1
|
Li X, Song S, Yao J, Liao X, Chen M, Zhai J, Lang L, Lin C, Zhang N, Yuan C, Li C, Li H, Wu X, Lin J, Li C, Wang Y, Lyu J, Li M, Zhou Z, Yang M, Jia H, Yan J. Autofluorescence spectral analysis for detecting urinary stone composition in emulated intraoperative ambient. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 300:122913. [PMID: 37262970 DOI: 10.1016/j.saa.2023.122913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023]
Abstract
The prevalence and disease burden of urolithiasis has increased substantially worldwide in the last decade, and intraluminal holmium laser lithotripsy has become the primary treatment method. However, inappropriate laser energy settings increase the risk of perioperative complications, largely due to the lack of intraoperative information on the stone composition, which determines the stone melting point. To address this issue, we developed a fiber-based fluorescence spectrometry method that detects and classifies the autofluorescence spectral fingerprints of urinary stones into three categories: calcium oxalate, uric acid, and struvite. By applying the support vector machine (SVM), the prediction accuracy achieved 90.28 % and 96.70% for classifying calcium stones versus non-calcium stones and uric acid versus struvite, respectively. High accuracy and specificity were achieved for a wide range of working distances and angles between the fiber tip and stone surface in an emulated intraoperative ambient. Our work establishes the methodological basis for engineering a clinical device that achieves real-time, in situ classification of urinary stones for optimizing the laser ablation parameters and reducing perioperative complications in lithotripsy.
Collapse
Affiliation(s)
- Xing Li
- Advanced Institute for Brain and Intelligence, School of Physical Science and Technology, Guangxi University, Nanning 530004, China; Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Siji Song
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jiwei Yao
- Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing 400030, China
| | - Xiang Liao
- Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing 400030, China
| | - Min Chen
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jinliang Zhai
- Advanced Institute for Brain and Intelligence, School of Physical Science and Technology, Guangxi University, Nanning 530004, China
| | - Lang Lang
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Chunyan Lin
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Na Zhang
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Chunhui Yuan
- Chongqing Institute for Brain and Intelligence, Guangyang Bay Laboratory, Chongqing 400064, China
| | - Chunxia Li
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Hui Li
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Xiaojun Wu
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jing Lin
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Chunlian Li
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Yan Wang
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Jing Lyu
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Min Li
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Zhenqiao Zhou
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Mengke Yang
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China; UK Dementia Research Institute at UCL, University College London, WC1E 6BT London, UK.
| | - Hongbo Jia
- Advanced Institute for Brain and Intelligence, School of Physical Science and Technology, Guangxi University, Nanning 530004, China; Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China; Leibniz Institute for Neurobiology, Magdeburg 39118, Germany.
| | - Junan Yan
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing 400030, China; Chongqing Institute for Brain and Intelligence, Guangyang Bay Laboratory, Chongqing 400064, China.
| |
Collapse
|
2
|
Sierra A, Corrales M, Kolvatzis M, Doizi S, Traxer O. Real Time Intrarenal Pressure Control during Flexible Ureterorrenscopy Using a Vascular PressureWire: Pilot Study. J Clin Med 2022; 12:jcm12010147. [PMID: 36614947 PMCID: PMC9821029 DOI: 10.3390/jcm12010147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
(1) Introduction: To evaluate the feasibility of measuring the intrapelvic pressure (IPP) during flexible ureterorenoscopy (f-URS) with a PressureWire and to optimize safety by assessing IPP during surgery. (2) Methods: Patients undergoing f-URS for different treatments were recruited. A PressureWire (0.014", St. Jude Medical, Little Canada, MN, USA) was placed into the renal cavities to measure IPP. Gravity irrigation at 40 cmH2O over the patient and a hand-assisted irrigation system were used. Pressures were monitored in real time and recorded for analysis. Fluid balance and postoperative urinary tract infection (UTI) were documented. (3) Results: Twenty patients undergoing f-URS were included with successful IPP monitoring. The median baseline IPP was 13.6 (6.8-47.6) cmH2O. After the placement of the UAS, the median IPP was 17 (8-44.6) cmH2O. With irrigation pressure set at 40 cmH2O without forced irrigation, the median IPP was 34 (19-81.6) cmH2O. Median IPP during laser lithotripsy, with and without the use of on-demand forced irrigation, was 61.2 (27.2-149.5) cmH2O. The maximum pressure peaks recorded during forced irrigation ranged from 54.4 to 236.6 cmH2O. After the surgery, 3 patients (15%) presented UTI; 2 of them had a positive preoperative urine culture, previously treated, and a positive fluid balance observed after the surgery. (4) Conclusion: Based on our experience, continuous monitoring of IPP with a wire is easy to reproduce, effective, and safe. In addition, it allows us to identify and avoid high IPPs, which may affect surgery-related complications.
