EVALUATING FACTORS RELATED TO THE RESULT OF OPEN OPERATION ON COMPLEX RENAL STONE TREATMENT WITH MULTIPLE STONES

2017 ◽  
pp. 215-251
Author(s):  
The Huynh Nguyen ◽  
Dinh khanh Le
Keyword(s):  
Urinary Tract ◽  
Kidney Stones ◽  
Renal Stone ◽  
Gender History ◽  
Female Ratio ◽  
Surgical Result ◽  
Open Operation ◽  
Stone Free Rate ◽  
History Of ◽  
Free Rate

Objective: To evaluate factors related to stone - free rate of open operation for treatment of multiple/ staghorn kidney stones. Materials and Methods: Prospective study comprises of 56 patients with multiple/ staghorn kidney stones underwent open surgery at Hue Central Hospital and Hue University Hospital from April 2016 to June 2017. We evaluate the relationship between age, gender, surgical history, hydronephrosis, location of stones, size of stones, number of stones, renal pelvic aspect and stone – free rate after surgery. Results: Male/female ratio is 35/21 (62.5%/27.5%). The average age is 52.3 ± 15.3, (the youngest age is 12, the highest is 76). The stone – free rate is 62.5%, the rate of stone residue is 37.5%. The factors related to surgical result are gender, history of urinary tract surgery, hydronephrosis, location and size of stones, number of stones, renal pelvic aspect and methode (pyelotomy/nephrostomy) for removing stones. There is no relation between age of the patient and result of operation. Conclusion: The factors related to surgical result are gender, history of urinary tract surgery, hydronephrosis, location and size of stones, number of stones, renal pelvic aspect and methode (pyelotomy/nephrostomy) for removing stones. There is no relation between age of the patient and result of operation. Key words: Renal stone, multiple/staghorn kidney stones

scholarly journals Prediction of the stone free rate by using the guy's stone score after percutaneous nephrolithotomy

2019 ◽  
Vol 45 (3) ◽  
pp. 197-200
Author(s):  
Mohammad Shafikul Islam ◽  
Muhammad Hossain ◽  
Md. Saiful Islam ◽  
AKM Khurshidul Alam ◽  
Md. Habibur Rahman Dulal ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Normal Body Mass Index ◽  
Patient Counseling ◽  
Residual Stone ◽  
Female Ratio ◽  
Stone Free Rate ◽  
Grade Ii ◽  
Free Rate ◽  
Grade Iii

Background: Urolithiasis is one of the common diseases of the urinary system, with an incidence of approximately 5-10% among the general population. Among the minimally invasive surgeries, percutaneous nephrolithotomy (PCNL) is the gold standard therapy for large and/or complex renal stones. Objective: The study was carried out to predict the stone-free rate after PCNL by using the Guy's stone score. Methods: This prospective cross-sectional study was conducted in the Department of Urology, Bangabandhu Sheikh Mujib Medical University, (BSMMU), Dhaka from February 2016 to January 2017. The patients with renal stone attending the outpatient department who met the criteria of standard PCNL. Results: Atotal of 52 patients with renal stone were included in this study.  The mean age was to be found 45.3±14.0 with range of 18 to 73 years. Male to female ratio was 3.3:1. Almost three fourth (74.5%) patients had normal body mass index. All patients had normal anatomy. More than half 27 of the (51.9%) patients had found grade I, 10 (19.2%) Grade II, 11(21.2%) Grade III and 4 (7.7%) Grade IV. Nearly two third 34 (65.4%) patients were found total stone cleared and 18(34.6%) had residual stone. Cleared stone was found 23(85.2%) in grade I, 7(70.0%) grade II, 3(27.3%) in grade III and 1(25.0%) in grade IV. Conclusion: Based on the study findings, it may be concluded that higher the GSS less the stone free rate.It will help in better patient counseling preoperatively, and to predict the need for ancillary treatment.

Laparoscopic pyelolithotomy in patients with previous ipsilateral renal stone surgery

2019 ◽  
pp. 039156031989099
Author(s):  
Mohammad Hadi Radfar ◽  
Mehdi Dadpour ◽  
Nasser Simforoosh ◽  
Abbas Basiri ◽  
Akbar Nouralizadeh ◽  
...  
Keyword(s):  
Renal Stone ◽  
Operating Time ◽  
Study Groups ◽  
Transfusion Rate ◽  
Renal Surgery ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
History Of ◽  
Free Rate

Objectives: To evaluate the safety and efficacy of transperitoneal laparoscopic pyelolithotomy in renal stone cases with previous renal surgeries. Patients and methods: In this prospective study, 190 consecutive patients with renal stones, who were candidates for transperitoneal laparoscopic pyelolithotomy, were enrolled. The patients were divided into two groups. In group A, 163 patients without a history of renal surgery underwent standard laparoscopic pyelolithotomy, whereas in group B laparoscopic pyelolithotomy was performed in 27 patients with a history of kidney stone surgery including percutaneous nephrolithotomy or open stone surgery. All intraoperative data including the operating time and complications such as bleeding requiring transfusion were recorded. Postoperative data such as length of hospitalization, hemoglobin level alteration, and other complications were also recorded. Results: There was no significant difference in the preoperative data such as stone size, stone site, age, sex, and stone side between the two groups. There was no significant difference in the stone-free rate between the two groups (p = 0.4). There was no significant difference between the two study groups regarding the operating time, hospital stay, stone-free rate, complications, and transfusion rate. Conclusion: Laparoscopic pyelolithotomy can be used as a safe and feasible treatment modality in the setting of previous renal surgery. The complications and stone-free rate of laparoscopic pyelolithotomy in patients with history of renal surgery are acceptable.

