Handling and Prevention of Complications in Stone Basketing

Rosette, Jean J.M.C.H. de la; Skrekas, Thomas; Segura, Joseph W.

doi:10.1016/j.eururo.2006.02.033

Cited by 67 publications

(37 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In three large retrospective studies it was found to occur less than 1% of the time [Weinberg et al 1987;Stoller and Wolf, 1996;Grasso, 2001]. Mucosal abrasions and ureteral perforation are much more common during ureteroscopy and are generally managed with prolonged stenting, with surprisingly little consequence [de la Rosette et al 2006]. Fortunately, with the advent of flexible ureteroscopy and durable access sheaths, ureteral injury is a rare event.…”

Section: Urologic Proceduresmentioning

confidence: 99%

Management of iatrogenic ureteral injury

Burks

Santucci

2014

Therapeutic Advances in Urology

213

160

View full text Add to dashboard Cite

Iatrogenic injury to the ureter is a potentially devastating complication of modern surgery. The ureters are most often injured in gynecologic, colorectal, and vascular pelvic surgery. There is also potential for considerable ureteral injury during endoscopic procedures for ureteric pathology such as tumor or lithiasis. While maneuvers such as perioperative stenting have been touted as a means to avoid ureteral injury, these techniques have not been adopted universally, and the available literature does not make a case for their routine use. Distal ureteral injuries are best managed with ureteroneocystostomy with or without a vesico-psoas hitch. Mid-ureteral and proximal ureteral injuries can potentially be managed with ureteroureterostomy. If the distal segment is unsuitable for anastomosis then a number of techniques are available for repair including a Boari tubularized bladder flap, transureteroureterostomy, or renal autotransplantation. In rare cases renal autotransplantation or ureteral substitution with gastrointestinal segments may be warranted to re-establish urinary tract continuity. Laparoscopic and minimally invasive techniques have been employed to remedy iatrogenic ureteral injuries.

show abstract

Section: Urologic Proceduresmentioning

confidence: 99%

Management of iatrogenic ureteral injury

Burks

Santucci

2014

Therapeutic Advances in Urology

213

160

View full text Add to dashboard Cite

show abstract

“…Reported complications from ureteroscopy with stone basketing in large series have included ureteral avulsion (0.28%), major ureteral perforation necessitating surgical repair (0.06%), minor ureteral perforation (1.99%), mucosal abrasion (0.52%), and ureteral stricture (0.58%). 7 To minimize morbidity, we generally do not extract stone fragments after ureteroscopy and laser lithotripsy for smaller renal pelvic stones.…”

mentioning

confidence: 99%

The Ureteroscope as a Safety Wire for Ureteronephroscopy

Patel

McLaren

Nakada

2012

Journal of Endourology

View full text Add to dashboard Cite

show abstract

“…As such, leaders in the field of endo-urology recommend that basketing of stones in the mid and proximal ureter be tried only with extreme caution, and-unless the stones are exceptionally small-never be retrieved intact. [19] In this study, unfavorable and favorable outcomes related to proximal ureteric stones were detected in 45.4 and 33.8% of the cases, respectively (p=0.001).…”

Section: Discussionmentioning

confidence: 92%

Evaluation of ureteroscopy outcome in a teaching hospital

Al‐Naimi¹,

Alobaidy²,

Majzoub³

et al. 2016

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: To evaluate factors affecting semi-rigid ureteroscopy (URS) results highlighting the influence of teaching on its outcomes. Material and methods:We reviewed the files of 891 adult patients who had undergone 1182 ureteroscopies at our institute during the period from July 2008 to June 2011. The outcomes of all URSs were evaluated. Outcomes were measured by stone-free rate and presence of complications, which were assessed using the Clavien-Dindo system. Patients were divided into 2 groups; Group 1 (favorable outcome) became stone-free after the first URS and had no documented complications, while Group 2 (unfavorable outcome) had residual stones and/or complications. Group 2 was subdivided according to the skill level of the operating surgeon into two subgroups. Patients belonging to subgroup A had their procedures performed by urology trainees under direct supervision of expert urologists, while those in subgroup B had their procedures performed by the expert urologists themselves. All groups were compared using univariate (chi-square and t tests) and multivariate (logistic regression) statistical tests to identify significant risk factors. All data was analyzed using SPSS.Results: A total of 1182 URSs were evaluated. 958 patients had a favorable outcome (Group 1) while 224 patients had an unfavorable outcome (Group 2). Factors associated with an unfavorable outcome include location of the presenting stone (p<0.001) and presence of stone impaction (p<0.001). No statistically significant differences were detected in the overall complication rate between trainees and expert urologists. Trainees stone-free rate was comparable to that of experts; 90.3% vs. 91.1%, respectively, p=0.6. Conclusion:Factors such as stone impaction and proximal location are associated with an unfavorable surgical outcome. In a high-volume teaching hospital, semi-rigid URS done by trainees under direct supervision is safe and their outcome is comparable to literature findings.

show abstract

Handling and Prevention of Complications in Stone Basketing

Cited by 67 publications

References 63 publications

Management of iatrogenic ureteral injury

Management of iatrogenic ureteral injury

The Ureteroscope as a Safety Wire for Ureteronephroscopy

Evaluation of ureteroscopy outcome in a teaching hospital

Contact Info

Product

Resources

About