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Tsaturyan A, Peteinaris A, Adamou C, Pagonis K, Musheghyan L, Natsos A, Vrettos T, Liatsikos E, Kallidonis P. Percutaneous antegrade management of large proximal ureteral stones using non-papillary puncture. Asian J Urol 2024; 11:110-114. [PMID: 38312817 PMCID: PMC10837659 DOI: 10.1016/j.ajur.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/17/2022] [Indexed: 10/16/2022] Open
Abstract
Objective To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy (npPCNL) for the management of large proximal ureteral stones. Methods We evaluated prospectively collected data of 37 patients with large proximal ureteral stones more than 1.5 cm in diameter treated by prone npPCNL. Depending on stone size, in-toto stone removal or lithotripsy using the Lithoclast® Trilogy (EMS Medical, Nyon, Switzerland) was performed. Perioperative parameters including operative time (from start of puncture to the skin suturing), stone extraction time (from the first insertion of the nephroscope to the extraction of all stone fragments), and the stone-free rate were evaluated. Results Twenty-one males and 16 females underwent npPCNL for the management of large upper ureteral calculi. The median age and stone size of treated patients were 58 (interquartile range [IQR]: 51-69) years and 19.3 (IQR: 18.0-22.0) mm, respectively. The median operative time and stone extraction time were 25 (IQR: 21-29) min and 8 (IQR: 7-10) min, respectively. One case (2.7%) of postoperative bleeding and two cases (5.4%) of prolonged fever were managed conservatively. The stone-free rate at a 1-month follow-up was 94.6%. Conclusion The npPCNL provides a straight route to the ureteropelvic junction and proximal ureter. Approaching from a dilated portion of the ureter under low irrigation pressure with larger diameter instruments results in effective and safe stone extraction within a few minutes.
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Affiliation(s)
| | | | | | | | - Lusine Musheghyan
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | | | - Theofanis Vrettos
- Department of Anesthesiology and ICU, University of Patras, Patras, Greece
| | - Evangelos Liatsikos
- Department of Urology, University of Patras, Patras, Greece
- Department of Urology, Medical University of Vienna, Vienna, Austria
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Zhou C, Yin G, Jiang Z, Tan J, Huang K, Yuan P. Mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of 10-20-mm kidney stones in patients with ileal conduit: a comparative study. Minerva Urol Nephrol 2023; 75:616-624. [PMID: 37728497 DOI: 10.23736/s2724-6051.23.05394-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Both mini-percutaneous nephrolithotomy (mPNL) and retrograde intrarenal surgery (RIRS) are two major strategies for the endourological management of kidney stones. In the current study, we aimed to compare the efficacy and safety of mPNL and RIRS for the treatment of 10-20 mm kidney stones in patients with ileal conduit. METHODS Patients with a history of bladder cancer and ileal conduit who had undergone mPNL or RIRS for unilateral kidney stones 10-20 mm in size between January 2015 and June 2022 were retrospectively included. Baseline characteristics and perioperative outcomes were analyzed and compared between mPNL and RIRS. RESULTS The failure rate of the initial surgery was 2.5% and 18.9% for mPNL and RIRS, respectively (P=0.025). In total, 39 and 30 patients were finally included in the mPNL and RIRS groups. One-session stone-free rate (SFR) was higher in the mPNL group than the RIRS group (97.4% vs. 66.7%, P=0.002). However, there was no statistically significant difference between the two groups with regard to operation time, postoperative hospitalization, complications according to Clavien-Dindo classification, as well as the change in hemoglobin, creatinine, procalcitonin, and pain Visual Analogue Scale Score before and after the surgery. Moreover, Results were consistent across subgroup analyses in patients stratified by years (2015-2018 and 2019-2022). CONCLUSIONS Both mPNL and RIRS were feasible and safe for the treatment of 10-20 mm kidney stones in patients with ileal conduit. However, mPNL achieved superior SFR outcomes with a similar incidence of complications, and it might be a sensible alternative for selected patients.
