scholarly journals A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hikmet Topaloglu ◽  
Nihat Karakoyunlu ◽  
Sercan Sari ◽  
Hakki Ugur Ozok ◽  
Levent Sagnak ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operation Time ◽  
Ureteral Stones ◽  
Surgical Equipment ◽  
Duration Of Hospital Stay ◽  
Stone Free Rate ◽  
Surgical Expertise ◽  
Significant Difference ◽  
History Of ◽  
Retroperitoneal Laparoscopic Ureterolithotomy

Purpose. To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones.Methods. Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed.Results. Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6 ± 1.1 g/dL versus 0.5 ± 0.3 g/dL, resp.;P=0.022). RLU group had longer operation time (for PAU group and RLU group 80.1 ± 44.6 min versus 102.1 ± 45.5 min, resp.;P=0.039).Conclusions. Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment.

Comparison of High-Sensitive CRP, RDW, PLR and NLR between Patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure

2021 ◽  
Vol 17 ◽  
Author(s):  
Mehrdad Solooki ◽  
Mohammad Parsa Mahjoob ◽  
Razieh Sadat Mousavi-roknabadi ◽  
Meghdad Sedaghat ◽  
Mohammad Rezaeisadrabadi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Stay ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
Hscrp Level ◽  
Obstructive Pulmonary Disease ◽  
Walking Test ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
History Of

Background: Chronic obstructive pulmonary disease (COPD) is a chronic systemic inflammation, which has similar signs and symptoms to chronic heart failure (CHF). Objective: To compare high-sensitive C-reactive protein (hsCRP) level and selected blood indices in patients with COPD and CHF. Methods: This prospective cross-sectional study (July 2019-July 2020) was conducted on patients aged 40-70 years old with a previous diagnosis of COPD, CHF, and cor pulmonale. They were divided into four groups: 1) patients with COPD, who were hospitalized due to exacerbation of dyspnea, 2) patients with CHF without a history of COPD, 3) patients with CHF and history of COPD (COPD+CHF), and finally 4) patients who had concomitant COPD and cor pulmonale condition. Spirometry, echocardiography, and six-minute walking test were performed. The hsCRP level was assessed at the beginning and end of hospital admission. Finally, RDW, neutrophil, lymphocyte, platelet counts, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) were measured. Data were analyzed by SPSS software (α = 0.05). Results: In total, 140 patients were enrolled. The highest hsCRP level was observed in patients in the COPD+CHF group, and the lowest level was found in patients with CHF. Overall, a significant difference was observed in the hsCRP level at the beginning and the end of admission (P <0.0001). HsCRP had a positive correlation with the duration of hospital stay and a negative correlation with the results of the six-minute walking test. The lymphocyte counts and PLR had significant positive correlations with the six-minute walking test (R =0.38, P <0.0001 vs. R =0.325, P =0.001, respectively), and significant negative correlations with duration of hospital stay (R =-0.317, P <0.0001 vs. R =-0.380, P =0.001, respectively). At the admission, a significant difference in hsCRP was only observed comparing the COPD and cor pulmonale groups (OR =1.097, P =0.002). There were significant differences in the six-minute walking test comparing the COPD group with either of CHF or COPD+CHF groups. Significant differences were noted in the hospital stay duration comparing the COPD group with all other groups. Conclusion: The results of this study showed that lymphocyte, neutrophil, platelets counts, as well as RDW, NLR, and PLR indices, were not useful for differentiating COPD from CHF. However, the hsCRP level may help in differentiating COPD from patients with cor pulmonale.

