Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Setthawong, Vasun; Srisubat, Attasit; Potisat, Somkiat; Lojanapiwat, Bannakij; Pattanittum, Porjai

doi:10.1002/14651858.cd007044.pub4

Cited by 16 publications

(10 citation statements)

References 90 publications

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“…Furthermore, available data suggests that, the quality of life is comparable to that with URS and that the rate of complications is lower. Nevertheless, the available data does not offer convincing evidence on these features when compared to PCNL [92].…”

Section: Andandmentioning

confidence: 95%

“…In the context of elderly patients, all studies underscored the effectiveness and safety of ESWL, noting no statistically significant differences in complications and SFR [66,[87][88][89][90]. However, while the three-month success rate in the general population remains comparable to URS and PCNL [91] in the geriatric population, it is notably lower [92]. Furthermore, available data suggests that, the quality of life is comparable to that with URS and that the rate of complications is lower.…”

Section: Andandmentioning

confidence: 99%

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Prevention, diagnosis, and treatment of urolithiasis in geriatric patients - differences, similarities and caveats in comparison to the general population

Schrag,

Diarra,

Veser

2024

Current Opinion in Urology

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Purpose of the review Purpose of the review is to address management and prevention of urolithiasis in elderly patients examining the dynamic interplay between general measures, dietary adjustments, lifestyle modifications, and targeted pharmacological and/ or surgical interventions. The goal is to provide understanding of the evolving strategies required for effective urolithiasis prevention in the geriatric population. Recent findings Age-specific diagnostic considerations are necessary because urolithiasis in the elderly population is characterized by bigger stones, greater peri-operative risks, and heightened symptom severity. When comorbidities are present, conservative treatments – especially analgesia – provide difficulties. Surgical procedures prove to be safe and effective, with complication rates and practical application comparable to younger cohorts. Prevention approaches that include lifestyle changes and the investigation of novel pharmaceutical options such as sodium-dependent glucose co-transporter 2 (SGLT-2)-inhibitors are promising in the management of urolithiasis in the elderly population. Summary Our review offers a thorough investigation of urolithiasis in the elderly population, elucidating distinct clinical manifestations, complex diagnostic issues, and treatment implications. The safety and effectiveness of ureteroscopy in older patients, as well as the possible prophylactic function of SGLT-2-I, offer crucial insights for clinicians. Subsequent studies are necessary to enhance age-specific therapies, addressing the distinct obstacles presented by urolithiasis in the elderly population within this rapidly growing demographic.

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Section: Andandmentioning

confidence: 95%

Section: Andandmentioning

confidence: 99%

Prevention, diagnosis, and treatment of urolithiasis in geriatric patients - differences, similarities and caveats in comparison to the general population

Schrag,

Diarra,

Veser

2024

Current Opinion in Urology

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“…Common treatment modalities for stones include Extracorporeal Shock Wave Lithotripsy, Ureteroscopy, Percutaneous Nephrolithotomy (PCNL), and occasionally open surgery. [7] PCNL is the preferred surgical method for treating large, multiple, and complex kidney stones. [8–10]…”

Section: Introductionmentioning

confidence: 99%

Machine learning algorithm to predict postoperative bleeding complications after lateral decubitus percutaneous nephrolithotomy

Meng,

Wang,

Zhai

et al. 2024

Medicine

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Bleeding is a serious complication following percutaneous nephrolithotomy (PCNL). This study establishes a predictive model based on machine learning algorithms to forecast the occurrence of postoperative bleeding complications in patients with renal and upper ureteral stones undergoing lateral decubitus PCNL. We retrospectively collected data from 356 patients with renal stones and upper ureteral stones who underwent lateral decubitus PCNL in the Department of Urology at Peking University First Hospital-Miyun Hospital, between January 2015 and August 2022. Among them, 290 patients had complete baseline data. The data was randomly divided into a training group (n = 232) and a test group (n = 58) in an 8:2 ratio. Predictive models were constructed using Logistic Regression, Random Forest, and Extreme Gradient Boosting (XGBoost). The performance of each model was evaluated using Accuracy, Precision, F1-Score, Receiver Operating Characteristic curves, and Area Under the Curve (AUC). Among the 290 patients, 35 (12.07%) experienced postoperative bleeding complications after lateral decubitus PCNL. Using postoperative bleeding as the outcome, the Logistic model achieved an accuracy of 73.2%, AUC of 0.605, and F1 score of 0.732. The Random Forest model achieved an accuracy of 74.5%, AUC of 0.679, and F1 score of 0.732. The XGBoost model achieved an accuracy of 68.3%, AUC of 0.513, and F1 score of 0.644. The predictive model for postoperative bleeding after lateral decubitus PCNL, established based on machine learning algorithms, is reasonably accurate. It can be utilized to predict postoperative stone residue and recurrence, aiding urologists in making appropriate treatment decisions.

