scholarly journals COMPARISON OF S.T.O.N.E. SCORE AND GUY SCORE IN PREDICTING STONE FREE RATES OF PERCUTANEOUS NEPHROLITHOTOMY PROCEDURES IN THE SOETOMO GENERAL HOSPITAL

2021 ◽  
Vol 28 (1) ◽  
pp. 91-97
Author(s):  
I Dewa Gede Reza Sanjaya ◽  
Doddy M. Soebadi ◽  
Tarmono Djojodimedjo ◽  
Bambang Soeprijanto
Keyword(s):  
General Hospital ◽  
Strong Relationship ◽  
Inclusion Criteria ◽  
Stone Size ◽  
Relationship Strength ◽  
X Ray ◽  
Stone Free Rate ◽  
Size Evaluation ◽  
The Relationship ◽  
Free Rate

Objective: To determine the effectiveness of Modified Guy's Stone Score (GSS) and S.T.O.N.E score (SS) as predictors of stone free rates in patients undergoing PCNL. Material & Methods: The design of this study was a prospective observational analytic. Samples were patients with kidney stones who came to the Urology Polyclinic of Soetomo0 General Hospital Surabaya, which was planned to undergo PCNL surgery, patients who met the inclusion criteria will have a CT stonographic examination then counted for the S.T.O.N.E score and Modified Guy's Stone Score before the PCNL procedure. Postoperative stone size evaluation used KUB X-ray (BOF) to assess Stone Free Rate (SFR). Results: In the ETA statistical test there was a strong relationship between GSS and SFR with a relationship strength value of 0.609, the direction of the relationship between these two variables was positive. This means that the greater the GSS, the less likely the SFR could be achieved. The relationship between these two variables was significant with p= 0.05. While between SS and SFR with a relationship strength value of 0.55, the strength of the relationship in these two variables was positive which indicated the higher the SS, the less likely the occurrence of SFR. But both of them were not statistically significant with p= 0.228. Conclusion: Guy Stone Score (GSS) gives a better predictive value than the STONE score (SS) on the stone free rates in patients undergoing PCNL procedures.

scholarly journals COMPARISON OF STONE FREE RATE OF STAGHORN STONE, RENAL PELVIC STONE, AND INFERIOR CALYX STONE FOLLOWING PCNL

2016 ◽  
Vol 23 (1) ◽  
Author(s):  
Pande Made Wisnu Tirtayasa ◽  
Ponco Birowo ◽  
Nur Rasyid
Keyword(s):  
General Hospital ◽  
Kidney Stones ◽  
Medical Records ◽  
Incomplete Data ◽  
Inclusion Criteria ◽  
Stone Free Rate ◽  
Staghorn Stone ◽  
Free Rate ◽  
Free Status ◽  
Staghorn Stones

Objective: To compare the stone free rates on patients with staghorn, renal pelvic, and inferior calyx stones with stone burden < 20 mm, 21-30 mm, and > 30 mm following percutaneous nephrolithotomy (PCNL) in Cipto Mangunkusumo General Hospital Jakarta. Material & methods: The data were collected retrospectively from PCNL medical records in Cipto Mangunkusumo General Hospital Jakarta between January 2000 and March 2011. Six hundred and twenty-three patients with 651 kidney stones underwent PCNL. The inclusion criteria were staghorn stones, renal pelvic stone, and inferior calyx stone. All cases outside these three criteria and incomplete data were excluded. Stone free status was defined as no residual fragment on radiography or ultrasonography. Results: As many as 364 kidney stones from 344 patients were included, with 47.8% cases of staghorn stones, 31.9% cases of renal pelvic stones, and 20.3% cases of inferior calyx stones. Overall, 273 (75%) cases were defined as stone free. In group < 20 mm, 4 staghorn stones (100%), 18 renal pelvic stones (81.8%), and 34 inferior calyx stones (94.4%) were cleared (p = 0.811). In group 21-30 mm, 20 staghorn stones (95.2%), 52 renal pelvic stones (91.2%), and 26 inferior calyx stones (92.9%) were cleared (p = 1.000). In group > 30 mm, 83 staghorn stones (55.7%), 28 renal pelvic stones (75.7%), and 8 inferior calyx stones (80%) were cleared (p = 0.037). Conclusion: PCNL is an important tool for treating various kinds and sizes of kidney stones with high stone free rate.

