scholarly journals Robotic Surgery for Large Renal Stones: Prospective Three Years Single-Institution Experience

2015 ◽  
Vol 22 (2) ◽  
pp. 31-37
Author(s):  
Ahmed J. Al Sayyad
Keyword(s):  
Robotic Surgery ◽  
Renal Stone ◽  
Ureteropelvic Junction Obstruction ◽  
Treatment Options ◽  
Renal Stones ◽  
Renal Calculi ◽  
Single Institution ◽  
Renal Stone Surgery ◽  
Robotic Pyelolithotomy

This prospective study evaluates the role of robotic surgery in the management of large renal stones.  Robotic renal stone surgery is safe and effective, and may be considered among the treatment options for large renal calculi in adults, especially for patients with concomitant ureteropelvic junction obstruction.  The benefits brought by robotic systems include improved 3-D visualization, greater dexterity, precision, and increased range of motion.  Thus, robotic pyelolithotomy has been recommended for the treatment of renal calculi with concurrent upper tract abnormalities.  The efficacy and safety of robotic pyelolithotomy as a treatment of large renal pelvic stones and partial staghorn stones is evident in our study, with a substantially high stone clearance rate.  We were able to complete the robotic procedures safely and successfully in all but one of our 38 patients, who was converted to open surgery due to bleeding and severe adhesions.  Overall, we found this procedure feasible, safe, efficacious, and high yielding in the management of large renal stones, especially when the procedure is accompanied by renal pelvis reconstructive surgery.  

scholarly journals Laparoscopic management of a large staghorn stone

2013 ◽  
Vol 6 (3) ◽  
pp. E121-E124
Author(s):  
Patrick Richard ◽  
Mathieu Bettez ◽  
Arold Martel ◽  
Yves Ponsot ◽  
Robert Sabbagh
Keyword(s):  
Economic Impact ◽  
Surgical Management ◽  
Renal Stone ◽  
Ureteropelvic Junction Obstruction ◽  
Urinary Calculi ◽  
Renal Stones ◽  
Significant Morbidity ◽  
Viable Option ◽  
Laparoscopic Pyelolithotomy ◽  
Staghorn Stone

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.

scholarly journals Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2728 ◽  
Author(s):  
Jiaqiao Zhang ◽  
Chuou Xu ◽  
Deng He ◽  
Yuchao Lu ◽  
Henglong Hu ◽  
...  
Keyword(s):  
Renal Stone ◽  
Operation Time ◽  
Renal Stones ◽  
Renal Calculi ◽  
Good Prognosis ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Ureteral Stenting ◽  
Free Rate

Purpose To clarify the outcome of flexible ureteroscopy (fURS) for management of renal calculi without preoperative stenting. Methods A total of 171 patients who received 176 fURS procedures for unilateral renal stones were reviewed. All procedures were divided into two groups depending on whether they received ureteral stenting preoperatively. Baseline characteristics of patients, stone burden, operation time, stone-free rates, and complications were compared between both groups. Results Successful primary access to the renal pelvis was achieved in 104 of 114 (91.2%) patients without preoperative stenting, while all procedures with preoperative stenting (n = 62) were successfully performed. A total of 156 procedures were included for further data analysis (56 procedures in stenting group and 100 in non-stenting group). No significant differences was found regardless of a preoperative stent placement in terms of stone-free rate (73.2% with stenting vs. 71.0% without, P = 0.854), operative time (70.4 ± 32.8 with stenting vs. 70.2 ± 32.1 without, P = 0.969). Conclusions fURS for management of renal stone without preoperative ureteral stenting are associated with well outcome in short term follow-up. Our study may help patients and doctors to decide if an optional stent is placed or not.

Ureteropelvic junction obstruction and coexisting renal calculi in children: role of metabolic abnormalities

Urology ◽  
2001 ◽  
Vol 57 (3) ◽  
pp. 542-545 ◽  
Author(s):  
Ali Tekin ◽  
Serdar Tekgul ◽  
Necmettin Atsu ◽  
Ali Ergen ◽  
Sezer Kendi
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Renal Calculi ◽  
Ureteropelvic Junction ◽  
Metabolic Abnormalities

scholarly journals Retrograde Intrarenal Surgery in Patients Who Previously Underwent Open Renal Stone Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Erdal Alkan ◽  
Ali Saribacak ◽  
Ahmet Oguz Ozkanli ◽  
Mehmet Murad Başar ◽  
Oguz Acar ◽  
...  
Keyword(s):  
Renal Stone ◽  
Perioperative Complications ◽  
Renal Stones ◽  
Control Group ◽  
Complication Rates ◽  
Retrograde Intrarenal Surgery ◽  
Renal Stone Surgery ◽  
Recorded Data ◽  
Group 2 ◽  
Control Group Group

