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Meng W, Zhang H, Wang J, Chen B, Jiang Z, Ma L, Guan Y. Retrospective study of single-use digital flexible ureteroscopic lithotripsy versus miniaturized percutaneous nephrolithotomy for 1.5-2.5cm lower pole renal stones. Int Urol Nephrol 2024; 56:55-62. [PMID: 37656387 DOI: 10.1007/s11255-023-03771-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/26/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Retrospective analysis was performed on the clinical information of patients with 1.5-2.5 cm lower pole renal stones treated by single-use digital flexible ureteroscopic lithotripsy (fURS) and miniaturized percutaneous nephrolithotomy (MPCNL) in affiliated hospital of the Nantong University from January 2020 to December 2022. To compare the safety and efficacy of single-use fURS and MPCNL in the treatment from 1.5cm to 2.5cm lower pole renal stones. METHODS Clinical information of 141 patients were collected and divided into single-use fURS group and MPCNL group according to their treatment methods, including 83 patients in the single-use fURS group and 58 patients in the MPCNL group. Baseline data, data on the clinical characteristics of stones, laboratory examination data, operation time, and postoperative data of the two groups were collected. Statistical analysis was made on the collected data to analyze the differences and causes between the two groups of patients. RESULTS There was no significant difference in the baseline data and preoperative clinical features of 141 patients between the two groups (P > 0.05). In comparison of postoperative serum indexes, the drop values of hemoglobin and creatinine in single-use fURS group were lower than those in MPCNL group, and the difference was statistically significant (P < 0.05). The stone free rate was higher in the MPCNL group than in the single-use fURS group on the first day after surgery. At the 1st month after surgery, the two groups were similar. At 3rd month after surgery, the single-use fURS group was slightly higher than the MPCNL group, with no statistical significance (P > 0.05). The total complication rate in single-use fURS group was slightly lower than that in MPCNL group, but there was no statistical significance (P > 0.05). CONCLUSIONS Single-use fURS has similar safety and efficacy to MPCNL in the treatment of 1.5-2.5cm lower pole renal stones. Single-use fURS may be a new option for the treatment of these stones.
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Affiliation(s)
- Wei Meng
- Department of Urology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China
| | - Huajun Zhang
- Dalian Medical University, Dalian, 116000, China
| | - Jiahao Wang
- Department of Urology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Bo Chen
- Department of Urology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China
| | - Zhaosheng Jiang
- Department of Urology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China
| | - Limin Ma
- Department of Urology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China.
| | - Yangbo Guan
- Department of Urology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China.
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Wishahi M, El Feel A, Elkhouly A, Fahmy A, Roshdy M, Elbaz AG, Kamel AI, Badawy M, Elesaily K, Eldahshan S, Ali A, Meheina A, Abdelwahed M. Concerns about stone free rate and procedure events of percutaneous nephrolithotripsy (PCNL) for 2-4 cm kidney stones by standard-PCNL vs mini-PCNL- comparative randomised study. BMC Urol 2023; 23:96. [PMID: 37208652 DOI: 10.1186/s12894-023-01270-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/05/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND To compare the efficacy and safety of standard percutaneous nephrolithotomy (PCNL) with mini- PCNL for kidney stones 2-4 cm. METHODS Eighty patients were enrolled in a comparative study, they were randomly divided into mini-PCNL group (n = 40) and standard-PCNL (n = 40). Demographic characteristics, perioperative events, complications, stone free rate (SFR) were reported. RESULTS Both groups showed no significant difference in clinical data about age, stone location, back pressure changes, and body mass index. The mean operative time was (95 ± 17.9 min) in mini-PCNL, and (72.1 ± 14.9 min). Stone free rate were 80% and 85% in mini-PCNL and standard-PCNL respectively. Intra-operative complications, post-operative need for analgesia, hospital stay were significantly higher in standard-PCNL compared to mini-PCNL (85% vs. 80%). The study followed CONSORT 2010 guidelines for reporting parallel group randomization. CONCLUSION Mini-PCNL is an effective and safe treatment of kidney stones 2-4 cm, it has the advantage over standard-PCNL being has less intra-operative events, less post-operative analgesia, shorter hospital stay, while operative time and stone free rate are comparable when considering multiplicity, hardness, and site of stones.