scholarly journals ESWL EFFECTIVENESS FOR LOWER POLE KIDNEY STONES

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Riza Mazidu Sholihin ◽  
Soetojo Soetojo ◽  
Haviv Muris
Keyword(s):  
General Hospital ◽  
Kidney Stones ◽  
Clearance Rate ◽  
Kidney Stone ◽  
Lower Pole ◽  
Stone Size ◽  
Chi Square ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Free Rate

Objective: To describe the profile of lower pole kidney stone patients who underwent Extracorporeal Shock Wave Lithotripsy (ESWL) and the clearance rate of ESWL for lower pole kidney stones at Soetomo General Hospital from 2012 to 2016. Material & Methods: This research design was analytical retrospective, lower pole kidney stone patients who underwent ESWL in Soetomo General Hospital from 2012 to 2016 who fulfill inclusion criteria become samples in this research. Samples were divided into two group, stone size <15 mm and 15-20 mm. Results: Total samples in this study were 128, consist of 81 males and 47 females. The age average was 48 ± 11.124. The stone size average was 9.5 ± 4.5 mm consisted of 109 patients with stone size <15 mm and 19 patients with stone size 15-20 mm. There were 119 single lower pole kidney stones and 9 multiple ones. From all patients, 77 patients (60.2%) were stones free and the rest (39.8%) were not. Stone free rate for lower pole kidney stones was higher in stone size <15 mm compared with 15-20 mm, 65.2% and 31.5% respectively. Statistical analysis with Chi-square showed significant ESWL clearance rate difference between lower pole kidney stone size <15mm group and 15-20 mm (p<0.05). Conclusion: ESWL was a safe option for lower pole kidney stones with high success rate. There was significant relationship between stone size and stone clearance rate. ESWL was effective for lower pole kidney stones size <15 mm. 

scholarly journals Trends in Renal Stone Clearance after Ureteroscopy: A Review

2019 ◽  
Vol 2 (4) ◽  
pp. e44-e50
Author(s):  
Subiksha Subramonian ◽  
Somasundari Gopalakrishnan ◽  
Yuko Smith
Keyword(s):  
Ct Scan ◽  
Clearance Rate ◽  
Holmium Laser ◽  
Clearance Rates ◽  
Stone Size ◽  
Stone Clearance ◽  
X Ray ◽  
Stone Free Rate ◽  
Free Rate ◽  
Over Time

Background and ObjectivesStone clearance rate in ureteroscopy has varied over the years. This study aims to review the stone clear-ance rate over the last 25 years and assess the change over time. We have analyzed the reasons for the peaks and troughs in stone clearance rate to see if it correlates with any factors such as the introduction of new technology like the holmium laser, flexible ureteroscopy, access sheaths, and digital ureteroscopy. Material and MethodsWe performed a PubMed search (August 2019) for papers including the terms “lithiasis”, “stone clear-ance”, “calculi”, “kidney stone”, “ureteric stone”, “ureteroscopy”, “holmium laser”, “retrorenal surgery” in their title and published between the years 1994 and 2019. The stone size, stone clearance rate and mode of imaging to determine clearance rates were recorded. For data analysis, only prospective studies with a minimum of 50 patients and ureteroscopy arm of prospective randomized controlled trials were included. ResultsWe reviewed 16 papers with a total of 1,689 patients with renal stones. Average stone clearance was 80% and the median stone size was 11.0mm. Stone clearance was determined by either: Computed tomography (CT) scan (8 studies), x-ray alone (3 studies), x-ray and ultrasound (3 studies) or not mentioned (2 studies). CT scan yielded lower stone clearance rates than x-ray due to the increased detail shown on CT. For studies that used absolute clearance with no residual stones, average clearance was 52%, and this stone clearance rate increased as the cut-off size used to determine the stone-free rate was increased.ConclusionThis study highlights that stone clearance rate after ureteroscopy varies significantly amongst different pa-pers because of the stone size used to define ‘stone-free rate’ and the method of imaging used to determine stone clearance. The study also shows that stone clearance rates have not improved significantly over time, despite the introduction of advances in technology.

