Comparison of mean operative time in patients undergoing Ho: YAG laser lithotripsy and pneumatic lithotripsy in ureterorenoscopy for ureteric calculus

Sajid, Muhammad; Ameen, Mohammad; Murtaza, Badar; Alvi, Muhammad Sarwar; Khan, Zahid Mehmood; Kiani, Faran

doi:10.12669/pjms.37.2.3049

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…For calculating lithotripsy, duration there's no standardized method, an RCT compared pneumatic and Ho: YAG Laser and evaluate complete operation time mentioning increased duration in the pneumatic group by 18±3.4 difference between the group. The lithotripter activation time of this study is 32.3±3.8 versus 30.8±3.7 in pneumatic and laser group respectively with a p-value of 0.1, which is like referenced researches 16,17 . Upon dividing the procedure time with stone characteristics to evaluate the variation, the location of stones showed elevated lithotripsy time in proximal ureter with a difference of 10 minutes.…”

Section: Resultssupporting

confidence: 55%

Comparing Holmium (Ho): YAG Laser with Pneumatic Lithoclast for Treatment Efficacy of Ureteric Stones

2022

PJMD

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Background: Holmium YAG (yttrium-aluminum-garnet) laser, a comparatively new technique, can clear all types and sizes of stones and is only being used in two institutes of Karachi, Pakistan. The study aimed to compare pneumatic lithoclast and holmium YAG laser, to evaluate stone-free rate (SFR), postoperative complications, operative duration, and effectiveness. Methods: This cross-sectional research included 60 patients with age 16-65 years having ureteric stones, reporting to kidney center, Urology Department, Karachi, Pakistan. CT Scan of Kidneys, Ureter, and Bladder (KUB) were used to record stone size, laterality, and location within the ureter. Patients were divided into two clusters of 30 each, group A (Ho: YAG laser) and group B (pneumatic Lithoclast) having 0.5 to 02 cm of size ureteric stones. An Independent two-sample “t” test was used to assess the difference for the continuous variables. A p-value of ≤0.05 was considered statistically significant. Results: Stone sizes distribution was 1.3±0.3cms and 1.4±0.3cms for A and B groups respectively (p=0.8). The insignificance of the p-value demonstrated no substantial divergence between both groups and stone sizes. Clearance from the proximal ureter was noted 26(84.6%) in group A and 41.7% in group B with (p<0.05). A reduced lithotripsy activation period of 30.8±3.7mins was associated with stone size (p<0.05). Conclusion: Holmium: YAG Laser had better stone-free rate (SFR), with 84% clearance than pneumatic. Improved and effective clearance reduces the risk of residual stones within a lesser time, required for getting back to normal life routines. Keywords: Lasers; Ureteric Stones; Ho: YAG Laser; Pneumatic Lithoclast; Kidney Stones.

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Section: Resultssupporting

confidence: 55%

Comparing Holmium (Ho): YAG Laser with Pneumatic Lithoclast for Treatment Efficacy of Ureteric Stones

2022

PJMD

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“…Ultrasoundguided PCNL has the advantages of higher success rate of single needle puncture, fewer puncture times and shorter puncture time. 21 Lazarus et al 22 believed that ultrasound guided puncture could significantly reduce the puncture time and the number of puncture statistically. It was confirmed in our study that compared with X-ray guidance, ultrasound-guided PCNL significantly reduced the operation time, channel establishment time, channel number and blood loss (p<0.05).…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound-guided PCNL has the advantages of higher success rate of single needle puncture, fewer puncture times and shorter puncture time. 21 Lazarus et al 22 believed that ultrasound guided puncture could significantly reduce the puncture time and the number of puncture statistically.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of ultrasound-guided percutaneous nephrolithotripsy and x-ray-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi without hydronephrosis