Flexible Ureteroscopy versus Retroperitoneal Laparoscopic Ureterolithotomy for the Treatment of Proximal Ureteral Stones >15 mm: A Single Surgeon Experience

2015 ◽  
Vol 96 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Volkan Tugcu ◽  
Berkan Resorlu ◽  
Selcuk Sahin ◽  
Arda Atar ◽  
Ramazan Kocakaya ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operation Time ◽  
Invasive Procedure ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Group I ◽  
Surgeon Experience ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Retroperitoneal Laparoscopic Ureterolithotomy

Objective: To compare safety and effectiveness of flexible ureteroscopy (F-URS) and laparoscopic retroperitoneal ureterolithotomy (L-RU) in treatment of proximal ureteral stones larger than 15 mm. Materials and Methods: This study included 103 patients treated with L-RU (Group I), and 80 patients treated with F-URS (Group II) due to proximal ureteral stones larger than 1.5 cm, in a single center. Patients' characteristics and procedure-related parameters including success rate, operation time, hospital stay, postoperative visual analogue scale (VAS) scores, auxiliary procedures, and complications were compared between Groups I and II. Results: It was seen that both methods were effective in the treatment of large ureteral stones; however, R-LU provided a higher stone-free rate (100 vs. 87.5%), a lower complication rate (10.6 vs. 23.7%), and a shorter operation time (65.4 vs. 75.1 min). On the other hand, patients treated with F-URS had less postoperative pain, a shorter hospital stay, a faster return to daily activities. Conclusions: For treatment of large proximal ureteral stones, L-RU provides significantly higher success and lower retreatment rate compared with F-URS. Our results also indicate that R-LU, which has been regarded as an invasive procedure is not as invasive as it is thought to be, and it must be kept in mind that F-URS may cause complications despite its noninvasive nature.

scholarly journals Effect of Amplatz Sheath on Cystolithotripsy for Women with Large Bladder Stone

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Tadashi Tabei ◽  
Takashi Kawahara ◽  
Shinnosuke Kuroda ◽  
Hiroki Ito ◽  
Kazuki Kobayashi ◽  
...  
Keyword(s):  
Total Energy ◽  
Standard Procedure ◽  
Operation Time ◽  
Bladder Stone ◽  
Volume Number ◽  
Number Of Patients ◽  
Stone Free Rate ◽  
Significant Difference ◽  
History Of ◽  
Perioperative Complication

Objective. This study compared the effect of endourological procedures with or without the Amplatz sheath (AS) on cystolithotripsy.Methods. We retrospectively analysed 18 patients who underwent treatment for bladder stone over 30 mm. This study consisted of two groups, namely, patients who underwent cystolithotripsy with an AS (AS group) and those who underwent standard procedure without an AS (SP group). The stone-free rate, total energy used for operation, operation time, days of admission after operation, and complication of both groups were compared.Results. The number of patients in the AS and SP groups was 10 and 8, respectively. Significant differences were not found between these two groups with regard to age, stone burden, stone volume, number of stones, and history of neurogenic bladder. All patients in both groups achieved a stone-free state. Total energy was significantly increased and operation time was shorter in the AS group. No significant difference was observed in terms of days of admission after operation. Any complications were not increased by the use of AS. Struvite was the most common stone component in both groups.Conclusion. Use of an AS can shorten the operation time of cystolithotripsy without increasing perioperative complication.

scholarly journals OUTCOME OF CEREBRAL CONTUSIONS DUE TO TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 11 (1) ◽  
pp. 39-43
Author(s):  
Zubair Ahmed Khan ◽  
Habib sultan ◽  
Amir Aziz ◽  
Shahrukh Rizvi ◽  
Tauqeer Ahmed ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents ◽  
Male And Female ◽  
Duration Of Hospital Stay ◽  
History Of ◽  
Age Range

ABSTRACT:BACKGROUND & OBJECTIVE: To compare the results of surgically operated vs conservatively treated patients of cerebral contusions due to traumatic brain injury. METHODOLOGY: This comparative study was conducted from January 2012 to December 2014 at the department of Neurosurgery, PGMI Lahore General Hospital, Lahore. A total of 50 patients were included in this study of both gender (male and female) and in the age range of 15-65 years. In our study 20 patients were managed conservatively while other 30 patients were operated for cerebral contusions. The mode of injury in our study was road traffic accidents and history of falls. RESULTS: Out of 50 patients, there were 41 (82%) males and 09 (18%) female patients. Their age ranged from 15 - 65 years. In this study the overall mean age is 38.36 years. The maximum numbers of patients were in their third and fourth decades of life. In our study the duration of hospital stay in conservatively managed patients was longer as compared to surgically treated patients who were discharged earlier. Mortality rate in surgically managed patients having a GCS ranged between 09 to 12 was very low contrary to the conservatively managed group, similarly the rate of delayed contusion formation and edema was also low in surgically managed patients as compared to those who were managed conservatively. CONCLUSION: Surgically managed patients of cerebral contusions in traumatic brain injury has better outcome and decreased hospital stay as compared to conservatively managed patients.