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Affiliation(s)
- Chuanchi Zhou
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Guangming Yin
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhiqiang Jiang
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jing Tan
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Kai Huang
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Peng Yuan
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China -
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Non-Papillary Access for the Percutaneous Antegrade Treatment of Renal and Ureteral Stones. Urology 2023; 171:71-76. [PMID: 36113579 DOI: 10.1016/j.urology.2022.08.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/01/2022] [Accepted: 08/24/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the feasibility and success of medial non-papillary percutaneous access for the antegrade treatment of different locations of ureteral stones, with and without concomitant renal stones. METHODS We performed an analysis of prospectively collected data of 72 patients, being subjected to percutaneous antegrade ureterolithotripsy. Stones located anywhere in the ureter with or without concomitant renal stones were included. A 12Fr, 22Fr, or 30Fr percutaneous tract dilation was performed based on the size of the stone pelvicalyceal system. Perioperative and demographic parameters were gathered and evaluated. The Lithoclast Trilogy (EMS Medical, Nyon, Switzerland) High-power holmium laser devices Cyber Ho 150 (Quanta System, Samarate, Italy) or MOSES Pulse 120H (Lumenis Ltd, Yokneam, Israel) were used for lithotripsy. RESULTS The average age and cumulative stone size of the patients were 57.9 ± 27.1 years and 24.2 ± 5.4 mm, respectively. The mean manipulation time was 36.9 ± 14.8 minutes. The mean hospitalization time was 2.5 ± 0.5 days and the average hemoglobin loss was 1.02 ± 0.18 gr/dL. The stone-free rate after percutaneous antegrade ureterolithotripsy was 95.8 % (69 patients), while the overall complications rate was 5.6 %, with 3 cases of fever and one case of prolonged hematuria that were treated conservatively. CONCLUSION Non-papillary percutaneous antegrade ureterolithotripsy is a safe and reliable technique for the treatment of patients with ureteral stones, with or without the co-existence of renal stones. A high stone-free rate of 95.8% was reported at 1-month after the surgery carrying a weighted risk of developing postoperative complications.
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Comparison of laparoscopic ureterolithotomy and retrograde lithotripsy in the treatment of proximal ureteral stones. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.4.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The current approach in the surgical treatment of ureteral calculi involves the use of endourological procedures such as retrograde ureteroscopy with lithotripsy or percutaneous antegrade lithotripsy in the proximal ureter. Ureterolithotomy as a treatment method is of an auxiliary nature and is used when endourological intervention is impossible or in case of intraoperative collisions during access conversion. However, there are several comparative studies on lithotripsy and lithotomy.The aim. Comparative analysis of the outcomes of laparoscopic lithotomy and retrograde lithotripsy in the surgical treatment of proximal ureteral calculi, as well as the search for predictors of prolonged disability.Materials and methods. A prospective randomized multicenter study included 53 patients with an established diagnosis of ureterolithiasis who were treated in the period 2018–2021 in urological hospitals in Irkutsk. All patients were divided into two comparison groups: Lithotomy group (group 1; n = 30) and Lithotripsy group (group 2; n = 23).Results. When analyzing the results of the study, it was found that the level of complications of class II–III according to Clavien – Dindo was statistically comparable in both groups (p > 0.05). However, in absolute and relative terms, the prevalence of this indicator was noted during retrograde ureterolithotripsy. According to hard endpoints (reoperation, presence of residual stones or migration during the operation), 29 (96.6 %) patients of group 1 and 17 (73.4 %) patients of group 2 (p = 0.514) were successfully operated on.Conclusion. Laparoscopic ureterolithotomy may be offered to patients with large proximal ureteral stones as an alternative treatment option with better residual stone freedom but generally similar overall outcomes and complication rates.
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The clinical efficacy of novel vacuum suction ureteroscopic lithotripsy in the treatment of upper ureteral calculi. World J Urol 2021; 39:4261-4265. [PMID: 33999260 DOI: 10.1007/s00345-021-03722-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To investigate the clinical efficacy of a novel vacuum suction ureteroscopic approach in the treatment of upper ureteral calculi and to compare it with traditional rigid and flexible ureteroscopic approaches. SUBJECTS AND METHODS A total of 160 patients with impacted upper ureteral calculi were included in this study. 50 patients underwent rigid ureteroscopic lithotripsy, 54 patients underwent flexible ureteroscopic lithotripsy, and 56 patients underwent vacuum suction ureteroscopic lithotripsy. The operative time, length of hospitalization, stone-free rate, the incidence of postoperative complications, and total treatment cost were compared among the three groups. Subgroup analysis was performed based on the stone diameter over and below 1.5 cm. RESULTS All operations were performed successfully, and there were no cases converted to open surgery. Compared with the other 2 groups, the vacuum suction ureteroscopy group had a higher stone-free rate at 3-5 days (90.0% vs. 61.9% vs. 55.6%, P < 0.05) and 1 month (96.4% vs. 77.7% vs. 74.0%, P < 0.05) postoperatively. In subgroup analysis, the stone-free rate of the vacuum suction ureteroscopy group was significantly higher when the stone diameter was > 1.5 cm at 1 month postoperatively (P < 0.05) compared with that in the other 2 groups; however, there were no differences in postoperative complications. (P > 0.05). CONCLUSION The novel vacuum suction ureteroscopic lithotripsy has significantly improved the stone-free rate especially in complicated cases, compared with that in rigid and flexible approaches; however, the complication and cost were not increased.