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Affiliation(s)
- Mohamed Wishahi
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt.
| | - Ahmed El Feel
- Department of Urology, Faculty of Medicine, Kasr Alaini Medical School, Cairo University, Cairo, Egypt
| | - Amr Elkhouly
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Abdullah Fahmy
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Mamdouh Roshdy
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Ahmed G Elbaz
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Ahmed I Kamel
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Mohamed Badawy
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Khaled Elesaily
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Samir Eldahshan
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Ayman Ali
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Ahmed Meheina
- Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Mohamed Abdelwahed
- Department of Urology, Faculty of Medicine, Kasr Alaini Medical School, Cairo University, Cairo, Egypt
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Balawender K. A Prospective Study of Renal Blood Flow during Retrograde Intrarenal Surgery. J Clin Med 2023; 12:jcm12083030. [PMID: 37109366 PMCID: PMC10146614 DOI: 10.3390/jcm12083030] [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: 02/08/2023] [Revised: 04/01/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
(I) Introduction: The use of Doppler ultrasound allows us to indirectly assess the effect of increased intrarenal pressure on renal blood flow during retrograde intrarenal surgery (RIRS). On the basis of vascular flow spectra from selected blood vessels in the kidney, it is possible to determine Doppler parameters that reflect the renal perfusion status, which indirectly shows the degree of vasoconstriction and reflects the resistance of kidney tissue. (II) Materials and methods: A total of 56 patients were included in the study. The study assessed the changes of three Doppler parameters of intrarenal blood flow: resistive index-RI, pulsatility index-PI, and acceleration time-AT in the ipsilateral and contralateral kidneys during RIRS. The effects of mean stone volume, energy used, and pre-stenting were examined as predictors and calculated at two time intervals. (III) Results: The mean value of RI and PI was significantly higher in the ipsilateral kidney than in the contralateral kidney just after RIRS. The mean value of the acceleration time was not significantly different before and after RIRS. The values of all three parameters 24 h after the procedure were comparable to their values immediately after the RIRS. The size of the stone exposed to laser lithotripsy, the value of the energy used, and pre-stenting are not factors that significantly influence Doppler parameters during RIRS. (IV) Conclusions: The significant increase in RI and PI after RIRS in the ipsilateral kidney suggests a vasoconstriction of the interlobar arteries generated by increased intrarenal pressure during the procedure.
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Affiliation(s)
- Krzysztof Balawender
- Clinical Department of Urology and Urological Oncology, Municipal Hospital in Rzeszow, 35-241 Rzeszow, Poland
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College, Rzeszow University, 35-301 Rzeszow, Poland
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Rodrigues JECM, Vicentini FC, Danilovic A, Marchini GS, Torricelli FCM, Batagello CA, Mazzucchi E, Nahas WC. Comparison of the outcomes of flexible ureteroscopy and mini-percutaneous nephrolithotomy for the treatment of kidney stones: a matched-pair analysis. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2022; 68:1481-1485. [PMID: 36417657 PMCID: PMC9683915 DOI: 10.1590/1806-9282.20221177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mini-percutaneous nephrolithotomy is a recent advancement in the field of kidney stone treatment; however, its role has not been completely established. We aimed to compare the outcomes of initial Mini-percutaneous nephrolithotomy and flexible ureteroscopy. METHODS A retrospective review of consecutive mini-percutaneous procedures was performed. Inclusion criteria were as follows: all percutaneous nephrolithotomy procedures performed with an access sheath up to 24Fr, kidney stone burdens up to 1550 mm3; and the presence of postoperative computed tomography (for control). The data collected for Mini-percutaneous nephrolithotomy procedures were paired 1:2 with patients treated with flexible ureteroscopy for stones between 100 and 1550 mm3, and with postoperative computed tomography for control. A 14Fr Mini-percutaneous nephrolithotomy set was used. The stone-free rate was defined as the absence of fragments on the control computed tomography, whereas success was limited to 2-mm residual fragments. Statistical analysis was performed using SPSS version 19. RESULTS A total of 63 patients met the inclusion criteria (42 with flexible ureteroscopy and 21 with mini-percutaneous nephrolithotomy). Demographic data were comparable. The stone-free rate and success were similar between the groups (76.2 vs. 66.7%, p=0.42 and 90.5 vs. 85.7%, p=0.57). The complication rate was also similar (26.1 vs. 9.6%, p=0.188), but Mini-percutaneous nephrolithotomy had longer hospitalization and fluoroscopy time (p=0.001 in both). CONCLUSIONS Our initial study of Mini-percutaneous nephrolithotomy showed that it is a promising procedure, with outcomes similar to flexible ureteroscopy, but with higher inpatient numbers and fluoroscopy times. A larger study population size and better equipment may improve the outcomes of mini-percutaneous nephrolithotomy.