scholarly journals Ureteral stricture formation after removal of proximal ureteral stone: retroperitoneal laparoscopic ureterolithotomy versus ureteroscopy with holmium: YAG laser lithotripsy

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3483 ◽  
Author(s):  
Henglong Hu ◽  
Lu Xu ◽  
Shaogang Wang ◽  
Xiao Yu ◽  
Huan Yang ◽  
...  
Keyword(s):  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Ureteral Stricture ◽  
Stricture Formation ◽  
Yag Laser ◽  
Stricture Rate ◽  
Confounding Variables ◽  
Significant Difference ◽  
Retroperitoneal Laparoscopic Ureterolithotomy ◽  
The Difference

Objective To compare the risk of postoperative ureteral stricture formation following retroperitoneal laparoscopic ureterolithotomy (RPLU) and ureteroscopy with holmium: YAG laser lithotripsy (URSL) in patients with proximal ureteral stones. Materials and Methods We retrospectively reviewed the medical records of patients who underwent RPLU or URSL for proximal ureteral stones between April 2011 and May 2015. Patients were allocated into URSL group or RPLU group and the outcomes were compared. Results A total of 201 patients who underwent 209 procedures including 159 URSL and 50 RPLU with a median follow-up of 30 months were included. No significant difference was observed among the two groups in most baseline parameters, while the stone size was significantly larger in the RPLU group (11.37 ± 2.97 vs 14.04 ± 4.38 mm, p = 0.000). Patients in RPLU group had markedly longer operative time (p = 0.000) and longer postoperative hospital stay (p = 0.000). The initial and one-month stone-free rates were significantly higher in the RPLU group (78.6% vs 100%, p = 0.000 and 82.4% vs 100%, p = 0.001, respectively). Patients in the RPLU had a higher complication rate (18.0% vs 9.4%, p = 0.098) and lower ureteral stricture rate (2.5% vs 2.0%, p = 1.000), while the difference was not significant. Further logistic regression model identified RPLU and female sex as independent risk factors for postoperative complication (Odds Ratio[OR] = 3.57, p = 0.035 and OR = 3.57, p = 0.025, respectively); however, URSL was not an independent risk factor for the formation of postoperative ureteral stricture after adjusting confounding variables (OR = 0.90, p = 0.935). Conclusion RPLU and URSL have similar postoperative ureteral stricture formation risks. RPLU can provide significantly higher stone clearance rate, but relates with more postoperative complications.

scholarly journals Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

2020 ◽  
pp. 145749692093860
Author(s):  
T. Mönttinen ◽  
H. Kangaspunta ◽  
J. Laukkarinen ◽  
M. Ukkonen
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Time Of Day ◽  
University Hospital ◽  
Patient Comfort ◽  
Intraoperative Bleeding ◽  
Significant Difference ◽  
Clinically Significant

Introduction: Although it is controversial whether appendectomy can be safely delayed, it is often unnecessary to postpone operation as a shorter delay may increase patient comfort, enables quicker recovery, and decreases costs. In this study, we sought to study whether the time of day influences the outcomes among patients operated on for acute appendicitis. Materials and Methods: Consecutive patients undergoing appendectomy at Tampere University Hospital between 1 September 2014 and 30 April 2017 for acute appendicitis were included. Primary outcome measures were postoperative morbidity, mortality, length of hospital stay, and amount of intraoperative bleeding. Appendectomies were divided into daytime and nighttime operations. Results: A total of 1198 patients underwent appendectomy, of which 65% were operated during daytime and 35% during nighttime. Patient and disease-related characteristics were similar in both groups. The overall morbidity and mortality rates were 4.8% and 0.2%, respectively. No time categories were associated with risk of complications or complication severity. Neither was there difference in operation time and clinically significant difference in intraoperative bleeding. Patients undergoing surgery during night hours had a shorter hospital stay. In multivariate analysis, only complicated appendicitis was associated with worse outcomes. Discussion: We have shown that nighttime appendectomy is associated with similar outcomes than daytime appendectomy. Subsequently, appendectomy should be planned for the next available slot, minimizing delay whenever possible.