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Bhanot R, Jones P, Somani B. Minimally Invasive Surgery for the Treatment of Ureteric Stones - State-of-the-Art Review. Res Rep Urol 2021; 13:227-236. [PMID: 33987110 PMCID: PMC8110280 DOI: 10.2147/rru.s311010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/08/2021] [Indexed: 01/04/2023] Open
Abstract
The landscape of managing ureteric stones has evolved over the last few decades and several treatment options exist depending on the stone size, location, and other patient and stone factors. While open surgery is now rarely performed, the use of medical expulsive therapy (MET) has been controversial and perhaps only recommended for large distal ureteric stones. The mainstay treatment balances between shockwave lithotripsy (SWL) and ureteroscopy (URS), with the latter usually recommended for larger stones. While the principles of ureteric stone management have remained largely unchanged, the modern era has generated new methods and means to deliver it. Advancements have occurred in all domains of endourology to try and refine treatment and balance it with cost, patient choice and quality of life. Dissemination of technologies and demonstration of their efficacy and safety will eventually result in new recommendations among international guidelines and evolution of new gold standards.
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Affiliation(s)
- Radhika Bhanot
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Patrick Jones
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,EAU Young Academic Urology Urolithiasis and Endourology Working Party, Arnhem, the Netherlands
| | - Bhaskar Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.,EAU Young Academic Urology Urolithiasis and Endourology Working Party, Arnhem, the Netherlands.,Manipal Academy of Higher Education, Manipal, India
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Qu X, Ma Y. A commentary on "Optimal management of large proximal ureteral stones (> 10 mm): A systematic review and meta-analysis of 12 randomized controlled trials" (Int J Surg 2020; 80:205-217). Int J Surg 2021; 89:105942. [PMID: 33862257 DOI: 10.1016/j.ijsu.2021.105942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Xiaohua Qu
- Department of Urology, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, 215010, China
| | - Yinchao Ma
- Department of Urology, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, 215010, China.
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Ureteral Stones: Shockwave Lithotripsy or Ureteroscopy, Which is Best? Eur Urol 2021; 80:55-56. [PMID: 33838959 DOI: 10.1016/j.eururo.2021.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 03/26/2021] [Indexed: 11/22/2022]
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Abdel Raheem A, Alowidah I, Hagras A, Gameel T, Ghaith A, Elghiaty A, Althakafi S, Al-Mousa M, Alturki M. Laparoscopic ureterolithotomy for large proximal ureteric stones: Surgical technique, outcomes and literature review. Asian J Endosc Surg 2021; 14:241-249. [PMID: 32875735 DOI: 10.1111/ases.12861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/17/2020] [Accepted: 08/16/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION We evaluated the efficacy and safety of laparoscopic ureterolithotomy (LPU) for the treatment of large proximal ureteric stone. METHODS A retrospective multicenter analysis for patients with solitary impacted proximal ureteric stone ≥15 mm who underwent LPU from 2016 to 2019 was performed. Primary outcome was to estimate the stone-free rate (SFR). SFR was defined as absence of residual stones on postoperative computed tomography scan. Secondary outcome was to assess the perioperative outcomes, as well as to review literature data of randomized controlled trials and meta-analyses comparing LPU to other treatment options. RESULTS Forty-four patients were included in our study. Mean stone size was 22.9 ± 5.8 mm and median follow-up was 14 months. Three patients had previous abdominal surgery, one patient had severe degree of scoliosis and six patients failed primary therapy. All stones were extracted successfully (SFR = 100%) without need of auxiliary treatments. Mean operative time and estimated blood loss were 86.6 ± 14.1 minutes. and 11.9 ± 14.7 mL, respectively. No intraoperative complications or conversion to open surgery were reported. No major postoperative complications (≥grade 3) were reported. Mean length of hospital stay was 2 ± 0.8 days. CONCLUSIONS For treatment of large ureteric stones, our study showed that LPU achieves 100% stone-free status. When performed by well-trained laparoscopic surgeons, it is safe and has no major perioperative complications. According to our results and literature data, when counseling patients with large impacted proximal ureteral stones, LPU should be advised as the procedure that has the higher SFR, lower auxiliary treatments, and comparable complication rates to other treatments.
