The initial evaluation of the retroperitoneoscopic pyelolithotomy for the partial staghorn renal stone

2019 ◽  
pp. 21-27
Author(s):  
Duc Minh Hoang ◽  
Van Binh Nguyen ◽  
Vinh Quy Truong

Purpose: To evaluate initial outcomes of retroperitoneoscopic pyelolithotomy for treating partial staghorn renal stones. Materials and Methods: 9 patients with partial staghorn renal stones were treated by retroperitoneal laparoscopic pyelolithotomy from June 2014 to June 2018. The mean age was 51.2 years (range 31-65); 5 males (55.6%) and 4 females (44.4%). The mean stone size was 5.1 cm (3.2 - 6.8 cm). Results: The retroperitoneoscopic pyelolithotomy procedures for treatment of staghorn renal stones were completely successful in 8/9 cases (88.9%), 1 case (11.1%) required conversion to open surgery by heavy bleed. The estimated blood lost was 20-50ml. The mean duration of the procedure is 95.3 mins (70-165 mins). All of cases (100%) was put the residual stent into the ureter. The mean post-operation hospital stay was 5.2 days (4 - 7 days). About complications: 1 cases (12.5%) of urinary infection; 3 cases (37.5%) of postoperative hematuria. Conclusions: Retroperitoneal laparoscopic pyelolithotomy could be indicated to remove the partial staghorn renal stones up to 6.8 cm in size. Success depends on the experience of surgeons and judicious selection of cases. Key words: Retroperitoneoscopic pyelolithotomy, Staghorn renal stones, Treatment

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.


2017 ◽  
pp. 107-112
Author(s):  
Duc Minh Hoang ◽  
khoa Hung Nguyen ◽  
Vinh Quy Truong ◽  
Van Binh Nguyen ◽  
Hong Duong Nguyen ◽  
...  

Purpose: To assess results of retroperitoneoscopy nephrectomy for benign non-function kidneys from June 2013 to June 2017 at Quang Tri General Hospital. Materials and Methods: The study comprised 43 patients who underwent retroperitoneoscopic nephrectomy during a 4 years period beginning from June 2013. Results: Mean age of surgery was 52.6 years (28-72 years). 23 males and 20 females. 25 patients underwent left nephrectomy; 18 underwent right nephrectomy. Retroperitoneoscopic nephrectomy were completed successfully in 38 patients (88.4%). There was 5 patients required conversion to open surgery (11.6%), all cases by poor progression. The mean operating time was 112.7 minutes (range 70 to 210), mean blood loss was 45.7 ml (range 15 to 170 ml), and mean post-operation hospital stay was 4.3 days (range 3 to 9). A total of 21.1% complications (8/38 cases), no severe complications occurred. No re-intervention was needed. No case was mortality. The indications for surgery included hydronephrosis in 19/38 cases (50.0%), atrophic kidney in 13/38 cases (34.2%) and multicystic kidney in 6/38 cases (15.8%). Conclusions: Retroperitoneoscopic nephrectomy can be performed safely and successfully with obvious advantages for benign nonfunctioning kidneys regardless of the etiology or pathogenesis. Key words: nephrectomy, kidney, benign, retroperitoneoscopy


2013 ◽  
Vol 6 (3) ◽  
pp. E121-E124
Author(s):  
Patrick Richard ◽  
Mathieu Bettez ◽  
Arold Martel ◽  
Yves Ponsot ◽  
Robert Sabbagh

Urinary calculi are prevalent and result in significant morbidity,with a marked economic impact. Various therapeutic optionsexist, from medical to surgical management according to stonesize. Laparoscopic pyelolithotomy is a viable option for significantstaghorn renal stones. We report the case of a laparoscopicpyelolithotomy performed on a 48-year-old man with a left recurrent staghorn renal stone secondary to an ureteropelvic junction obstruction following a grade IV renal trauma several years ago.


Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Muhammad Saifullah ◽  
Hanan Noor ◽  
Muhammad Waqas Iqbal ◽  
Nauman Khalid ◽  
Muhammad Sohail ◽  
...  