The Risk Factors of Postoperative Delirium after Total Knee Arthroplasty

2016 ◽  
Vol 30 (06) ◽  
pp. 600-605 ◽  
Author(s):  
Lih Wang ◽  
Sungsoo Kim ◽  
Kyungtaek Kim ◽  
Seunghyun Lee ◽  
Kyungho Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Hospital Stay ◽  
Knee Arthroplasty ◽  
Operating Time ◽  
Start Time ◽  
Duration Of Hospital Stay ◽  
History Of ◽  
Total Knee ◽  
Underlying Diseases

AbstractWe investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee Society Knee Score and Knee Society Function Score) and the number of underlying diseases and associations with each disease; Second, the operative factors including the anesthesia method, amount of blood loss, operating time, laboratory factors, and transfusion count; Third, the postoperative factors such as start time of walking and duration of hospital stay were analyzed. There were significant statistical difference between two groups just in age, history of dementia, cerebrovascular disease, difference of hemoglobin and albumin, start time of walking, and duration of hospital stay. The delirium after TKA delays the postoperative ambulation and extends the hospital stay, which causes functional and socioeconomic loss of patients. Therefore, the risk factors for delirium should be assessed and proper prevention and management should be conducted.

scholarly journals Extracorporeal Shock Wave Lithotripsy verus Rigid Ureteroscopy in Treatment of Mid-Ureteric Stones; Randomized Prospective Study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A S Hegazy ◽  
M I Ahmed ◽  
A F M Abdelgawad
Keyword(s):  
Shock Wave ◽  
Urinary Tract ◽  
Prospective Study ◽  
Hospital Stay ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stones ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Operative Complications ◽  
Free Rate

Abstract Background Urinary stone disease or nephrolithiasis, the third most common disease of the urinary tract is a major health problem due to its high prevalence, incidence and recurrence. The lifetime incidence of kidney stones for men and women is approximately 13% and 7% respectively. Although stones may be asymptomatic, potential consequences include abdominal and flank pain, nausea and vomiting, urinary tract obstruction, infection, and procedure-related morbidity. Ureteral stones frequently cause renal colic and if left untreated can cause obstructive uropathy. Objectives A prospective randomized study to compare between extracorporeal shock-wave lithotripsy and rigid ureteroscopy in mid-ureteric stone treatment regarding efficacy, stone-free rate, retreatment rates, associated complications (intra-operative and post-operative), operative duration, hospital stay. Patients and Methods This study was performed at Ain Shams University (Urology department) and El Doaah hospital (Urology department), From August 2016 to August 2017, a total of 50 patients having solitary radiopaque middle ureteral stone ranges between 0.5 – 1.5 in size were divided into two groups 25 patients each enrolled in our prospective study. Results In this study the overall stone free rate was considered after two sessions of ESWL (in case of ESWL group) or one trial of ureteroscopy (in case of URS group). ESWL group: 14 cases became stone free after the first session, while the remaining 11 out of 25 patients needed second session, 6 cases became stone free after the second session. ESWL failure occurred in 5 cases and they were successfully managed by ureteroscopy. URS group: 23 cases became stone free after first ureteroscopy, while the remaining 2 patients needed second ureteroscopy due to proximal migration of the stone. In ESWL group, patients were already at outpatient clinic so there were no admission or hospital stay, all cases done without anesthesia, just analgesic ± sedation. While in URS group patients admitted and the hospital stay varies from one day to seven days according to the condition of the case, all URS cases had Spinal anesthesia. ESWL was shown to be less time consuming than URS with a mean operative time of 46.84±3.61 minutes versus 56.20±7.11 minutes respectively. In URS group there were 22 patients had ureteric catheter inserted for 24 to 72 hours postoperatively and 3 patients had double (J) stent inserted for 4 weeks postoperatively, while all the patients who underwent ESWL, no auxiliary procedure done as this procedure is completely non-invasive. Among ESWL cases, No case had an intra-operative complication, while URS group had 3 cases of intra-operative complication. There were 4 cases who had post-operative complications among ESWL group, while there were 5 cases who had post-operative complications among URS group. Conclusion In treatment of mid-ureteral stones range 0.5-1.5 in size, both URS and ESWL modalities are comparable but URS is recommended as a first option as it is more effective than ESWL regarding stone free rate and it provides immediate stone clearance with lower re-treatment rates and higher patient satisfaction, but URS requires anesthesia, longer hospitalization, and associated with a higher incidence of complications.