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Affiliation(s)
- Ali Abdel Raheem
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia.,Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ibrahim Alowidah
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ayman Hagras
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Tarek Gameel
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Ghaith
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Elghiaty
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Sultan Althakafi
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | | | - Mohammed Alturki
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
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Taguchi K, Hamamoto S, Osaga S, Sugino T, Unno R, Ando R, Okada A, Yasui T. Comparison of antegrade and retrograde ureterolithotripsy for proximal ureteral stones: a systematic review and meta-analysis. Transl Androl Urol 2021; 10:1179-1191. [PMID: 33850753 PMCID: PMC8039618 DOI: 10.21037/tau-20-1296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Antegrade percutaneous ureterolithotripsy (URSL) could be a treatment option for large and/or impacted proximal ureteral stones, which are difficult to treat. To review the current approach and treatment outcomes and to compare the efficacy of retrograde and antegrade URSL for large proximal ureteral stones, we evaluated the unique perspectives of both surgical modalities. Methods This systematic literature review and meta-analysis was performed in July 2020. Articles on human studies and treatment of ureteral stones with URSL were extracted from the PubMed, MEDLINE, Embase, Cochrane Library, Scopus, and the Japan Medical Abstracts Society databases without any language restrictions. The risks of bias for randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) were assessed using the Cochrane risk of tool and the Risk of Bias in Non-randomized Studies- of Interventions tool, respectively. Results A total of 10 studies, including seven RCTs and three non-RCTs, were selected for the analysis; 433 and 420 cases underwent retrograde and antegrade URSL, respectively. The stone-free rate (SFR) was significantly higher in antegrade URSL than in retrograde URSL (SFR ratio: 1.17, 95% CI: 1.12-1.22; P<0.001), while the hospital stay was significantly longer in antegrade URSL than in retrograde URSL (standardized mean difference: 2.56, 95% CI: 0.67-4.46; P=0.008). There were no significant differences in the operation time and the overall complication rate between the two approaches. Conclusions Despite the heterogeneity of data and bias limitations, this latest evidence reflects real practice data, which may be useful for decision making.
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Affiliation(s)
- Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shuzo Hamamoto
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoshi Osaga
- Clinical Research Management Center, Nagoya City University, Nagoya, Japan
| | - Teruaki Sugino
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Rei Unno
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ryosuke Ando
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Atsushi Okada
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Güler Y, Erbin A. Comparative evaluation of retrograde intrarenal surgery, antegrade ureterorenoscopy and laparoscopic ureterolithotomy in the treatment of impacted proximal ureteral stones larger than 1.5 cm. Cent European J Urol 2021; 74:57-63. [PMID: 33976917 PMCID: PMC8097644 DOI: 10.5173/ceju.2021.0174.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 10/10/2020] [Accepted: 01/03/2021] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The aim of this article was to compare retrograde intrarenal surgery (RIRS), antegrade ureterorenoscopy (URS), and laparoscopic ureterolithotomy (LU) for impacted proximal ureter stones larger than 1.5 cm in terms of operative data, success, complications, auxiliary treatment rates, and visual analog scale (VAS) scores. MATERIAL AND METHODS Medical records of patients undergoing RIRS, antegrade URS, or LU were retrospectively reviewed. After exclusion criteria, 122 patients were included in advanced analyses. Patients were divided into 3 groups as RIRS (n = 43), antegrade URS (n = 38) and LU (n = 41). RESULTS Operation time was shortest in the antegrade URS and hospitalization time was shortest in the RIRS group (p <0.001 and p <0.001, respectively). VAS scores were lowest in the RIRS group and highest in the LU group (p <0.001). Success (complete stone clearance) rates were 83.7%, 97.4%, and 97.5% in the RIRS, antegrade URS, and LU groups, respectively (p <0.001). Auxiliary treatment rates in the RIRS, antegrade URS, and LU groups were 19.1%, 2.6%, and 4.7%, respectively (p <0.001). Although there was no significant difference in terms of general complication rates, grade II complication rate (blood transfusion) was significantly higher in the antegrade URS group and grade IVb complication rate (urosepsis) was higher in the RIRS group according to the modified Clavien-Dindo classification system (p = 0.007 and p = 0.02, respectively). CONCLUSIONS Antegrade URS or LU are more logical options than RIRS for the treatment of large impacted proximal ureter stones. Between antegrade URS or LU, antegrade URS seems to be a more reasonable option due to its less invasive nature.
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Affiliation(s)
- Yavuz Güler
- Department of Urology, Private Safa Hospital, Istanbul, Turkey
| | - Akif Erbin
- Department of Urology, Haseki Traning and Research Hospital, Haseki, Turkey
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Affiliation(s)
- Fábio C M Torricelli
- Divisão de Urologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
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Abdel Raheem A, Alowidah I. A commentary on "Optimal management of large proximal ureteral stones (>10mm): A systematic review and meta-analysis of 12 randomized controlled trials" (International Journal of surgery. 2020 July, https://doi.org/ 10.1016/j.ijsu.2020.06.025). Int J Surg 2020; 83:218-219. [PMID: 33039653 DOI: 10.1016/j.ijsu.2020.09.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Ali Abdel Raheem
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia; Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Ibrahim Alowidah
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
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Ahmed A, Kasaraneni P. Approach to large proximal ureteric stones: Let facts drive practice. Int J Surg 2020; 81:14-15. [PMID: 32721567 DOI: 10.1016/j.ijsu.2020.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Asma Ahmed
- Department of Surgery, Ramaiah Medical College and Hospital, Bangalore, India.
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