Purpose. To ascertain whether retrograde intrarenal surgery (RIRS) is as effective in patients treated previously with open renal stone surgery (ORSS) on the same kidney as in patients with no previous ORSS.Methods. There were 32 patients with renal stones who had previous ORSS and were treated with RIRS in the study group (Group 1). A total of 38 patients with renal stones who had no previous ORSS and were treated with RIRS were selected as the control group (Group 2). Recorded data regarding preoperative characteristics of the patients, stone properties, surgical parameters, outcomes, SFRs (no fragments or small fragments <4 mm), and complications between groups were compared.Results. Mean age, mean BMI, mean hospital stay, and mean operative time were not statistically different between groups. Mean stone size (10.1 ± 5.6 versus 10.3 ± 4.2;p=0.551) and mean stone burden (25.4 ± 14.7 versus 23.5 ± 9.9;p=0.504) were also similar between groups. After the second procedures, SFRs were 100% and 95% in groups 1 and 2, respectivelyp=0.496. No major perioperative complications were seen.Conclusion. RIRS can be safely and effectively performed with acceptable complication rates in patients treated previously with ORSS as in patients with no previous ORSS.

The Predictive Role of Abdominal Fat Parameters and Stone Density on SWL Outcomes

2020 ◽  
Vol 16 (1) ◽  
pp. 80-87
Author(s):  
Coskun Kaya ◽  
Yurdaer Kaynak ◽  
Aral Karabag ◽  
Aykut Aykaç
Keyword(s):  
Predictive Factors ◽  
Renal Stones ◽  
Renal Calculi ◽  
Abdominal Fat ◽  
Ureteral Stones ◽  
Stone Size ◽  
X Ray ◽  
Extracorporeal Shock Wave ◽  
Stone Density

Background: Our aim was to detect the role of radiological abdominal fat parameters by tomography and stone density by plain X-ray on extracorporeal Shock Wave Lithotripsy (SWL) stone-free rate. Methods: The patients who had undergone SWL for a single opaque renal stone < 2 cm in diameter and proximal ureteric stone < 1 cm in diameter were collected retrospectively. The characteristics of patients and stones were recorded. The stone attitude, HU, abdominal fat parameters, paraperirenal fat area, perirenal infiltration and severity of hydronephrosis with pre-treatment Non- Contrast Computed Tomography (NCCT) and stone density with radiography were evaluated by a radiologist. Four weeks after the last SWL; all patients were evaluated by plain X-ray and categorized as Stone Free (SF) and Residual Fragment (RF) group. Results: 51 patients with renal stones and 88 patients with proximal ureteral stones were included in the study. 24 (47%) and 63 (71%) patients were classified as SFfor renal and ureteral stones respectively. Only stone size was an independent predictor for stone-free rates after SWL for renal and proximal ureteral stones on multivariate analysis. The Receiver Operating Characteristic (ROC) curves for renal calculi revealed that creatinine level, stone size, stone attitude, Houns-Field Unit (HU) and Skin-to-Stone Distance (SSD) were the predictive factors for the SWL outcome (p< 0.05). The ROC curve for ureteral calculi demonstrated that HU, stone size and attitude were the predictive factors (p< 0.05). Conclusion: All abdominal fat parameters and the stone density were not related to SWL failure. A large follow-up with more patients is essential to confirm the role of radiological parameters on the outcome of SWL.

Does Previous Open Renal Stone Surgery Affect the Outcome of Extracorporeal Shockwave Lithotripsy Treatment in Adults with Renal Stones?

2017 ◽  
Vol 31 (12) ◽  
pp. 1295-1300 ◽  
Author(s):  
Mehmet Hamza Gültekin ◽  
Fethi Ahmet Türegün ◽  
Burak Ozkan ◽  
Beril Tülü ◽  
Gamze Gül Güleç ◽  
...  
Keyword(s):  
Renal Stone ◽  
Renal Stones ◽  
Extracorporeal Shockwave Lithotripsy ◽  
Shockwave Lithotripsy ◽  
Extracorporeal Shockwave ◽  
Renal Stone Surgery

In Vitro Models for Studying Renal Stone Formation: A Clear Alternative

1998 ◽  
Vol 26 (4) ◽  
pp. 481-503
Author(s):  
Felix Grases ◽  
Rafael M. Prieto ◽  
Antonia Costa-Bauzá
Keyword(s):  
Renal Stone ◽  
Stone Formation ◽  
Renal Stones ◽  
Renal Calculi ◽  
In Vitro Models ◽  
Laboratory Animals ◽  
In Vitro Experiments ◽  
Experimental Conditions

This paper discusses the limitations of using laboratory animals for direct in vivo observation of the development of renal stones. In fact, the majority of hypotheses related to mechanisms of stone formation have been based on the results of in vitro experiments. The relevance of in vitro experiments that allow the study of urolithiasis depends upon the degree of correspondence between the experimental conditions and those prevailing in the stone-forming kidney in vivo. For this reason, several in vitro experimental systems that attempt to reproduce the conditions found in vivo have been developed in order to study renal stone formation, which have been classified into two main groups: a) models to study papillary stone formation; and b) models to study “sedimentary” stone formation. These models are briefly described in this paper, and the information obtained was compared with that resulting from a study of the fine structure of real human renal calculi, in order to prove the validity of the models. It was concluded that the experimental in vitro models can closely reproduce the renal conditions under which human calculi are developed. This allows important data to be obtained about the aetiology of renal lithiasis, which is of great relevance to the development of effective treatments for this disease. Therefore, experimental in vitro models constitute a clear alternative to the use of laboratory animals.