scholarly journals Restrictive Transfusion Strategy Does Not Affect Clinical Prognosis in Patients with Ectopic Pregnancy

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Yanjuan Huang ◽  
Yi Liang ◽  
He Ma ◽  
Mei Ling ◽  
Xuelian Ran ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Ectopic Pregnancy ◽  
Emergency Surgery ◽  
Operation Time ◽  
Transfusion Strategy ◽  
Clinical Prognosis ◽  
Restrictive Transfusion ◽  
Significant Difference ◽  
Restrictive Transfusion Strategy

To assess the effects of restrictive transfusion strategy on hemoglobin (Hb) levels and prognosis in patients with ectopic pregnancy and severe hemorrhage undergoing emergency surgery, patient data were collected from 2012 to 2016. Following transfusion guidelines, restrictive transfusion was performed; at Hb levels of 60–70 to 100 g/L, transfusion was continued or not based on disease status. The patients were divided into four groups: blood loss < 400 ml (N1), 400–799 ml (N2), 800–1199 ml (N3), and ≥1200 ml (N4). Several prognosis parameters were assessed. GroupN4 was further divided based on blood loss amounts (1200–1999, 2000–2999, 3000–3999, and 4000–5000 ml) for subgroup analyses. Blood loss, hemoglobin levels at discharge, and American Society of Anesthesiologists (ASA) scores were not associated with patient prognostic parameters, including intensive care unit (ICU) occupancy, cure, and healing rates, and surgical complications and hospital stay. No statistically significant difference was obtained in hospital stay amongN1,N2, andN3 groups. Compared withN1 patients, cases with blood loss ≥ 1200 ml had significantly longer hospital stay. Interestingly, hospital stay was correlated with surgical approach, location of pregnancy, and operation time. Restrictive transfusion strategy could be safely used for emergency surgery in ectopic pregnancy with acute blood loss.

Preoperative Renal Tumor Embolization

1987 ◽  
Vol 28 (3) ◽  
pp. 303-306 ◽  
Author(s):  
A.-R. Fischedick ◽  
P. E. Peters ◽  
G. Kleinhans ◽  
E. Pfeifer
Keyword(s):  
Statistical Evaluation ◽  
Renal Tumor ◽  
Operation Time ◽  
Renal Tumors ◽  
Preoperative Embolization ◽  
Tumor Embolization ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Medical Reports ◽  
Staging Classification

The medical reports of 113 patients operated upon for renal tumors were retrospectively reviewed to assess the value of preoperative embolization. Coils or ethanol were used preoperatively in 55 patients while 58 patients underwent nephrectomy without embolization. The tumors were staged according to the TNM and the Robson staging classification. T1 and T2 tumors as well as T3 and T4 tumors were grouped together for statistical evaluation. There was no significant difference in intraoperative blood loss, operation time and survival rate between patients undergoing preoperative embolization and those who had only nephrectomy. Duration of hospital stay was always longer in the preoperatively embolized group. Preoperative embolization of renal tumors neither improved the patients' outcome nor reduced the surgical risk. Robson's classification, stage III/IV, did not show any significant differences for embolized patients or for those nephrectomized without embolization.

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