Collapse
Affiliation(s)
- Alba Sierra
- Urology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Spain
- Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, F-75020 Paris, France
- Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France
| | - Mariela Corrales
- Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, F-75020 Paris, France
- Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France
| | - Merkourios Kolvatzis
- Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, F-75020 Paris, France
- Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France
- 2nd Department of Urology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Steeve Doizi
- Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, F-75020 Paris, France
- Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France
| | - Olivier Traxer
- Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, F-75020 Paris, France
- Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France
- Correspondence:
| |
Collapse
|
3
|
Gao SL, Wu H, Su QX, Zhang ZY, Zhang Z, Lu C, Zhang LF, Zuo L. Comparison of the effects of retroperitoneoscopic ureterolithotomy and ureteroscopic lithotripsy in the treatment of upper ureteral calculi. Medicine (Baltimore) 2021; 100:e27328. [PMID: 34559152 PMCID: PMC8462599 DOI: 10.1097/md.0000000000027328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/24/2021] [Accepted: 09/07/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT This study compares the efficacy of retroperitoneoscopic ureterolithotomy (RPUL) and ureteroscopic lithotripsy (URL) in the treatment of upper ureteral calculi.The clinical data of 150 patients with upper ureteral calculi who underwent RPUL and 136 patients who underwent URL between January 2014 and October 2019 were retrospectively analyzed. The operation time, postoperative hospital stay, operation success rate, stone clearance rate, and surgical complications were evaluated between the two groups.For the RPUL and URL groups, respectively, the average operation time was 74.5 ± 24.6 minutes and 54.5 ± 13.2 minutes; the postoperative hospital stay was 5.8 ± 1.4 days and 3.2 ± 1.2 days; the operation success rate was 96.0% (144/150) and 85.3% (116/136); the incidence rate of complications was 3.5% (5/144) and 17.5% (18/103); and the stone clearance rate was 100% (144/144) and 88.8% (103/116), which were all statistically significant (P < .05).Both RPUL and URL had the advantages of low trauma and fast recovery rate for patients with upper ureteral calculi. However, patients who underwent RPUL showed higher success and fewer complication rate. RPUL might be a safe and effective laparoscopic method for the treatment of patients with upper ureteral calculi.