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Affiliation(s)
| | | | | | | | | | | | - Eduardo Mazzucchi
- Universidade de São Paulo, Hospital of Clinics – São Paulo (SP), Brazil
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Size Distribution of Fragments by High-power Holmium Laser Lithotripsy in MiniPCNL with Suction. Curr Urol Rep 2021; 22:64. [PMID: 34913152 DOI: 10.1007/s11934-021-01072-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Data are lacking on distribution of size of fragments created with the laser lithotripsy, stone density, and composition. Dust (< 1 mm) and small fragments (1-3 mm) may be too small to be efficiently removed with forceps compared to larger fragments (> 3 mm). We aim to report the size distribution of fragments formed during holmium laser lithotripsy. RECENT FINDINGS One hundred ten patients with renal calculi < 3 cm underwent miniPCNL using ClearPetra sheath (Well Lead Medical Co., China) with controllable irrigation and suction system that minimizes fragment dispersion and maximizes fragment aspiration. Moses holmium laser (Lumenis INC, Israel) was used with predefined laser energy settings for lithotripsy. Proportion of fragment size < 1 mm was 46.36 ± 16.68%, 1-3 mm was 28.18 ± 10.01%, and > 3 mm was 25.19 ± 16.18% for the entire cohort. Complete stone clearance at 48 h was achieved in 77.3% cases. The remaining 22.7% patients had complete clearance at 1-month follow-up CT. In all the stone density, volume, and composition groups, majority of fragments created were either < 1 mm or 1-3 mm. Only 25% fragments were > 3 mm that would get aspirated out through the sheath with suction or could be retrieved with forceps. The combination of a high-power holmium laser and suction would help in complete stone clearance with effective aspiration of smaller stone fragments and dust simultaneously during lasing.
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Shabana W, Oquendo F, Hodhod A, Ahmad A, Alaref A, Trigo S, Hadi RA, Nour HH, Kotb A, Shahrour W, Elmansy H. Miniaturized Ambulatory Percutaneous Nephrolithotomy Versus Flexible Ureteroscopy in the Management of Lower Calyceal Renal Stones 10-20 mm: A Propensity Score Matching Analysis. Urology 2021; 156:65-70. [PMID: 34097943 DOI: 10.1016/j.urology.2021.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the efficacy of ambulatory mini percutaneous nephrolithotomy (Mini-PCNL) and flexible ureteroscope (F-URS) in treating 10-20 mm lower calyceal stones using propensity score matching analysis (PSM). PATIENTS AND METHODS A retrospective analysis of 136 adult patients that underwent Mini-PCNL or F-URS for a single lower calyx calculus. Participants that underwent F-URS were allocated to Group I, while those who underwent Mini-PCNL were assigned to Group II. Patients were discharged on the same day and followed up by CT after 3 months. Both groups were matched by stone size and density using propensity stone matching (PSM) and the matched group were further compared. RESULTS Before matching, there were statistical differences in stone size (P = .02), preoperative hydronephrosis (P = .004), and Hounsfield Unit (P = .04) between both groups. A logistic regression model was created between independent variables such as stone size and density. The new groups following PSM were statistically similar in terms of age, BMI, stone size, and HFU (P = .43, P = .74, P = .49, P = .36). The stone-free rates after PSM was not significantly higher in the Mini-PCNL group than the F-URS group (91.7% vs 81.7%, respectively P = .1) while the operative time for the F-URS group was significantly shorter than the Mini-PCNL group 54 (49-64.3) minutes vs 68.2 (62-73.5) minutes, respectively, P = .045. CONCLUSION Ambulatory Mini-PCNL and F-URS have a comparable hospital stay, stone-free rates, and complication rates for treating lower calyceal stones 10-20 mm. Both techniques may be considered acceptable treatment options, with a prolonged operative time in Mini-PCNL.
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Affiliation(s)
- Waleed Shabana
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Fabiola Oquendo
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Amr Hodhod
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Abdulrahman Ahmad
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Amer Alaref
- Radiology Departmet, Northern Ontario School of Medicine, Thuder Bay, Ontario, Canada
| | - Sabrina Trigo
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Ruba Abdul Hadi
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Hani H Nour
- Department of Urology, Theodor Bilharz Research Institute, Giza, Egypt
| | - Ahmed Kotb
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Walid Shahrour
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada
| | - Hazem Elmansy
- Urology Department, Northern Ontario School of Medicine, Thunder bay, Ontario, Canada.