Objective: To assess the knowledge and practice patterns among medical officers of DHQ Hospital, Faisalabad in the prevention of recurrent renal stones. Cross sectional study. DHQ hospital, Faisalabad during 01-01-2019 to 30-09-2019. Methods: In this study the medical officers of either gender and age more than 25 years and working in DHQ Hospital, Faisalabad were included. They were assessed on the basis of a designed questionnaire regarding their general practice and knowledge in order to prevent renal stone recurrence. The paper based questionnaire was circulated to medical officers in different departments of the hospital. Results: In this study total 225 medical officers that were included. 135 (60%) of these participants were males and 90 (40%) were females. The mean age of the participants was 29.70±3.21 years. The mean working experience was 4.40±2.18 years. On assessment, 65.67% medical officers had adequate knowledge regarding recurrent renal stone prevention according to latest practice guidelines. Unfortunately 62.22% respondents were not practicing their knowledge adequately. Conclusion: The knowledge regarding the clinical practices in light of recent guidelines was optimal, however the practice regarding the preventive strategies was below power. Keywords; Renal stone, Recurrence, Medical officer, prevention.


2020 ◽  
Vol 23 (1) ◽  
pp. 17-23
Author(s):  
Shiba Prasad Nandy ◽  
AKM Akramul Bari ◽  
Anirban Ghose ◽  
Hasmot Ali Mia ◽  
Md Alamgir ◽  
...  

Introduction and Objective: Laparoscopic surgery is increasingly exercised in urology due to improvements in technical capabilities and experience. It comes with many advantages compared to open surgery such as lesser degree of pain and haemorrhage, shorter hospital stay and better cosmetic results. This study is carried out to evaluate the outcomes and complications of urological laparoscopic surgery cases performed Chittagong Medical College Hospital, Chattogram, Bangladesh. Methods: This was a hospital based prospective observational study of total 29 patients, who received laparoscopic surgery of different kinds between January 2017 and September 2019 for urological causes with a minimum one month follow-up. Included patients were assessed in terms of demographic characteristics, preoperative diagnosis, type of laparoscopic approach, duration of surgery and hospitalization, complications after surgery and need for conversion to open surgery. Results: The mean age was 45.03 years where 12 patients were women and 17 were male. All patients underwent trans-peritoneal procedures where2 patients received renal cyst excision, 4 simple nephrectomy, 5 ureterolithotomy, 9 radical nephrectomy, 1 radical cystectomy, 2 adrenalectomy, 3 pyelolithotomy and 3 pyeloplasty. Three of the 29 patients required conversion to open surgery. Except these patients, no major complication or mortality was encountered. The mean duration of surgery for the most commonly applied procedures were as follows: renal cyst excision 87.5 (70-105) min, simple nephrectomy 141.25 (120-170) min, ureterolithotomy 120 (100-140) min, radical nephrectomy 215.56 (180-260) min, pyelolithotomy 120 (100-140) min, and pyeloplasty 156.67 (130-190) min. The mean hospital stay was 4.59±1.7 (2-8) days. Conclusions: The success and complications rate of the laparoscopic urological surgeries performed in our hospital were consistent with those reported in the literature. In the light of technological advances and increasing experience, we believe that laparoscopic surgery is an effective technique with excellent outcome along with a safe and feasible alternative to open surgery in the field of urology. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.17-23


2021 ◽  
pp. 1-5
Author(s):  
Cesar Britto ◽  
Daniel Pfalzgraf ◽  
Ronnie Lima ◽  
Paulo Medeiros ◽  
Rafael Rebouças ◽  
...  