Collapse
Affiliation(s)
- Sheng-Lin Gao
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Hao Wu
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
- Dalian Medical University, Dalian, China
| | - Quan-Xin Su
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
- Dalian Medical University, Dalian, China
| | - Zi-Yi Zhang
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
- Dalian Medical University, Dalian, China
| | - Ze Zhang
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
- Dalian Medical University, Dalian, China
| | - Chao Lu
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Li-Feng Zhang
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Li Zuo
- Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| |
Collapse
|
4
|
Huang B, Lu G, Tu W, Zhao Y, Wang Y, Zhang L, Shao Y, Wang D. Factors Influencing Surgical Outcome in Retrograde Management of Parapelvic Renal Cysts. J Endourol 2020; 35:466-472. [PMID: 33050738 DOI: 10.1089/end.2020.0508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the outcomes of retrograde flexible ureteroscopy in managing parapelvic renal cysts and speculate the factors affecting therapeutic efficacy. Methods: Thirty-eight patients with parapelvic renal cysts were recruited and underwent retrograde flexible ureteroscopy using holmium laser. Parapelvic cysts were divided into peripheral type and central type based on the position of cyst convex to the perirenal tissue. Feasibility and safety were retrospectively evaluated, and cases were analyzed to detect their distinctive characteristics. Independent-sample t-test and chi-square test were undertaken for continuous variables and categorical variables, respectively. Results: Radiologic evidence of success was achieved in 31 (81.58%) cases after a mean follow-up of 14.4 months (range 6-26 months). No significant perioperative complications were identified. There were seven cases with features of peripherally located parapelvic cyst. Four cysts shown as irregular protrusion were unable reduce to less half of previous size. Reductions were recorded in the other three patients with spherically peripheral protrusion. There was significant difference between these two types (p = 0.029). Among the 31 patients with centrally located parapelvic cyst, 28 of these have simple cysts that achieved radiologic success and 3 of the 31 patients were identified as failed cases indicated by renal pelvis enveloped by cyst on radiologic investigation. The success rate of simple cysts was significantly higher than that of the later type (p < 0.001). Conclusion: The location and shape of parapelvic cyst may play a critical role in the radiologic outcome of internal incision and patients with simple central or spherical peripheral cyst may benefit more from retrograde flexible ureteroscopy combined with laser incision.
Collapse
Affiliation(s)
- Baoxing Huang
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guoliang Lu
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Weichao Tu
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yang Zhao
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuanchun Wang
- Monash Health, Faculty of Medicine, Monash University, Melbourne, Australia
| | - Lin Zhang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.,Victorian Comprehensive Cancer Centre, The University of Melbourne Centre for Cancer Research, Parkville, Australia
| | - Yuan Shao
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Dawei Wang
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| |
Collapse
|
5
|
Wang T, Chen X, Qu H. Economical and efficient autonomous ureteroscopic irrigation systems. Asian J Surg 2020; 44:409-411. [PMID: 33176969 DOI: 10.1016/j.asjsur.2020.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/18/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Tengteng Wang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Xiude Chen
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Huawei Qu
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China.
| |
Collapse
|
6
|
Outcomes of ureteroscopy (URS) for stone disease in the paediatric population: results of over 100 URS procedures from a UK tertiary centre. World J Urol 2020; 38:213-218. [PMID: 30949802 PMCID: PMC6954136 DOI: 10.1007/s00345-019-02745-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/27/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To report the outcomes of paediatric ureteroscopy (URS) for stone disease from a specialist endourology centre in the UK. Ureteroscopy for management of stone disease has increased worldwide and is now being done more commonly in the paediatric age group. METHODS Data were analysed retrospectively from a database maintained between April 2010 and May 2018. Consecutive patients ≤ 16 years of age undergoing semi-rigid or flexible URS for stone disease were included. Stone size and stone-free rate (SFR) were routinely assessed using an ultrasound (USS) and/or plain KUB XR. Complications were graded according to the Clavien-Dindo classification and recorded within 30 days post-procedure and readmissions within 90 days after the procedure were also captured. RESULTS Over the 8-year period between April 2010 and April 2018, 81 patients with a mean age of 8.8 years (range 18 months-16 years) and a male to female ratio 1:1.1 underwent 102 procedures (1.28 procedure/patient to be stone free). Of the 81 patients, 29 (35.8%) had comorbidities, with 26 (32%) having multiple comorbidities. The mean (± SEM) single and overall stone size was 9.2 mm (± 0.48, range 3-30 mm) and 11.5 mm (± 0.74, range 4-46 mm) respectively, with 22 (27.1%) having multiple stones. Thirty-five (34.7%) had stent in situ pre-operatively. The stone location was in the ureter (26.6%), lower pole (35.4%), and renal pelvis (16.5%), with 22/81(27%) having multiple stones and 21/102 (20.5%) where a ureteral access sheath (UAS) was used. With a mean hospital stay of 1.2 days, the initial and final SFR was 73% and 99%, respectively, and 61/102 (60%) had ureteric stent placed at the end of the procedure. While there were no intra-operative complications, the readmission rate was less than 1% and there were only three early complications recorded. This included a case each of prolonged admission for pain control (grade I), urinary retention (grade II) and post-operative sepsis requiring a brief ITU admission (grade IV). CONCLUSION Our study demonstrates that in appropriate setting a high stone-free rate can be achieved with minimal morbidity for paediatric patients. There is potentially a need to factor the increasing role of URS in future paediatric urolithiasis guidelines.