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Erkoc M, Bozkurt M. Comparison of Mini-Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Renal Pelvic Stones of 2-3 cm. J Laparoendosc Adv Surg Tech A 2020; 31:605-609. [PMID: 33316204 DOI: 10.1089/lap.2020.0860] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Backgrounds: Mini-percutaneous nephrolithotomy (M-PCNL) and retrograde intrarenal surgery (RIRS) are commonly used methods for the treatment of kidney stones. The aim of our study is to compare the effectiveness and safety of M-PCNL and RIRS for the treatment of renal pelvic stones with a diameter of 2-3 cm. Materials and Methods: The study included 250 patients, who underwent surgery for renal pelvic stones. M-PCNL and RIRS were performed on 130 and 120 patients, respectively. Age, gender, body mass index of the patients, stone size, the side of surgery, operative times, history of extracorporeal shock-wave lithotripsy, Hounsfield unit (HU) values, the length of hospital stay, stone-free rate (SFR), complication rates according to the modified Clavien system, postoperative hemoglobin loss, postoperative transfusion rates, postoperative narcotic analgesic use, and the number of secondary interventions were recorded. SFR in the postoperative first and third months were calculated. A chi-square test, Student's t-test, and the Wilcoxon test were used for statistical analyses. Results: No statistically significant differences were found in the demographic data, stone size, complication rates defined according to the modified Clavien system, HU values, and postoperative transfusion rates between the patient groups (P > .05). The success rate was statistically significantly higher regarding the postoperative first-month SFR in the M-PCNL group (P < .05). The postoperative third-month SFR after secondary interventions were similar between the groups. The examination of the postoperative hemoglobin loss and narcotic analgesic use and the length of hospital stay revealed superior results in the RIRS group (P < .05). Conclusion: M-PCNL and RIRS are effective and safe methods for the treatment of renal pelvic stones. M-PCNL is advantageous because of high SFR in the postoperative first month and the low need for secondary interventions, whereas RIRS has been found more advantageous in terms of the length of hospital stay, use of narcotic analgesics, and postoperative hemoglobin loss. Further studies on patients with multiple caliceal stones and on patients with a greater stone burden are needed.
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Affiliation(s)
- Mustafa Erkoc
- Department of Urology, Basaksehir Cam and Sakura City Hospital-Istanbul, Istanbul, Turkey
| | - Muammer Bozkurt
- Department of Urology, Basaksehir Cam and Sakura City Hospital-Istanbul, Istanbul, Turkey
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A clinical experience of thulium fibre laser in miniperc to dust with suction: a new horizon. World J Urol 2020; 39:2727-2732. [PMID: 32960327 DOI: 10.1007/s00345-020-03458-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To report safety and efficacy of mini-PCNL with suction attached to sheath combined with high-power Thulium Fibre laser (TFL). The secondary aim was to evaluate optimal laser settings for maximum stone dusting. MATERIALS AND METHODS Prospective, single arm study was conducted from June 2019-December 2019 using miniPCNL with suction and TFL in 54 patients with renal stones < 3 cm. Stone fragments for each laser setting were independently retrieved and segregated according to size(< 1 mm,1-3 mm, > 3 mm) and weighed. Xray/CT scan imaging was performed in all patients within 48 h and 30 days to assess stone clearance. Optimal laser settings were evaluated for maximum dusting. RESULTS Mean stone size was 18.32 ± 6.37 mm, volume was 2337.75 ± 1996.84mm3 and stone density was 1300.55 ± 435.32 HU. Total operative time was 39.85 ± 20.52 min, laser time was 10.08 ± 7.41 min and stone fragmentation rate was 5.02 ± 3.93 mm3/s. The procedure was completely tubeless in 37.04%, nephrostomy tube in 37.04% and DJ stent placed in 25.92%. Postoperatively, three patients had urinary infection (Clavien 2). Complete stone clearance at 48 h was achieved in 35 (64.8%) cases. 19 patients (35.2%) who had residual fragments at 48 h, had 100% clearance at one month on CT/Xray KUB. CONCLUSIONS MiniPCNL using a nephrostomy sheath with suction along with high power Thulium Fibre Laser is safe and effective modality for lithotripsy. An initial laser setting of 0.2 J and 125-200 Hz was optimal for maximum dusting and simultaneous aspiration. Randomized comparative studies with other energy sources are being considered.
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Li Z, Lai C, Shah AK, Xie W, Liu C, Huang L, Li K, Yu H, Xu K. Comparative analysis of retrograde intrarenal surgery and modified ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm). BMC Urol 2020; 20:27. [PMID: 32178654 PMCID: PMC7074985 DOI: 10.1186/s12894-020-00586-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/17/2020] [Indexed: 12/20/2022] Open
Abstract
Background To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5–3.5 cm lower pole renal stones (LPSs). Methods A total of 63 patients with 1.5–3.5 cm LPSs who underwent RIRS (n = 33) or modified UMP (n = 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p < 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p < 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p < 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p < 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p < 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p = 0.504, p = 0.675). There were no significant differences between the two groups in complications (p = 0.228). Conclusion For patients with 1.5–3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.
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Affiliation(s)
- Zhuohang Li
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China
| | - Cong Lai
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China
| | - Arvind K Shah
- Department of Urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal
| | - Weibin Xie
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China
| | - Cheng Liu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China
| | - Li Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China
| | - Kuiqing Li
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China
| | - Hao Yu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China
| | - Kewei Xu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510210, China.
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Mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of 10–20 mm lower pole renal stones: a systematic review and meta-analysis. World J Urol 2019; 38:2621-2628. [DOI: 10.1007/s00345-019-03043-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022] Open
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