scholarly journals The various metabolic factors involved in stone recurrence: a prospective study

2020 ◽  
Vol 7 (2) ◽  
pp. 393
Author(s):  
Jitendra Kumar Singh ◽  
Sanjay Singh ◽  
A. Maha Devan ◽  
Anish Kola
Keyword(s):  
Dietary Restriction ◽  
Renal Stone ◽  
Urine Analysis ◽  
Stone Formation ◽  
Renal Stones ◽  
Renal Calculi ◽  
Potassium Citrate ◽  
Metabolic Factors ◽  
Medical College ◽  
A Prospective Study

Background: Nephrolithiasis is the most common chronic kidney condition, is globally increasing in both sexes. Five main types of renal stones viz., calcium oxalate stones, calcium phosphate stones, uric acid stones, struvite stones and cystine stones. Purpose of the study is to evaluate various metabolic factors contributing to recurrent renal stone and determining appropriate medical treatment and diet modification to prevent recurrent renal stone disease.Methods: This study was carried out in P.G. Department of Surgery, S.R.N. Hospital associated with M.L.N. Medical College, Allahabad. A total of 120 cases of recurrent renal calculi in and outpatient between August 2017 and July 2019 were included in the study. All patients were stone free at the time of metabolic urine evaluation.Results: Most of the patients in the study were in the age 21 to 50 years. 80% were males and 20% were females. In 24-hour urine analysis most common metabolic abnormality seems to be hyperoxaluria (92.5%) followed by hypercalciuria (82.5%), high pH (67.5%), and least common seems to be hypocitraturia (15%), followed by hyperphosphaturia (20%), hypernatreturia (25%), and low level of potassium (25%).Conclusions: All patient of recurrent stone formation are advised increase fluid intake. In patient with hypercalciuria and hypocitraturia, dietary restriction of protein, oxalate and sodium, treatment includes thiazides supplemented with potassium citrate. In patient with hyperoxaluria dietary restriction of oxalate rich food and in hyperuricosuria dietary restriction of animal protein is advised. 

scholarly journals Percutaneous nephrolithotomy through superior calyceal approach - our experience

Pulse ◽  
1970 ◽  
Vol 3 (1) ◽  
pp. 4-6
Author(s):  
AU Shaikh ◽  
R Biswas ◽  
NUM Arif ◽  
N Miah ◽  
W Zaman
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Invasive Procedure ◽  
Renal Stones ◽  
Renal Calculi ◽  
Stone Size ◽  
Stone Clearance ◽  
X Ray ◽  
Percutaneous Punctures ◽  
Main Complication

Introduction: Percutaneous Nephrolithotomy (PCNL) is considered the treatment of choice for large (> 2 cm size) renal stones at present. Aim of this study was to evaluate the results of PCNL as monotherapy in our centre which were done through superior calyceal approach.Materials and Methods: Seventy five patients with three bilateral renal stone (total 78 renal units) that underwent PCNL through superior calyceal approach at Apollo Hospitals Dhaka from May 15, 2005 to December 15, 2007 were included in this retrospective study. Selected patients had renal stones more than 2 cm in size (average stone size 35 mm and surface area 750 mm2). Ultrasonogram, intravenous urogram and in some selected cases CT scan were done to detect the location and size of the stone. Urologist performed percutaneous punctures through superior calyx in prone position under fluoroscopic guidance and general anaesthesia were employed in all cases. Post-operative stone clearance was documented on plain X-ray KUB and ultrasonogram KUB.Results: PCNL was successfully (complete stone clearance and insignificant residue) carried out in 68 patients (69 renal units). Average stone clearance was 88.46%. No second look procedures were needed. Uro-sepsis was the main complication, occurred in 9 renal units (11.53 %) while urinary leakage/ fistula in 6.41%, significant bleeding in 6 renal units (7.69 %) and pleural breach with fluid in pleural cavity (hydrothorax) in 2 (2.6 %) cases. Mean blood transfusion was 1.2 units and mean hospital stay was 67 hours.Conclusion: Monotherapy with PCNL is highly effective in the treatment of large volume renal calculi and staghorn calculi using superior calyceal supracostal and subcostal approach. As a minimally invasive procedure, it is quite safe in experienced hand.Keywords: Percutaneous nephrolithotomy, Renal stone, Superior calyceal puncture, Staghorn calculiDOI: 10.3329/pulse.v3i1.6543Pulse Vol.3(1) July 2009 p4-6

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