Collapse
|
7
|
Xun Y, Wang Q, Hu H, Lu Y, Zhang J, Qin B, Geng Y, Wang S. Tubeless versus standard percutaneous nephrolithotomy: an update meta-analysis. BMC Urol 2017; 17:102. [PMID: 29132344 PMCID: PMC5683212 DOI: 10.1186/s12894-017-0295-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/30/2017] [Indexed: 12/14/2022] Open
Abstract
Background To update a previously published systematic review and meta-analysis on the efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL). Methods A systematic literature search of EMBASE, PubMed, Web of Science, and the Cochrane Library was performed to confirm relevant studies. The scientific literature was screened in accordance with the predetermined inclusion and exclusion criteria. After quality assessment and data extraction from the eligible studies, a meta-analysis was conducted using Stata SE 12.0. Results Fourteen randomized controlled trials (RCTs) involving 1148 patients were included. Combined results demonstrated that tubeless PCNL was significantly associated with shorter operative time (weighted mean difference [WMD], −3.79 min; 95% confidence interval [CI], −6.73 to −0.85; P = 0.012; I2 = 53.8%), shorter hospital stay (WMD, −1.27 days; 95% CI, −1.65 to −0.90; P < 0.001; I2 = 98.7%), faster time to return to normal activity (WMD, −4.24 days; 95% CI, −5.76 to −2.71; P < 0.001; I2 = 97.5%), lower postoperative pain scores (WMD, −16.55 mm; 95% CI, −21.60 to −11.50; P < 0.001; I2 = 95.7%), less postoperative analgesia requirements (standard mean difference, −1.09 mg; 95% CI, −1.35 to −0.84; P < 0.001; I2 = 46.8%), and lower urine leakage (Relative risk [RR], 0.30; 95% CI 0.15 to 0.59; P = 0.001; I2 = 41.2%). There were no significant differences in postoperative hemoglobin reduction (WMD, −0.02 g/dL; 95% CI, −0.04 to 0.01; P = 0.172; I2 = 41.5%), stone-free rate (RR, 1.01; 95% CI, 0.97 to 1.05; P = 0.776; I2 = 0.0%), postoperative fever rate (RR, 1.05; 95% CI, 0.57 to 1.93; P = 0.867; I2 = 0.0%), or blood transfusion rate (RR, 0.79; 95% CI, 0.36 to 1.70; P = 0.538; I2 = 0.0%). The results of subgroup analysis were consistent with the overall findings. The sensitivity analysis indicated that most results remained constant when total tubeless or partial tubeless or mini-PCNL studies were excluded respectively. Conclusions Tubeless PCNL is an available and safe option in carefully evaluated and selected patients. It is significantly associated with the advantages of shorter hospital stay, shorter time to return to normal activity, lower postoperative pain scores, less analgesia requirement, and reduced urine leakage.