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“…Urinary tract stones represent one of the most prevalent conditions in urology,with their global incidence and prevalence on a signi cant rise.In Asia,1%-19.1% of the population is affected by urinary tract stones, particularly men over 30 years old [1][2][3] .The acute onset of this condition results in substantial treatment costs,reaching billions of dollars annually in developed nations like the United States [4][5] .The treatment of urinary stones is contingent upon factors such as size,shape,and location.Mainstream treatment methods encompass drug therapy,extracorporeal shock wave lithotripsy(ESWL),transureteroscopic lithotomy(rigid transurethral ureterolithotomy and exible transurethral ureterolithotomy),and percutaneous nephrolithotomy (PCNL),among others [6] .PCNL has emerged as the primary minimally invasive treatment for urinary tract stones,especially for multiple,complex,and larger stones(>20mm).However, postoperative bleeding is an inevitable consequence of PCNL,stemming from factors such as kidney puncture,urinary tract dilatation,and lithotripsy [7][8] .Previous studies have indicated that stone size,shape,surgical history,and operation time may in uence post-PCNL bleeding [9][10] .…”

Section: Introductionmentioning

confidence: 99%

Preoperative prediction of bleeding complications in percutaneous nephrolithotomy using a machine learning model based on CT radiomics and clinical variables

Zou,

Yuan,

Zhou

et al. 2024

Preprint

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Background and objective Radiomics and machine learning play a significant role in clinical medical research, particularly in the development of prediction models.This study aims to utilize radiomic features and clinical variables in combination with machine learning to predict the risk of postoperative bleeding after percutaneous nephrolithotomy (PCNL). Materials and Methods A retrospective study analyzed 151 patients who had PCNL at the Second Affiliated Hospital of Nanchang University.Clinical variables linked to postoperative bleeding were identified using univariate analysis,and radiomic features were screened using the least absolute shrinkage and selection operator algorithm(lasso regression).Logistic regression,Random Forest(RF),and Support Vector Machine(SVM) were then used to develop prediction models based on the correlated clinical variables and radiomic features.The predictive accuracy of these models was assessed through identification and calibration. Results The postoperative statistics revealed that the postoperative bleeding rate was 31.1%(n=47),the blood transfusion rate was 1.42%(n=3),and the final probability of requiring vascular embolization was 0.94%(n=2).The accuracy rates for predicting postoperative bleeding in patients with PCNL using logistic regression,RF and SVM algorithms were 75.6%,75.6%,and 71.1% respectively.The corresponding area under the curve AUC(95% CI) were 0.76(0.72-0.81),0.74(0.69-0.79) and 0.63(0.54-0.68).The top four prediction importance scores in logistic regression and RF algorithms were wavelet-HLH_glrlm_ShortRunLowGrayLevelEmphasis,wavelet-HLH_glrlm_LowGrayLevelRunEmphasis,stone shape,operation time and stone shape,stone diameter,operation time,Wavelet-HLH_glrlm_ShortRunLowGrayLevelEmphasis. Conclusion The logistic regression model demonstrated the highest efficiency in predicting postoperative bleeding in PCNL.Our study successfully developed an effective machine learning model that can assist urological surgeons in making appropriate treatment decisions for predicting postoperative bleeding in PCNL.

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Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Cited by 16 publications

References 90 publications

Prevention, diagnosis, and treatment of urolithiasis in geriatric patients - differences, similarities and caveats in comparison to the general population

Prevention, diagnosis, and treatment of urolithiasis in geriatric patients - differences, similarities and caveats in comparison to the general population

Machine learning algorithm to predict postoperative bleeding complications after lateral decubitus percutaneous nephrolithotomy

Preoperative prediction of bleeding complications in percutaneous nephrolithotomy using a machine learning model based on CT radiomics and clinical variables

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