scholarly journals Comparison of ultrasound-assisted and pure fluoroscopy-guided extracorporeal shockwave lithotripsy for renal stones

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tsung-Hsin Chang ◽  
Wun-Rong Lin ◽  
Wei-Kung Tsai ◽  
Pai-Kai Chiang ◽  
Marcelo Chen ◽  
...  
Keyword(s):  
Shock Wave ◽  
Renal Stones ◽  
Disintegration Rate ◽  
Stone Size ◽  
Stone Free Rate ◽  
The Usa ◽  
Retreatment Rate ◽  
Ultrasound Assisted ◽  
Localization And Tracking ◽  
Free Rate

Abstract Background In this study, we aimed to compare the efficacy and clinical outcomes of shock wave lithotripsy (SWL) for patients with renal stones using pure fluoroscopy (FS) or ultrasound-assisted (USa) localization with two lithotripters. Methods We retrospectively identified 425 patients with renal calculi who underwent SWL with either a LiteMed LM-9200 ELMA lithotripter (209 cases), which combined ultrasound and fluoroscopic stone targeting or a Medispec EM-1000 lithotripter machine (216 cases), which used fluoroscopy for stone localization and tracking. The patient demographic data, stone-free rates, stone disintegration rates, retreatment rates and complication rates were analyzed. Results The USa group had a significantly higher overall stone-free rate (43.6 vs. 28.2%, p < 0.001) and stone disintegration rate (85.6 vs. 64.3%, p < 0.001), as well as a significantly lower retreatment rate (14.8 vs. 35.6%, p < 0.001) and complication rate (1.9 vs. 5.5%, p = 0.031) compared with the FS group. This superiority remained significant in the stone size < 1 cm stratified group. In the stone size > 1 cm group, the stone-free rate (32.4 vs. 17.8%, p = 0.028), disintegration rate (89.2 vs. 54.8%, p = 0.031) and retreatment rate (21.6 vs. 53.4%, p < 0.001) were still significantly better in the USa group, however there was no significant difference in the complication rate. The most common complication was post-SWL-related flank pain. Conclusion SWL is a safe and non-invasive way of treating renal stones. This study compared two electromagnetic shock wave machines with different stone tracking systems. LiteMed LM-9200 ELMA lithotripter, which combined ultrasound and fluoroscopic stone targeting outperformed Medispec EM-1000 lithotripter, which used fluoroscopy for stone localization and tracking, with better stone-free rates and disintegration rates, as well as lower retreatment rates and complications with possible reduced radiation exposure.

scholarly journals The Role of Antegrade Irrigation via Percutaneous Nephrostomy on Surgical Outcomes in Semirigid Ureteroscopy among Patients with Upper Ureteral Stones

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Wonho Jung ◽  
Hye Jin Byun ◽  
Dong Sup Lee
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Operation Time ◽  
Percutaneous Nephrostomy ◽  
Stone Size ◽  
Stone Free Rate ◽  
Ureter Stones ◽  
Free Rate

Objective. We aimed to investigate the role of antegrade irrigation via percutaneous nephrostomy on surgical outcomes in retrograde ureteroscopy in patients with upper ureter stones. Materials and Methods. In this retrospective study, we analyzed 134 patients who underwent retrograde semirigid ureteroscopy for upper ureter stones between August 2012 and December 2017. Patients were divided into two groups: retrograde irrigation group (conventional URS) and antegrade irrigation group (using percutaneous nephrostomy). Operation time, postoperative hospital stay, complications, and stone-free rate were measured for each patient after ureteroscopy. Results. The mean age in the retrograde irrigation and antegrade irrigation groups was 53.3 and 60.7 years, respectively (p=0.007). The operation time was 60.8 min vs. 43.0 min (p=0.002), and stone-free rate was 82.0 % vs. 95.5 % (p=0.033). Stone size, laterality, the proportion of male patients, and urinary tract infection prevalence were comparable between the groups. In the subgroup analysis of stone size >10 mm, the antegrade irrigation group had a shorter operation time and a higher stone-free rate. For stone size of 5–10 mm, operation time in the antegrade irrigation group was shorter and the stone-free rate between the two groups was comparable. Conclusion. Antegrade irrigation via percutaneous nephrostomy during ureteroscopy has a higher stone-free rate with a shorter operation time without an increased urinary tract infection risk. Therefore, if percutaneous nephrostomy is necessary before ureteroscopy, antegrade irrigation of external fluid via percutaneous nephrostomy is strongly recommended.

