 0.36). The success rates were 96%, 81% and 79%, respectively in the laparoscopy, SWL, and ureteroscopy groups. The success rate in laparoscopy group was significantly higher (p < 0.05). When these groups were compared for complication rates, RIRS seemed to be the group with the lowest complication rates (4.11%) (p < 0.05). SWL and laparoscopy seem to have similar rates of complication (7.06% and 7.86%, respectively, p = 0.12). Interpretation: To our knowledge, this is the first study to compare the results of laparoscopy, SWL and RIRS in ureteral stones. Our results showed that in management of patients with upper ureteral stones between 1 and 2 cm, laparoscopy is the most successful method based on its stone-free rates and acceptable complication rates. However, the limitations of our study are lack of hospital stay and cost-effectiveness data. Also, studies conducted on larger populations should support our findings. When a less invasive method is the only choice, SWL and flexible ureterorenoscopy methods have similar success rates. RIRS, however, has a lower complication rate than the other approaches. IntroductionUpper ureteral stones, which are hard to treat, are frequently encountered in daily practice. For treatment, the most effective and the safest approach should be chosen. Upper ureteral stones can be managed by various approaches. There is no gold standard treatment for stones between 1 and 2 cm. Even though some researchers recommend extracorporeal shock wave lithotripsy (SWL) as first-line treatment, 1 it has a 40% success rate in larger proximal ureteral calculi.2 With the common use of flexible devices in urology, ureteroscopy has gained popularity in the treatment of upper ureteral stones. For stones larger than 1 cm and fully obstructing the passage in the ureter, open or laparoscopic surgery may be an option with success rates up to 100%.1 In recent years, some authors have published their data on the laparoscopic approach and have recommended its use for its high success and low complication rates. 3This study compares the success and complication rates of SWL and laparoscopic and ureteroscopic approaches for proximal ureteral calculi between 1 and 2 cm. MethodsAfter Institutional Review Board approval, we enrolled 150 patients who had ureteral stones between 1 and 2 cm in the study; they were randomized into 3 groups by an online randomization program (52 for SWL, 51 for laparoscopy, and 48 for retrograde intrarenal surge...

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Which Is the Best Option to Treat Large (>1.5 cm) Midureteric Calculi?

Cited by 22 publications

References 11 publications

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

O emprego do cateter duplo J diminui as complicações na ureterolitotomia retroperitoneoscópica

The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones

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