<b><i>Introduction:</i></b> Transposition of the gracilis has been used in a large number of reconstructive procedures. Its advantage is its proximity to these defects and a good blood supply. Traditionally, the gracilis mobilization is performed by open surgery with one or more incisions. We describe our initial experience with the video-endoscopic mobilization of gracilis. <b><i>Method:</i></b> We described a retrospective review of all patients who underwent gracilis muscle mobilization for treatment of rectourethral fistula, performed by video-endoscopy, between March 2013 and September 2017, for treatment of rectourethral fistula. Also, our surgical technique is described in detail. <b><i>Results:</i></b> Three patients, with a mean age of 66.6 years, underwent the procedures. The mean time for mobilization of the gracilis was 107 min (range 60–145). There was no case of donor area infection, no change in the sensitivity of the medial aspect of the thigh or chronic pain. Conversion to open surgery was not necessary in any case. The hospital discharge occurred in average after 4 days. The bladder catheter was removed after 4 weeks after cystography was performed without evidence of leakage. One patient had a recurrence of the fistula. <b><i>Discussion:</i></b> The gracilis is an excellent choice of tissue to be interposed in reconstructive procedures of the perineal region, especially in the treatment of rectourinary fistulas. However, endoscopic harvest of the gracilis muscle has not yet found its way into everyday practice. The results in the treatment of rectourinary fistulas are excellent, with a success rate of 87.7%. Our rate of 67% is below, probably due to the small number of cases. In open surgery, complications are uncommon; however, approximately half of the patients expressed concern about the painful scar, which can be reduced by minimally invasive access. <b><i>Conclusion:</i></b> Video-endoscopic mobilization of gracilis muscle for the treatment of rectourethral fistula is feasible and safe. Studies comparing this technique with the conventional mobilization are required.


2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
P del Val Ruiz ◽  
S Sanz Navarro ◽  
B Carrasco Aguilera ◽  
C García Bernardo ◽  
A Miyar de Leon ◽  
...  

Abstract INTRODUCTION Laparoscopic liver surgery has undergone a great evolution in recent years, allowing increasingly complex resections without increasing complications and with evident postoperative benefits. Our purpose is to analyze our initial experience in this type of resection. MATERIAL AND METHODS We performed a retrospective observational study analyzing 41 patients who underwent liver resections by laparoscopy in our centre from March 2019 to January 2020. RESULTS The mean age of the patients was 64.5 years (SD 11) with a mean BMI of 27.56 (from 4.59). The most common surgical indication was colon cancer metastasis (41.4%), followed by hepatocarcinoma (36.6%) and usually single lesions (75.6%). The procedure passed without complications except in the case of 5 patients who required conversion to open surgery (12.5%) and 3 patients (7.5%) who required intraoperative transfusion. During the postoperative period 4 patients (9.8%) presented complications and all of them were classified as Clavien-Dindo II. We only reported 1 death (2.4%) in &gt; 90 days, which was not related to the reason for surgery. No reinterventions were necessary during admission and there were no readmissions in the first 30 days after discharge, CONCLUSIONS Laparoscopic liver surgery is technically demanding and requires previous experience in open surgery, as well as specific training, which makes a regulated implementation of the technique necessary.


2018 ◽  
Vol 91 (1) ◽  
pp. 85-91
Author(s):  
Rikki Singal ◽  
Siddharth Dhar

Background. The introduction of endourological procedures such as percutaneous nephrolithotomy and ureterorenoscopy have led to a revolution in the the management of urinary stone disease. The indications for open stone surgery have been narrowed significantly, making it a second- or third-line treatment option.Aims and Objectives. To study the safety and efficacy of retroperitoneal laparoscopic pyelolithotomy in retroperitoneal renal stone. We compared the results of laparoscopic and open surgery in terms of easy accessibility, operative period, renal injuries, and early recovery.Methods. This prospective study was conducted on renal pelvic stone cases from January 2009 to February 2016 in Suchkhand Hospital, Agra, India. The study included a total of 1700 cases with the diagnosis of solitary renal pelvic stones. In group A - 850 cases - retroperitoneal laparoscopic pyelolithotomy was performed, while group B - 850 cases – underwent open pyelolithotomy.Results. The mean operative time was less in group B than group A (74.83 min vs. 94.43 min) which was significant (p<0.001).The blood loss was less in the laparoscopic group than in the open group (63 mL vs. 103mL). There were statistically significant differences in the post-operative pain scores, and postoperative complications compared to group B (p<0.001). The mean hospital stay was less in group A (p<0.03), which was significant.Conclusion. Laparoscopic surgery reduces analgesic requirements, hospital stay, and blood loss. The disadvantages include the reduced working space, the cost of equipment and the availability of a trained surgeon.


