A Simple Modification for the Usage of Flexible Cystoscope in Modified Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction with Renal Calculi: A Flexible Guiding Tube

Hong, Peng; Li, Ziao; Zhu, Dongdong; Zhuang, Liyan; Yang, Kun‐Lin; Hao, Han; Li, Xuesong; Zhou, Liqun

doi:10.1159/000495569

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…The time to get out of bed referred to the time it takes from the end of the operation to the first time to get out of bed. The stone clearance rate was recorded and analyzed when the patient was discharged [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Effects of Laparoscopic Surgery and Traditional Open Surgery on Stone Clearance, Laboratory Indexes and Life Quality in Patients with Renal Calculi

Ai¹,

Dong²,

Li³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. A case-control study was conducted to determine the effectiveness of laparoscopic surgery and traditional open surgery on stone clearance, laboratory indexes, and life quality in patients with renal calculi. Methods. During March 2017 to March 2022, 272 patients with complex renal calculi (CRC) cured in our hospital were assigned into control group ( n = 136 ) and research group ( n = 136 ) arbitrarily. The former accepted traditional open surgery, while the latter accepted laparoscopic surgery. The operation time, intraoperative blood loss, hospital stay, and time of getting out of bed were compared. The degree of postoperative incision pain was assessed by visual analogue scale (VAS). The life quality was assessed by the Comprehensive Assessment Questionnaire-74 (GQOL-74). The indexes of renal function and urine metabolism were measured. Then, the postoperative stone clearance rate and complications were calculated. Results. Operation time, blood loss intraoperatively, time out of bed, and hospitalization were all remarkably reduced in the research group, and the difference was statistically significant ( P < 0.05 ). The complete stone clearance rates in study and control cohorts were 75.73% and 63.24%, respectively. The VAS scores were lessened after the operation. Compared with the two groups, the VAS scores of the research group were remarkably lower at 1 to 2 weeks and 1 and 3 months after the operation, and the difference was statistically significant ( P < 0.05 ). One week after operation, the levels of β 2-microglobulin (β 2-MG), N-acetyl-β-glucosaminidase (NAG), and renal injury molecule-1 (kidney injury molecule-1, Kim-1) in the research group were remarkably lower. The levels of urinary β 2-MG, NAG, and KIM-1 in the research group were remarkably lower, and the difference was statistically significant ( P < 0.05 ). One week after operation, the levels of urinary oxalic acid, uric acid, and urinary calcium lessened averagely. The levels of urinary oxalic acid, uric acid, and urinary calcium in the research group were lower, and the difference was statistically significant ( P < 0.05 ). The quality-of-life scores were compared. One week after the operation, the scores of physical function, psychological function, social function, and material function were all augmented, and the difference was statistically significant ( P < 0.05 ). The incidence of complications was 9.56% and 2.21%, respectively. The incidence of complications in the research group was lower, and the difference was statistically significant ( P < 0.05 ). Conclusion. Laparoscopic surgery is successful when treating CRC, which is superior to invasive surgery in postoperative complications, stone clearance rate, improvement of postoperative renal function, and life quality. It is one of the ideal treatment methods for CRC. However, the role of open surgery when treating CRC cannot be ignored. This needs to be further confirmed by large samples of randomized controlled trials.

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Section: Methodsmentioning

confidence: 99%

Comparison of the Effects of Laparoscopic Surgery and Traditional Open Surgery on Stone Clearance, Laboratory Indexes and Life Quality in Patients with Renal Calculi

Ai¹,

Dong²,

Li³

et al. 2022

Computational and Mathematical Methods in Medicine

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“…c DJ stent placement. [15]. The median stricture length was 3 cm (range 2-5 cm) according to the intraoperative measurement.…”

Section: Resultsmentioning

confidence: 99%

Modified Laparoscopic and Robotic Flap Pyeloplasty for Recurrent Ureteropelvic Junction Obstruction with a Long Proximal Ureteral Stricture: The “Wishbone” Anastomosis and the “Ureteral Plate” Technique

