Development and Internal Validation of a Classification System for Predicting Success Rates After Endoscopic Combined Intrarenal Surgery in the Modified Valdivia Position for Large Renal Stones

Kuroda, Shinnosuke; Ito, Hiroki; Sakamaki, Kentaro; Tabei, Tadashi; Kawahara, Takashi; Terao, Hideyuki; Fujikawa, Atsushi; Makiyama, Kazuhide; Yao, Masahiro; Matsuzaki, Junichi

doi:10.1016/j.urology.2015.07.002

Cited by 30 publications

(41 citation statements)

References 25 publications

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“…ECIRS is a new useful approach for the treatment of large renal stones . We have regularly carried out ECIRS in the modified Valdivia position for the treatment of large renal stones since April 2010 because of studies showing the effectiveness of ECIRS for the treatment of large renal stones …”

Section: Discussionmentioning

confidence: 99%

“…Combining the clinical advantages of both PCNL and ureteroscopy, ECIRS is now accepted as a useful approach for the treatment of large renal stones, and it is associated with less radiation exposure and less bleeding than PCNL monotherapy . However, infectious diseases are one of the most severe complications after ECIRS, as it has clinical characteristics of PCNL and ureteroscopy, both of which are commonly complicated by UTI.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

et al. 2016

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The number of involved calyces larger than four, stone surface area >500 mm(2) and a history of febrile urinary tract infection independently predicted the development of systemic inflammation response syndrome after endoscopic combined intrarenal surgery. This is the first study to identify the independent predictors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

et al. 2016

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“…The retrograde approach using a flexible ureteroscope has shown good surgical outcomes. However, the antegrade approach using a flexible ureteroscope or nephroscope can increase the SFRs in cases of acute infundibulopelvic angle or narrow infundibulum, musculoskeletal deformities, or anatomical abnormalities ECIRS can be carried out in either the supine or prone position. However, there has been no randomized controlled study examining the patients’ position ECIRS contains two different concepts of location (bidirectional) and time (simultaneous; Fig.…”

Section: Clinical Questions and Answersmentioning

confidence: 99%

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline – consisting 43 clinical questions – and overview its key practical issues.

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“…ECIRS has a comparable stone-free rate with no increase in access number or blood loss. [14,15] Although supine PNL is gaining popularity, prone position is used most commonly and it is the traditional position for PNL. We routinely perform prone PNL in our department because of lack of experience with supine PNL.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, many studies have focused on increasing the success rate without increasing the complication rate by performing multiple treatments, using additional instruments, and exploiting technological advances. [7][8][9][10][11][12][13][14][15] Here, we present a technique that combines standard PNL with microperc to achieve stone free status without increasing complication rates. To the best of our knowledge, this is the first study presenting the efficacy of combined micro-, and standard PNL techniques for complex kidney stones.…”

Section: Introductionmentioning

confidence: 99%

Combined micro-and standard percutaneous nephrolithotomy for complex renal calculi

Buldu

Tepeler

Karatag

et al. 2016

Turkish Journal of Urology

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Objective: We aimed to present the technique of combination of standard percutaneous nephrolithotomy (PNL) with microperc for achieving higher success rates without increasing complication rates in the management of complex renal calculi. Material and methods:The patients who underwent microperc procedure as a complementary procedure to standard PNL for complex kidney stones in two reference hospitals between 2013 and 2015, were evaluated retrospectively.Results: All patients underwent a total of two accesses one for standard PNL and one for microperc. The mean stone size was measured as 54.3 mm. The procedures were completed after an average operative time of 88.2 minutes and fluoroscopy time of 5.3 minutes. Stone free status was achieved in 18 cases (78.2%) and small residual fragments (≤4 mm) were detected in 3 cases (13.1%). Complications were seen in three patients (13%) as hemorrhage in one and postoperative fever in two patients. Conclusion:Despite the limitations of this study, the combination of standard PNL and microperc might reduce the complication rates and increase the success rates when treating complex kidney stones. Future prospective and comparative studies are needed.

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Development and Internal Validation of a Classification System for Predicting Success Rates After Endoscopic Combined Intrarenal Surgery in the Modified Valdivia Position for Large Renal Stones

Cited by 30 publications

References 25 publications

Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

The Urological Association of Asia clinical guideline for urinary stone disease

Combined micro-and standard percutaneous nephrolithotomy for complex renal calculi

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