Xue¹,

Zhang

Luo³

et al. 2022

Pak J Med Sci

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Objective: To compare and analyze the clinical effects of ultrasound-guided percutaneous nephrolithotripsy and X-ray-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi without hydronephrosis. Methods: Eighty patients with multiple stones without hydronephrosis were admitted at Department of Ultrasound Diagnosis, The first medical center of Chinese PLA General Hospital from January 21, 2020 to December 21, 2020 randomly divided into two groups: experimental group and control group, with 40 cases in each group. Patients in the experimental group were treated with ultrasound-guided percutaneous nephrolithotomy, while those in the control group were treated with X-ray-guided percutaneous nephrolithotomy. The differences in operation time, channel establishment time, channel number, blood loss and stone clearance rate between the two groups were compared and analyzed. Venous blood was drawn before surgery and on the first day after surgery, and serum creatinine, urea nitrogen, blood β2-microglobulin, blood uric acid and other renal indexes were detected. Moreover, renal parenchymal injury was compared between the two groups by renal static imaging, and the incidence of postoperative complications such as pain, fever, urination through incision and injury of surrounding organs were compared and analyzed. Results: The operation time, channel establishment time, channel number and blood loss in the experimental group were significantly lower than those in the control group, with statistically significant differences (p<0.05). The postoperative renal injury score of the experimental group was 1.03±0.37, which was lower than 1.85±0.63 of the control group (p=0.00); Postoperative Cr, BUN, blood β 2-microglobulin and other indicators in the control group were significantly higher than those in the experimental group, with statistically significant differences (p<0.05). The incidence of peripheral organ injury in experimental group was lower than that in control group, with a statistically significant difference (p=0.04). Conclusion: Ultrasound-guided percutaneous nephrolithotomy is a safe and effective treatment regimen, boasting various advantages such as real-time monitoring of the surgical process, more accurate and clear channel establishment, avoidance of large vessel injury, shortening of surgical time, alleviation of kidney injury and reduction of surgical complications, which is more advantageous for the treatment of complex renal calculi. doi: https://doi.org/10.12669/pjms.38.8.5904 How to cite this:Xue SW, Zhang M, Luo Y, Li N, Shi S. A comparative study of ultrasound-guided percutaneous nephrolithotripsy and x-ray-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi without hydronephrosis. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5904 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…General anesthesia per se (induced by inhaled anesthetics) increased Aβ production and aggregation, and tau accumulation (Run et al, 2009;Perucho et al, 2010), and inhibited the activities of cholinergic neurons in preclinical studies (Luo et al, 2020). However, clinical studies found no evidence that general anesthesia increased POCD, compared to non-general anesthesia (neuraxial, regional and local anesthesia; Mason et al, 2010;Silbert et al, 2014). Usually, anesthesia is followed by surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgery Performed Under Propofol Anesthesia Induces Cognitive Impairment and Amyloid Pathology in ApoE4 Knock-In Mouse Model

Kim

Jung

Lee

et al. 2021

Front. Aging Neurosci.

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Background: Postoperative cognitive dysfunction (POCD) following anesthesia and surgery is a common and severe complication, especially in elderly patients. A pre-existing cognitive impairment may impart susceptibility to further cognitive dysfunction; the mechanism remains unclear. We hypothesized that the specific impacts of anesthesia and surgery on individuals with preclinical Alzheimer’s disease (AD) may render them more susceptible to an increase in the risk of cognitive impairment. The aim of this study was to compare the cognitive impairment between normal adult mice and those with preclinical AD after propofol anesthesia and surgery.Methods: We performed abdominal surgery in cognitively pre-symptomatic, 5-month-old male mice with sporadic AD (apolipoprotein E4 allele, ApoE4-KI) and age-matched (C57BL/6J) controls. Propofol anesthesia (170 mg/kg) was induced via retro-orbital injection over 2 h. Morris water maze (MWM) and Y-maze tests were conducted 2 days before and 2, 4, and 7 days after surgery. The mean escape latencies and spontaneous alternation percentages were the major outcomes. Neuronal apoptosis in hippocampal sections was evaluated using the terminal dUTP nick-end labeling (TUNEL) assay. Hippocampal amyloid beta (Aβ) levels were assessed via quantitative immunohistochemistry (IHC).Results: The control mice exhibited increased mean escape latencies of MWM at postoperative 2 and 4, but not at day 7; ApoE4-KI mice exhibited such increases at postoperative days 2, 4 and 7. Significant differences between ApoE4-KI and control mice in terms of the mean escape latencies were evident at days 2 and 7 (both P < 0.05). However, performance on a non-hippocampal memory tasks (Y-maze test) did not differ. More TUNEL-positive neurons were evident in the hippocampal CA3 region of ApoE4-KI mice at postoperative days 2 and 4, but not at day 7 compared to the control group (both P < 0.05). IHC revealed significantly elevated Aβ deposition in the hippocampal CA3 region of ApoE4-KI mice at postoperative days 4 and 7 compared to control mice (both P < 0.05).Conclusions: Propofol anesthesia followed by surgery induced persistent changes in cognition, and pathological hippocampal changes in pre-symptomatic, but vulnerable AD mice. It would be appropriate to explore whether preclinical AD patients are more vulnerable to POCD development.

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Comparison of mean operative time in patients undergoing Ho: YAG laser lithotripsy and pneumatic lithotripsy in ureterorenoscopy for ureteric calculus

Cited by 6 publications

References 20 publications

Comparing Holmium (Ho): YAG Laser with Pneumatic Lithoclast for Treatment Efficacy of Ureteric Stones

Comparing Holmium (Ho): YAG Laser with Pneumatic Lithoclast for Treatment Efficacy of Ureteric Stones

A comparative study of ultrasound-guided percutaneous nephrolithotripsy and x-ray-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi without hydronephrosis

Surgery Performed Under Propofol Anesthesia Induces Cognitive Impairment and Amyloid Pathology in ApoE4 Knock-In Mouse Model

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