Cheng

Yang

et al. 2021

Urol Int

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Objectives: The aim of the study was to present our modified flap pyeloplasty techniques for recurrent ureteropelvic junction obstruction (UPJO) with a long proximal ureteral stricture and compare outcomes of laparoscopic and robotic procedures. Materials and Methods: Between March 2018 and January 2020, 21 patients underwent modified laparoscopic or robotic flap pyeloplasty for recurrent UPJO with a long proximal ureteral stricture. Our surgical modifications included the “wishbone” anastomosis and “ureteral plate” technique. Demographic, perioperative, and follow-up data were recorded and compared retrospectively between the groups. Success was defined as subjective pain alleviation and hydronephrosis improvement. Results: Thirteen modified laparoscopic flap pyeloplasty (mLFP) and 8 modified robotic flap pyeloplasty (mRFP) were performed successfully without conversion. mRFP tended to have shorter overall operative time (142.4 vs. 179.1 min, p = 0.122) and anastomosis time (43.1 vs. 61.0 min, p = 0.093) than mLFP. No difference was found in estimated blood loss (p = 0.723) and pararenal draining time (p = 0.175) between the groups. The mean postoperative hospital stay of mRFP was significantly shorter than that of mLFP (5.0 vs. 8.2 days, p = 0.015). No major complications occurred. During the mean follow-up of 17.9 months, the overall success rate was 90.5%, and there was no significant difference between 2 groups. Conclusions: The modified flap pyeloplasty could be considered a practical and effective treatment option with a high success rate for recurrent UPJO with a long proximal ureteral stricture, and the robotic procedures showed advantages of higher efficiency and faster recovery.

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“…Compared with that in Group A, the traditional open surgery group, the stone clearance rate in Group C was significantly higher but lower than that in groups B and D. In addition, we also found that the bleeding volume, complication rate, VAS score, and LOS were significantly lower in Group C than in Groups A and B, demonstrating that the flexible cystoscope was a less invasive operation method. However, there is still a deficiency of this technique, as the use of flexible guiding tubes increase the operation time, the complexity of the procedure and the difficulty of controlling the flexible cystoscope [ 14 ]. In addition, plenty of washing fluid is needed and timely clearance of washing fluid is necessary to decrease the incidence of extravasation related perirenal infection.…”

Section: Discussionmentioning

confidence: 99%

Treatment of ureteropelvic junction obstruction in patients with renal calculi via laparoscopic pyeloplasty and flexible vacuum-assisted ureteral access sheath ureteroscopy: a multicenter retrospective observational study

Mi,

Kang,

Wang

et al. 2024

BMC Urol

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Background Ureteropelvic junction obstruction (UPJO) is a common obstructive disease of the urinary tract. UPJO patients commonly exhibit coexistent renal calculi. The main aim of therapy is to relieve the obstruction and remove the stones at the same time. Methods This retrospective study included 110 patients diagnosed with UPJO coexisting with multiple renal calculi at Shanxi Bethune Hospital and the First Hospital of Shanxi Medical University between March 2016 and January 2022. Patients were divided according to the methods used for dealing with UPJO and renal calculi. In Group A, patients underwent traditional open pyeloplasty and pyelolithotomy. In Group B, patients underwent percutaneous nephrolithotomy first and then laparoscopic pyeloplasty. In Group C, patients underwent flexible cystoscopy to remove stones and then laparoscopic pyeloplasty. In Group D, patients underwent flexible vacuum-assisted ureteral access sheath (FV-UAS)assisted flexible ureteroscopy (f-URS) and underwent laparoscopic pyeloplasty. The stones were broken up using a holmium laser. The pyeloplasty success rate, stone clearance rate, operation time, bleeding amount, complication occurrence rate, postsurgical pain, length of stay, and hospitalization cost were compared between the groups. The follow-up period was at least 2 years. Results The use of f-URS and the FV-UAS, significantly increased the renal stone clearance rate and significantly reduced the complication incidence and operation time in UPJO patients with multiple coexisting renal calculi. Conclusions Laparoscopic pyeloplasty combined with f-URS and FV-UAS is safe and effective for treating UPJO in patients complicated by renal caliceal stones. Trial registration Retrospectively registered.

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A Simple Modification for the Usage of Flexible Cystoscope in Modified Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction with Renal Calculi: A Flexible Guiding Tube

Cited by 9 publications

References 33 publications

Comparison of the Effects of Laparoscopic Surgery and Traditional Open Surgery on Stone Clearance, Laboratory Indexes and Life Quality in Patients with Renal Calculi

Comparison of the Effects of Laparoscopic Surgery and Traditional Open Surgery on Stone Clearance, Laboratory Indexes and Life Quality in Patients with Renal Calculi

Modified Laparoscopic and Robotic Flap Pyeloplasty for Recurrent Ureteropelvic Junction Obstruction with a Long Proximal Ureteral Stricture: The “Wishbone” Anastomosis and the “Ureteral Plate” Technique

Treatment of ureteropelvic junction obstruction in patients with renal calculi via laparoscopic pyeloplasty and flexible vacuum-assisted ureteral access sheath ureteroscopy: a multicenter retrospective observational study

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