scholarly journals Introducing in clinical practice a new laser suction handpiece for percutaneous nephrolithotomy

2021 ◽  
pp. 039156032110318
Author(s):  
Noam Bar-Yaakov ◽  
Haim Hertzberg ◽  
Ron Marom ◽  
Jemal Jikia ◽  
Roy Mano ◽  
...  
Keyword(s):  
Operative Time ◽  
Statistical Significance ◽  
Hounsfield Units ◽  
Stone Size ◽  
Stone Clearance ◽  
Stone Free Rate ◽  
Average Operative Time ◽  
Group A ◽  
Group B ◽  
Free Rate

Objective: To assess a novel combined laser suction handpiece (LSH) for performing PCNL in a clinical setting. Methods: The study comprised 40 consecutive PCNLs performed between May 2019 and February 2020. The first 20 procedures (Group A) were performed with conventional ultrasonic or pneumatic devices and the other 20 (Group B) were performed with the use of the new LSH. All patients were treated by tubeless supine PCNL. The groups were compared for demographics, clinical data, operative time, lithotrite effectiveness, stone clearance rate (SCR), and outcome. Results: Groups A and B were similar in age, and in stone size, complexity, and density (Hounsfield units) ( p < 0.05). The average operative time was 99 and 78 min, SCR 143 and 200 mm3/min, hospital stay 1.6 and 1.1 days, and stone-free rate 90% and 95%, respectively. Despite a trend toward better results with the new LSH, none of these comparisons reached statistical significance. Ineffective lithotripsy with the initial device (ultrasonic) requiring conversion to another modality (ballistic) occurred in six (30%) procedures in Group A, while all procedures were effectively accomplished with the LSH in Group B ( p = 0.02). There were two complications in Group A and none in Group B ( p > 0.05). Conclusions: The LSH is as effective and safe as the traditional lithotrites for performing PCNLs. This new tool completes the capabilities of the holmium laser high-power machines, enabling them to serve as the sole platform for all endourological treatments.

scholarly journals Comparison of Ultrasound-assisted and Pure Fluoroscopy-guided Extracorporeal Shockwave Lithotripsy for Renal Stones

2020 ◽  
Author(s):  
Tsung-Hsin Chang ◽  
Wun-Rong Lin ◽  
Wei-Kung Tsai ◽  
Pai-Kai Chiang ◽  
Marcelo Chen ◽  
...  
Keyword(s):  
Complication Rate ◽  
Renal Stones ◽  
Complication Rates ◽  
Disintegration Rate ◽  
Stone Size ◽  
Stone Free Rate ◽  
The Usa ◽  
Retreatment Rate ◽  
Ultrasound Assisted ◽  
Free Rate

Abstract Background: In this study, we aimed to compare the efficacy and clinical outcomes of shock wave lithotripsy (SWL) for patients with renal stones using pure fluoroscopy (FS) or ultrasound-assisted (USa) localization with two lithotripters.Methods: We retrospectively identified 425 patients with renal calculi who underwent SWL with either a LiteMed LM-9200 ELMA lithotripter (209 cases), which combined ultrasound and fluoroscopic stone targeting or a Medispec EM-1000 lithotripter machine (216 cases), which used fluoroscopy for stone localization and tracking. The patient demographic data, stone-free rates, stone disintegration rates, retreatment rates and complication rates were analyzed.Results: The USa group had a significantly higher overall stone-free rate (43.6 vs. 28.2%, p<0.001) and stone disintegration rate (85.6 vs. 64.3%, p<0.001), as well as a significantly lower retreatment rate (14.8 vs. 35.6%, p<0.001) and complication rate (1.9 vs. 5.5%, p=0.031) compared with the FS group. This superiority remained significant in the stone size <1cm stratified group. In the stone size >1cm group, the stone-free rate (32.4 vs. 17.8%, p=0.028), disintegration rate (89.2 vs. 54.8%, p=0.031) and retreatment rate (21.6 vs. 53.4%, p<0.001) were still significantly better in the USa group, however there was no significant difference in the complication rate. The most common complication was post-SWL-related flank pain.Conclusion: Extracorporeal SWL using ultrasound combined with fluoroscopy for stone localization and real-time tracking, provides higher stone-free rates and stone disintegration rates, as well as lower retreatment rates and fewer complications.

