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 Renal stones

2018 ◽  
Vol 56 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Adie Viljoen ◽  
Rabia Chaudhry ◽  
John Bycroft
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Renal Stone ◽  
Surgical Intervention ◽  
Recurrent Disease ◽  
Renal Stones ◽  
Evidence Base ◽  
Stone Disease ◽  
Significant Morbidity ◽  
Renal Stone Disease

Renal stone disease is a worldwide problem which carries significant morbidity. It frequently requires specialist urology intervention. Patients with recurrent disease and those at high risk require specialist investigations and review. Certain cases benefit from medical and surgical intervention. In this review, we discuss the pathophysiology, risk assessment, specialist investigations and various interventions, their rationale and evidence base. This review aims to provide an update of the previous publication in 2001 in this journal on this topic.

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.  

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
Keyword(s):  
Open Surgery ◽  
Renal Stone ◽  
Urinary Infection ◽  
Renal Stones ◽  
Stone Size ◽  
Conversion To Open Surgery ◽  
Laparoscopic Pyelolithotomy ◽  
Post Operation ◽  
The Mean ◽  
Selection Of

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

scholarly journals Gas-Containing Renal Stones: A Case Report and Literature Review

2020 ◽  
pp. 1-3
Author(s):  
Lim Tze Ying Benjamin ◽  
Lim Tze Ying Benjamin ◽  
Lim Sey Kiat ◽  
Koh Li-Tsa
Keyword(s):  
Escherichia Coli ◽  
Lower Urinary Tract ◽  
Renal Stone ◽  
Urine Culture ◽  
Renal Stones ◽  
E Coli ◽  
Urinary Tract Symptoms ◽  
Staghorn Stone ◽  
Lower Urinary

We report the 11th case of gas containing renal stone. A 92-year-old Chinese female presented with fever and lower urinary tract symptoms. Urine culture grew Escherichia coli (E. coli). CT abdomen pelvis showed a large gas containing partial staghorn stone. She was managed conservatively with two weeks of antibiotics. Follow up plain kidney, ureter and bladder (KUB) radiograph at 3 months showed that the stone was stable in size. She remained asymptomatic at follow up.

Use of non-contrast computed tomography determined urinary stone fragility in predicting the outcome of extracorporeal shockwave lithotripsy treatment: a single-center study

2020 ◽  
Vol 14 (2) ◽  
pp. 59-63
Author(s):  
Athar Hameed ◽  
Khazir Hayyat Gondal
Keyword(s):  
Shock Waves ◽  
Renal Stone ◽  
Plain Film ◽  
Renal Stones ◽  
Renal Calculus ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Fisher Exact Test

Background: Renal stones represent a common urological pathology where standard treatment advised is ESWL in current practice. However, NCCT based determination of stone fragility may help to predict the outcome of ESWL treatment, hence optimizing its clinical use. Therefore, this study evaluated the role of NCCT determined urinary stone fragility in predicting the outcome of ESWL treatment in local clinical settings. Patients and methods: One hundred patients with single renal calculus of 0.6-2 cm in size were included. NCCT based determination of stone fragility in HU units was done for all patients. Patients were then subjected to ESWL, with a maximum of 3000 shock waves given per ESWL session. Plain film and/or ultrasonography was used to monitor ESWL treatment progress with a final NCCT evaluation at 12 weeks to determine the clearance of the calculi for each patient. Association of NCCT based stone fragility and outcome of ESWL was statistically analyzed using Fisher exact test. Results: The mean age of the patients was 37.7 ± 10.9 years with 54% being male. Decreasing stone fragility on NCCT (high = <500HU, moderate = 500-1000HU, and high = 1000HU) required more number and intensity of ESWL sessions (1-2 visits and 3000-6000 shock waves for high stone fragility group, 3-5 visits and 7000-18000 shock waves for the moderate group, and 6 visits and >18000 shock waves for low fragility group, respectively) necessary for clearance of urinary stones (p<0.001). In 98% of patients, the clearance of urinary stones was excellent. Conclusion: Renal stone patients with NCCT determined high and moderate stone fragility show an optimal response after ESWL treatment, whereas, for low fragility renal stones attenuative treatment like percutaneous nephrolithotomy and/or ureteroscopy should be considered instead of ESWL. This approach can enable patient stratification before ESWL therapy ensuring better clinical management of the renal stone disease.

scholarly journals Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Size ◽  
Intraoperative Complication ◽  
Safety And Efficacy ◽  
Single Center Experience ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean

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.

scholarly journals Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098313
Author(s):  
Tie Mao ◽  
Na Wei ◽  
Jing Yu ◽  
Yinghui Lu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Efficacy And Safety ◽  
Complementary Treatment ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Free Rate

Background We aimed to compare the efficacy and safety of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) for treating renal stones larger than 2 cm. Methods We searched the PubMed, Embase, Web of Science, SinoMed, and Chinese National Knowledge Infrastructure databases for studies that compared the surgical outcomes of LPL and PCNL. We conducted a meta-analysis of the retrieved studies, expressed as weighted mean difference or risk ratios with 95% confidence intervals. Results We included 25 studies (1831 patients). LPL was associated with a significantly higher stone-free rate, lower rates of blood loss, complementary treatment, blood transfusion, and complications, and less reduction in hemoglobin level compared with PCNL. LPL and PCNL were similar in terms of duration of hospital stay, conversion rate, changes in glomerular filtration rate and creatinine level, and mean time of postoperative analgesia. However, LPL was associated with a longer operation time than PCNL. Conclusion LPL appears to be more effective and safer than PCNL in patients with large renal stones, by increasing the stone-free rate and reducing blood loss, complementary treatment, blood transfusion, and complications compared with PCNL. LPL may thus be a useful modality for treating patients with large renal stones.

scholarly journals A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2 cm

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Janak Desai ◽  
Guohua Zeng ◽  
Zhijian Zhao ◽  
Wen Zhong ◽  
Wenzhong Chen ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Urinary Calculi ◽  
Renal Stones ◽  
Laser Lithotripsy ◽  
Complication Rates ◽  
Modified Technique ◽  
Average Operative Time ◽  
Grade Ii ◽  
The Mean ◽  
Metal Sheath

Objectives. To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6 Fr mininephroscope through an 11–13 Fr metal sheath to perform holmium: YAG laser lithotripsy.Methods. The medical records of 36 patients with moderate-sized (<20 mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status.Results. The mean stone size was 14.9 ± 4.1 mm (rang: 6–20). The average operative time was 59.8 ± 15.9 (30–90) min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2–5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion.Conclusions. UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

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