Collapse
Affiliation(s)
- Yang Xun
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Qing Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Henglong Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Yuchao Lu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Jiaqiao Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Baolong Qin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Yudi Geng
- Reproductive medicine center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China.
| |
Collapse
|
8
|
Xun Y, Wang Q, Hu H, Lu Y, Zhang J, Qin B, Geng Y, Wang S. Tubeless versus standard percutaneous nephrolithotomy: an update meta-analysis. BMC Urol 2017. [PMID: 29132344 DOI: 10.1186/s12894-017-0295-2.pmid:29132344;pmcid:pmc5683212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND To update a previously published systematic review and meta-analysis on the efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL). METHODS A systematic literature search of EMBASE, PubMed, Web of Science, and the Cochrane Library was performed to confirm relevant studies. The scientific literature was screened in accordance with the predetermined inclusion and exclusion criteria. After quality assessment and data extraction from the eligible studies, a meta-analysis was conducted using Stata SE 12.0. RESULTS Fourteen randomized controlled trials (RCTs) involving 1148 patients were included. Combined results demonstrated that tubeless PCNL was significantly associated with shorter operative time (weighted mean difference [WMD], -3.79 min; 95% confidence interval [CI], -6.73 to -0.85; P = 0.012; I2 = 53.8%), shorter hospital stay (WMD, -1.27 days; 95% CI, -1.65 to -0.90; P < 0.001; I2 = 98.7%), faster time to return to normal activity (WMD, -4.24 days; 95% CI, -5.76 to -2.71; P < 0.001; I2 = 97.5%), lower postoperative pain scores (WMD, -16.55 mm; 95% CI, -21.60 to -11.50; P < 0.001; I2 = 95.7%), less postoperative analgesia requirements (standard mean difference, -1.09 mg; 95% CI, -1.35 to -0.84; P < 0.001; I2 = 46.8%), and lower urine leakage (Relative risk [RR], 0.30; 95% CI 0.15 to 0.59; P = 0.001; I2 = 41.2%). There were no significant differences in postoperative hemoglobin reduction (WMD, -0.02 g/dL; 95% CI, -0.04 to 0.01; P = 0.172; I2 = 41.5%), stone-free rate (RR, 1.01; 95% CI, 0.97 to 1.05; P = 0.776; I2 = 0.0%), postoperative fever rate (RR, 1.05; 95% CI, 0.57 to 1.93; P = 0.867; I2 = 0.0%), or blood transfusion rate (RR, 0.79; 95% CI, 0.36 to 1.70; P = 0.538; I2 = 0.0%). The results of subgroup analysis were consistent with the overall findings. The sensitivity analysis indicated that most results remained constant when total tubeless or partial tubeless or mini-PCNL studies were excluded respectively. CONCLUSIONS Tubeless PCNL is an available and safe option in carefully evaluated and selected patients. It is significantly associated with the advantages of shorter hospital stay, shorter time to return to normal activity, lower postoperative pain scores, less analgesia requirement, and reduced urine leakage.
Collapse
Affiliation(s)
- Yang Xun
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Qing Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Henglong Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Yuchao Lu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Jiaqiao Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Baolong Qin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China
| | - Yudi Geng
- Reproductive medicine center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, China.
| |
Collapse
|
9
|
Tuğcu V, Şener NC, Şahin S, Yavuzsan AH, Akbay FG, Apaydın S. Robot-assisted kidney transplantation: comparison of the first 40 cases of open vs robot-assisted transplantations by a single surgeon. BJU Int 2017; 121:275-280. [DOI: 10.1111/bju.14014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Volkan Tuğcu
- Department of Urology; Bakirkoy Dr Sadi Konuk Teaching and Research Hospital; Istanbul Turkey
| | - Nevzat Can Şener
- Department of Urology; Bakirkoy Dr Sadi Konuk Teaching and Research Hospital; Istanbul Turkey
| | - Selçuk Şahin
- Department of Urology; Bakirkoy Dr Sadi Konuk Teaching and Research Hospital; Istanbul Turkey
| | - Abdullah H. Yavuzsan
- Department of Urology; Bakirkoy Dr Sadi Konuk Teaching and Research Hospital; Istanbul Turkey
| | - Fatih G. Akbay
- Department of Nephrology; Bakirkoy Dr Sadi Konuk Teaching and Research Hospital; Istanbul Turkey
| | - Süheyla Apaydın
- Department of Nephrology; Bakirkoy Dr Sadi Konuk Teaching and Research Hospital; Istanbul Turkey
| |
Collapse
|
10
|
Goates AJ, Kung RW, Tracy CR, Hoffman HT. Intraductal Laser Fiber Tip Fracture and Retrieval During Sialendoscopic Laser-Assisted Lithotripsy. Ann Otol Rhinol Laryngol 2017; 126:774-777. [PMID: 28895432 DOI: 10.1177/0003489417728736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fragmentation of flexible laser fiber tips has been reported to occur during therapeutic bronchoscopy and urologic stone treatment. We report fragmentation of 200-µm single-use silica-based fibers during sialendoscopy-controlled Holmium:YAG laser treatment of a parotid and a submandibular stone. The technique employed to successfully retrieve the fiber tips is described in the context of identifying this potential complication from endoscopic management of sialolithiasis.