scholarly journals Non-Fluoroscopic Uretero-Lithotripsy for Distal and Mid Ureteric Stone: Is it Safe and Feasible? Single Center Experience

2017 ◽  
Vol 16 (1) ◽  
pp. 48-52
Author(s):  
Naser S Hussein ◽  
Hussein A Al Khumasi
Keyword(s):  
Operative Time ◽  
Intraoperative Complications ◽  
Medical Science ◽  
Ureteric Stone ◽  
Stone Size ◽  
Residual Stone ◽  
Single Center Experience ◽  
Stone Free Rate ◽  
Case Basis ◽  
Free Rate

Objective: To assess safety and feasibility of completely non-fluoroscopic ureteroscopy for treatment of mid and distal ureteric stone in term of stone free-rate and complications.Material and Methods: Over study period between January 2014 and January 2015, ninety-one complete fluoroscopy-less semirigid ureteroscopies were performed for treatment of symptomatic ureteric stones. Age, sex, stone size, location, side, operative time, auxiliary procedures, stonefree rate and complications, all were assessed. A Stone-free rate was defined as the lack of radiographic evidence of residual stone at 4 weeks. Postoperative imaging, and complications were grading according to modified Clavien classification system, which used initially to grade complications of general surgery.Results: The average age of our subjects was 32.9, with male and right side predominant, 68 % and 64.8% respectively. The average stone size and operative time were 10.07 and 32.08 respectively. Fifty six semirigid retrograde ureteroscopies were done for distal ureteric and 35 for mid ureteric stones, achieving 91.2% stone –free rate, with overall intraoperative complications of 18.6%. All cases were managed on day case basis, ureters were stenting preoperatively in 37 patients and all cases were stenting with an appropriate size of double J.Conclusion: Zero fluoroscopic semirigid retrograde ureteroscopy is a safe and feasible treatment modality for management of distal and mid ureteric stones.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.48-52

scholarly journals The effect of inclined position on stone free rates in patients with lower caliceal stones during SWL session

2015 ◽  
Vol 87 (1) ◽  
pp. 38
Author(s):  
Basri Cakiroglu ◽  
Orhun Sinanoglu ◽  
Tuncay Tas ◽  
Ismet Aydin Hazar ◽  
Mustafa Bahadir Can Balci
Keyword(s):  
Shock Wave ◽  
Urinary Bladder ◽  
Shock Wave Lithotripsy ◽  
Renal Stones ◽  
Lower Pole ◽  
Trendelenburg Position ◽  
Stone Size ◽  
Treatment Groups ◽  
Stone Free Rate ◽  
Free Rate

Objective: To compare the outcomes of shock wave lithotripsy (SWL) combined with inclined position and SWL alone in patients with lower pole calyx stones. Methods: Seven hundred forty patients who underwent SWL treatment for lower pole renal stones with a total diameter of 2 cm or less were prospectively randomized into two groups. They were comparable in terms of age, sex, and stone diameters. Patients with lower calyceal stones (4-20 mm) were randomized to SWL (368 patients) or SWL with simultaneous inclination (372 patients) with 30o head down Trendelenburg position). Shock wave and session numbers were standardized according to stone size. Additional standardized shock waves were given to patients with stone fragments determined by kidney urinary bladder film and ultrasound at weeks 1, 4, 10. Results: The overall stone free rate (SFR) was 73% (268/368) in patients with SWL alone and 81% (300/372) in SWL with inclination at the end of 12th week (p = 0.015). No significant adverse events were noted in both treatment groups. Conclusion: Simultaneous inclination of patients during SWL session increase SFR in lower caliceal stones significantly compared to SWL treatment alone.

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