scholarly journals RELATIONSHIP BETWEEN RENAL STONE LOCATION WITH STONE-FREE RATE AFTER ESWL

2017 ◽  
Vol 24 (1) ◽  
Author(s):  
Laudeo Dhanaba Siregar ◽  
Syah Mirsya Warli
Keyword(s):  
Urinary Tract ◽  
Renal Stone ◽  
Stone Composition ◽  
Patient Medical Record ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Urinary Tract Stones ◽  
Retrospective Study Design ◽  
The Relationship ◽  
Free Rate

Objective: This study aims to evaluate the relationship between stone location and stone location in kidney stone to the stone-free rate after Extracorporeal Shock Wave Lithotripsy (ESWL) procedure. Material & method: This is a non-experimental research using descriptive analytic method with retrospective study design that takes data from patient medical record diagnosis of urinary tract stones and ESWL action from January 2011 until December 2013 in the Department of Surgery Division of Urology General Hospital H. Adam Malik, Medan. Results: It was found that if the size of the stone only is the only factor that counts in patients who get a urinary tract stones ESWL therapy, it is not found a statistically significant relationship. Stone location plays an important role in the incidence of stone-free patients with urinary tract stones ESWL therapy. Conclusion: ESWL therapeutic efficacy in the treatment of patients with kidney stones is not only determined by the size and location of the stone, but is also determined by the number of stones, stone composition, frequency ESWL is used, and the thickness of the skin of the patient.

scholarly journals Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2106 ◽  
Author(s):  
Widi Atmoko ◽  
Ponco Birowo ◽  
Nur Rasyid
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Univariate Analysis ◽  
Staghorn Calculi ◽  
Stone Burden ◽  
Stone Free Rate ◽  
History Of ◽  
Renal Stone Surgery ◽  
The Mean ◽  
Free Rate

Objectives: Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Methods: We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. Results: The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery (p = 0.01), stone burden (p = < 0.001), and type of anesthesia (p = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; p 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; p 0.00] were significant independent risk factors for stone-free.

scholarly journals Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2106 ◽  
Author(s):  
Widi Atmoko ◽  
Ponco Birowo ◽  
Nur Rasyid
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Univariate Analysis ◽  
Staghorn Calculi ◽  
Stone Burden ◽  
Stone Free Rate ◽  
History Of ◽  
Renal Stone Surgery ◽  
The Mean ◽  
Free Rate

Objectives: Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Methods: We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. Results: The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery (p = 0.01), stone burden (p = < 0.001), and type of anesthesia (p = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; p 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; p 0.00] were significant independent risk factors for stone-free.

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 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 COMPARISON OF THE EFFICACY AND SAFETY OF THE SUPINE AND PRONE POSITIONS IN PERCUTANEOUS NEPHROLITHOTOMIES FOR KIDNEY STONES

2019 ◽  
pp. 60-62
Author(s):  
RIO RAHMADI ◽  
NUR RASYID ◽  
PONCO BIROWO
Keyword(s):  
Kidney Stones ◽  
Controlled Trial ◽  
Similar Efficacy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Efficacy And Safety ◽  
Conversion To Open Surgery ◽  
Stone Free Rate ◽  
Student’S T ◽  
Free Rate

Objective: This study was designed to compare the efficacy and safety of the supine and prone positions in percutaneous nephrolithotomies (PCNLs) used for the treatment of kidney stones in Indonesian patients. Methods: This was a single-blinded randomized controlled trial of those patients undergoing PCNLs from February to May of 2018. There were 19 subjects in the supine group and 19 in the prone group for a total of 38 study subjects. The study outcomes that were compared included the operative time, hospital length of stay (LOS), stone-free rate, blood loss, conversion to open surgery, blood transfusion, and complications. These outcomes were evaluated using the Student’s t test and the chi-squared test. Results: There were no significant differences in the patient demographics or stone locations between the two groups. Additionally, the medians of the operative times, LOSs, blood losses, and blood transfusions were not statistically different. There was a higher stone-free rate in the supine group than in the prone group (70.0% vs. 47.4%, respectively, p = 0.151). More subjects were transfused in the supine group (30.0%) than in the prone group (15.8%), but this difference was not statistically significant (p = 0.292). The only complications were infundibular lacerations, which occurred in 20% of the subjects in the supine group and 15.8% of the subjects in the prone group (p = 0.732). Conclusion: This study showed that the supine and prone positions for PCNLs had similar efficacy and safety outcomes.

scholarly journals The use of a ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones

2013 ◽  
Vol 32 (1) ◽  
pp. 229-232 ◽  
Author(s):  
Gaetan Berquet ◽  
Paul Prunel ◽  
Grégory Verhoest ◽  
Romain Mathieu ◽  
Karim Bensalah
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Ureteral Access Sheath ◽  
Access Sheath ◽  
Stone Free Rate ◽  
Urinary Tract Stones ◽  
Free Rate
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