Collapse
Affiliation(s)
- Andrew J Goates
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Raymond W Kung
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Chad R Tracy
- 2 Department of Urology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Henry T Hoffman
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| |
Collapse
|
11
|
Proietti S, Dragos L, Somani B, Butticè S, Talso M, Emiliani E, Baghdadi M, Giusti G, Traxer O. In Vitro Comparison of Maximum Pressure Developed by Irrigation Systems in a Kidney Model. J Endourol 2017; 31:522-527. [PMID: 28381092 DOI: 10.1089/end.2017.0005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: To evaluate in vitro the maximum pressure generated in an artificial kidney model when people of different levels of strengths used various irrigation systems. Materials and Methods: Fifteen people were enrolled and divided into three groups based on their strengths. Individual strength was evaluated according to the maximum pressure each participant was able to achieve using an Encore™ Inflator. The irrigation systems evaluated were as follows: T-Flow™ Dual Port, Hiline™, continuous flow single action pumping system (SAPS™) with the system close and open, Irri-flo II™, a simple 60-mL syringe, and Peditrol™. Each irrigation system was connected to URF-V2 ureteroscope, which was inserted into an artificial kidney model. Each participant was asked to produce the maximum pressure possible with every irrigation device. Pressure was measured with the working channel (WC) empty, with a laser fiber, and a basket inside. Results: The highest pressure was achieved with the 60 mL-syringe system and the lowest with SAPS continuous version system (with continuous irrigation open), compared to the other irrigation devices (p < 0.0001). Irrespective of the irrigation system, there was a significant difference in the pressure between the WC empty and when occupied with the laser fiber or the basket inside it (p < 0.0001). The stratification between the groups showed that the most powerful group could produce the highest pressure in the kidney model with all the irrigation devices in almost any situation. The exception to this was the T-Flow system, which was the only device where no statistical differences were detected among these groups. Conclusion: The use of irrigation systems can often generate excessive pressure in an artificial kidney model, especially with an unoccupied WC of the ureteroscope. Depending on the strength of force applied, very high pressure can be generated by most irrigation devices irrespective of whether the scope is occupied or not.
Collapse
Affiliation(s)
- Silvia Proietti
- Department of Urology, San Raffaele Hospital, Ville Turro Division, Milan, Italy.,Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France
| | - Laurian Dragos
- Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.,Department of Urology, East Surrey Hospital, Surrey and Sussex Healthcare NHS, Redhill, United Kingdom
| | - Bhaskar Somani
- Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Salvatore Butticè
- Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.,Department of Human Pathology, Unit of Urology, University of Messina, Messina, Italy
| | - Michele Talso
- Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.,Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Esteban Emiliani
- Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.,Department of Urology, Fundacion Puigvert Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Mohamed Baghdadi
- Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France
| | - Guido Giusti
- Department of Urology, San Raffaele Hospital, Ville Turro Division, Milan, Italy
| | - Olivier Traxer
- Department of Urology, GRC Lithiase (Groupe Recherche Clinique), Université Pierre et Marie Curie - Paris VI, Paris, France
| |
Collapse
|