2019 ◽  
Vol 18 (2) ◽  
pp. 42-47
Author(s):  
Bikash Bikram Thapa ◽  
Bina Basnet ◽  
Bikash Bahadur Rayamajhi ◽  
Narayan Thapa ◽  
Bharat Bhadur Bhandari

Introduction: Since its introduction in 1976, percutaneous renal stone surgery has undergone several modifications. Reduction in size of access sheath was one of them which was first reported by Jackman in 1998. The miniaturisation of access sheath in Mini-Percutaneous Nephrolithotomy surgery has significantly reduced the intervention related morbidity with similar outcome as of standard Percutaneous Nephrolithotomy. Methods: This is a prospective cohort study where a single surgeon without previous experience of independent PCNL surgery performed Mini PCNL under controlled condition for renal stone sized 10 to 30 mm. The outcome was measured in terms of stone free rate and postoperative complications. The association of stone free rate and drop in haemoglobin level with different preoperative and operative variables were calculated with Pearson’s correlation test and p value <0.05 was considered significant. Results: Mini PCNL was performed in total of 63 renal units. The mean age was 37.8 ± 9.9 years with male: female ratio of 1.8:1. The average stone size was 16.8 ± 2.9 mm. The mean operative time was 55.2 ± 19.0 (30-110) minutes. The stone free rate was 98.2 ± 3.6 %. The mean drop in haemoglobin was 1.3 ± 0.8 and blood transfusion rate was 4.7%. The average hospital stay was 2.6 ± 1.3 days. The grade I complications was 15.8% and grade II and III was 7.9% each. Stone free rate was significantly associated with stone number (r = -0.47, p = 0.004). Similarly fall in haemoglobin was associated with total operative time (r = 0.49, p = 0.003). The stone size, hardness of stone (HU) and size of access sheath had no significant association with stone free rate and fall in haemoglobin. Conclusions: Mini PCNL is as effective as standard PCNL with higher safety margin in small and medium size stone (10 to 30 mm) during learning curve of endo-urology procedure.  


2021 ◽  
Vol 9 (B) ◽  
pp. 36-41
Author(s):  
Trung Duong ◽  
Trinh Hoang Hoan ◽  
Hoang Nguyen ◽  
Quan Tran

AIM: This study assesses the results of treatment using the mini-percutaneous nephrolithotipsy (PCNL) procedure on renal stone patients in a lateral position under ultrasound guidance, performed at the Ha Noi Hospital of Post and Telecommunications. METHODS: The study was conducted with 650 kidney stone patients who were treated using the ultrasound-guided mini-PCNL procedure in a lateral position, at the Ha Noi Hospital of Post and Telecommunications, over the period from June 2018 to June 2019. RESULTS: For the 650 patients, the mean age was 47.3 ± 7.6 (from 21 to 91 years old); the mean size of stones: 19.4 ± 1.2 mm (from 12 mm to 60 mm); the mean operative time: 49.3 minutes (from 37 to 90 min); the mean period of hospitalization: 3.9 days (from 3 to 12 days); the mean stone-free rate (SFR): 90.6%; the rate of second surgery: 1.07%; hemorrhage complication: 0.8%; urinary tract infections: 7.7%; septicemia: 0.6%; administered open surgery: 0.46%; and administered other methods: 0.76%. CONCLUSION: Renal stone fragmentation using the mini-PCNL procedure, performed on patients placed in lateral position under ultrasound guidance, is a method that is effective, beneficial, and safe for patients with renal stones and upper ureteral stones.


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