Efficacy of flexible fibreoptic ureteroscopy and Holmium laser in retrograde intrarenal surgery for calyceal calculi

Doddamani, D; Sinha, Tapan; Talwar, Rajnish

doi:10.1016/s0377-1237(11)60044-0

Cited by 2 publications

(3 citation statements)

References 25 publications

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“…The active deflection of the flexible ureteroscope into acute angles enables access to all calyces, including the lower calyx [4] . Flexible URS is usually performed under general anaesthesia [3] , [4] . In our present study, all patients underwent general anaesthesia and neuromuscular blockage to facilitate stone access.…”

Section: Discussionmentioning

confidence: 99%

“…A ureteric sheath allows fast, safe, and multiple accesses to the upper urinary tract, as well as increasing ureteroscope lifespan, whilst decreasing intra-renal pressure by continuous drainage [3] , [4] , [5] . More effective irrigant flow also increases visibility.…”

Section: Discussionmentioning

confidence: 99%

“…It was introduced through the access sheath to the renal pelvis ( Fig. 1 C) [3] . Once the scope reaches the pelvicalyceal system, it is rotated gently on both sides with use of the deflecting mechanism, to visualise the pelvicalyceal system clearly.…”

Section: Methodsmentioning

confidence: 99%

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Fluoroscopy free flexible ureteroscopy with holmium: Yttrium-aluminium-garnet laser lithotripsy for removal of renal calculi

Aboutaleb

2016

Arab Journal of Urology

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ObjectiveTo evaluate the feasibility of access sheath insertion and ureteric stent placement without image guidance in flexible ureteroscopic lithotripsy with holmium:yttrium-aluminium-garnet laser for renal stones.Patients and methodsBetween March 2014 and October 2015, 80 patients with renal stones treated with flexible ureteroscopic laser lithotripsy were evaluated. Indications for surgery were renal obstruction, failed shockwave lithotripsy (SWL), stones in polycystic kidneys, and mal-rotated kidneys. A 6.5-F Cobra flexible ureteroscope was used in all cases with an access sheath of 12 F, 35/45 cm in length. Fluoroscopy was not intended for use in all cases and postoperative JJ stenting was optional. The perioperative complications were listed and the collected data were analysed.ResultsThe study included 80 patients (66 male, 14 female), with a mean (SD; range) age of 48.2 (8; 28–54) years and a stone burden of 13 (3.5; range 6–23) mm. In all, 26 patients had a stone burden of >15 mm and 48 patients had lower calyceal stones. The mean (SD; range) operative time was 71.5 (20; 25–130) min. Overall, 76 (95%) access sheath insertions were performed successfully without the use of fluoroscopy. JJ stenting was used in 22 patients (27.5%). The mean (SD; range) hospital stay was 10 (8.5; 10–36) h. After one session, a stone-free rate (SFR) of 87.5% was achieved (93.3% for stones of <15 mm). A single session was successful in 87.9% of cases with lower calyceal stones, with a SFR of 91.7% for post-SWL failure cases. The perioperative complication rate was 15%.ConclusionAccess sheath insertion without fluoroscopic guidance is feasible. This technique reduces radiation exposure in patients requiring flexible ureteroscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Fluoroscopy free flexible ureteroscopy with holmium: Yttrium-aluminium-garnet laser lithotripsy for removal of renal calculi

Aboutaleb

2016

Arab Journal of Urology

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Prospective randomized trial comparing shock wave lithotripsy and flexible ureterorenoscopy for lower pole stones smaller than 1 cm

et al. 2013

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In this study, we aimed to compare the success and complications of flexible ureterorenoscopy (F-URS) with its advanced technology and the accomplished method of shock wave lithotripsy (SWL) in the treatment of lower pole stones smaller than 1 cm. One hundred and forty patients were randomized as 70 undergoing SWL (Group 1) and 70 undergoing F-URS (Group 2). Patients were evaluated by plain X-ray and urinary ultrasound 1 week and after 3 months following SWL. The same procedure was done for F-URS patients 1 week after surgery and after 3 months. Success rates were established the day following the procedure and after 3 months. Fragmentation less than 3 mm was considered success. Mean operative time was 44 ± 7.4 min for Group 2 and mean fluoroscopy duration was 51 ± 12 s. In F-URS group, all the patients were stone free after 3 months (100 %). Group 1 had 2.7 ± 0.4 sessions of SWL. Sixty-four patients were stone free in that group after 3 months (91.5 %). The procedure yielded significant success in FURS group, even though patients underwent SWL for 2.7 ± 0.4 sessions and F-URS for 1 session (p < 0.05). With higher success and similar complication rates, fewer sessions per treatment, and advances in technology and experience, we believe F-URS has a potential to be the first treatment option over SWL in the future.

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Efficacy of flexible fibreoptic ureteroscopy and Holmium laser in retrograde intrarenal surgery for calyceal calculi

Cited by 2 publications

References 25 publications

Fluoroscopy free flexible ureteroscopy with holmium: Yttrium-aluminium-garnet laser lithotripsy for removal of renal calculi

Fluoroscopy free flexible ureteroscopy with holmium: Yttrium-aluminium-garnet laser lithotripsy for removal of renal calculi

Prospective randomized trial comparing shock wave lithotripsy and flexible ureterorenoscopy for lower pole stones smaller than 1 cm

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