Influence of the renal lower pole anatomy and mid-renal-zone classification in successful approach to the calices during flexible ureteroscopy

Marroig, Bruno; Frota, Rodrigo; Fortes, Marco A.; Sampaio, Francisco J.B.; Favorito, Luciano A.

doi:10.1007/s00276-015-1562-0

Cited by 10 publications

(17 citation statements)

References 18 publications

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“…They experienced relative difficulty in accessing to the calyces of the lower pole in cases with type A2 Sampaio classification when compared to others. [ 18 19 20 ] By announcing a complicated classification system Takazawa et al classified the kidneys based on just CT urography findings in patients under follow-up for hematuria or ureteral tumor. They demonstared only the anatomical data obtained but provided no data regarding the clinical and surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

The impact of the pelvicalyceal anatomy characteristics on the prediction of flexible ureteroscopy outcomes

Kireççi

İlgi²,

Yeşildal

et al. 2021

Urol Ann

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Background: The anatomical architecture is a prominent factor in the outcomes of flexible ureteroscopy (FURS). Aims and Objectives: The aim to regard the success of procedures based on Pelvicalyceal body that called Sampaio classification system. Materials and Methods: A total of 125 FURS procedures were reviewed between December 2012 and December 2016 in our department. Seven patients were excluded from the study due to the horseshoe kidney in two cases and recurrent cystine stone configuration in five patients. The patient's renal collecting system anatomy characteristics are regarded, and they are classified into four main groups based on the mid-renal-zone anatomy assessed according to Sampaio Classification. Results: Total stone-free rate (SFR) during the postoperative 1 st -month evaluation was noncontrast computerized tomography 75 (63.6%). The evaluation of the SFR in all subgroup of cases based on Sampaio classification noticed easily, SFR was significantly lower in subgroup A2 (30.4%) ( P = 0.00), significantly higher in subgroup B2 ( P = 0.008). The comparative analysis of the operative duration defined that it was the shortest (75.3 ± 18.1 min) in Type B1 subgroup cases, and the longest (84.7 ± 25.7 min) in the Type A2 subgroup cases. Even though this duration was found to be relatively higher in Type A2 subgroup cases than the others, this difference was not statistically significant ( P = 0.271). Fluoroscopy time was noted to be the shortest (11.9 ± 13.4 s) in B1 subgroup and the longest in A2 subgroup with a statistically significant different (median: 21.3 ± 30.4) ( P = 0.04). While 6 (5.1%) cases had Clavien 2 and 3 (2.5%) cases, demonstrated Clavien 3a complications. Conclusion: The calyceal structure of the kidney affects the SFR; therefore, a detailed classification of pelvicalyceal could improve the outcomes, decrease the rate of auxiliary procedures and prevent the complications.

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Section: Discussionmentioning

confidence: 99%

The impact of the pelvicalyceal anatomy characteristics on the prediction of flexible ureteroscopy outcomes

Kireççi

İlgi²,

Yeşildal

et al. 2021

Urol Ann

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“…Atalay et al reported that generating kidney models of PCSs by using 3D printing technology is feasible, and understandings of the disease and the surgical procedure from patients were well appreciated with this novel technology (18). Nevertheless, some other studies showed the importance of the renal anatomy applied to training and execution of the flexible ureteroscopy (19,20). Recently, Marroig et al standardized the building of a three-dimensional silicone mold (cavity) of the collecting system, on the basis of polyester resin endocasts, which can be used in surgical training programs (21).…”

Section: Discussionmentioning

confidence: 99%

Factors affecting fluoroscopy time during percutaneous nephrolithotomy: Impact of stone volume distribution in renal collecting system

et al. 2019

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Purpose: To identify the factors increased fl uoroscopy time during percutaneous nephrolithotomy and investigate the relationship between the 3D segmentation volume ratio of stone to renal collecting system and fl uoroscopy time. Materials and Methods: Data from 102 patients who underwent percutaneous nephrolithotomy were analyzed retrospectively. Volume segmentation of both the renal collecting system and stones were obtained from 3D segmentation software with the images on CT data. Analyzed stone volume (ASV), renal collecting system volume (RCSV) measured and the ASV-to-RCSV ratio was calculated. Several parameters were evaluated for their predictive ability with regard to fl uoroscopy time. Results: The stone-free rate was 55.9% after the percutaneous nephrolithotomy. Complications occurred in 31(30.4%) patients. The mean fl uoroscopy time was 199.4±151.1 seconds. The fl uoroscopy time was signifi cantly associated with the ASV-to-RCSV ratio (p<0.001, r=0.614). The single tract was used in 77 (75.5%) cases while multiple tracts were used in 25 (24.5%) cases. Fluoroscopy time was signifi cantly associated with multiple access (p<0.001, r=0.689). On univariate linear regression analysis, longer fl uoroscopy time was related with increased stone size, increased stone volume, increased number of access, increased calyx number with stone, increased ASV-to-RCSV, increased operative time and decreased stone essence. On multivariate linear regression analysis, the number of access and the ASV-to-RCSV were independent predictors of fl uoroscopy time during percutaneous nephrolithotomy. Conclusions: The distribution of the stone burden volume in the pelvicalyceal system is a signifi cant predictor for prolonged fl uoroscopy time during percutaneous nephrolithotomy. Measures to decrease FT could be benefi cial in patients with a high ASV-to-RCSV ratio for precise preoperative planning.

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“…In the cases of duplicated pelvicalyceal collecting system we analyzed separately the superior and the inferior units. Measurements of width and length of the inferior infundibulum and infundibulum of the minor calyces and the angles were made with the aid of the LibreOffice 6.3 software (15)(16)(17), as shown in Figure -1.…”

Section: Methodsmentioning

confidence: 99%

Lower pole anatomy of horseshoe kidney and complete ureteral duplication: Anatomic and radiologic study applied to endourology

2022

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Purpose: To analyze the 3-dimensional intrarenal anatomy of horseshoe kidneys (HK) and kidney with complete ureteral duplication (CUD), in polyester resin endocasts of the collecting system and in patients submitted to 3D computerized tomography scan (CT-scan). Materials and Methods: We analyzed seven 3-dimensional polyester resin endocasts of the kidney collecting system obtained from 6 fresh adult cadavers (4 with unilateral CUD and 2 with horseshoe kidney) and CT-scan reconstruction images of kidneys from 24 patients: 6 patients with HK, 8 with CUD and 10 patients without renal anomalies that were used as controls. We analyzed the spatial distribution of the calices, the infundibula diameters, the angle between the lower infundibulum and the renal pelvis (LIP) and the angle between the lower infundibulum and the inferior minor calyces (LIICA). Measurements of the width and length of the inferior infundibulum and the infundibula of the minor calyces, as well as the angles (LIP and LIICA) were made with the aid of the LibreOffi ce 6.3 software. The data were analyzed with the IBM® SPSS® Statistics. Results: There was no statistical difference in the inferior pole measurements between the groups with anomalies and the control group, both in polyester resin endocasts and CT-scan reconstruction images for LIP. When we compared the LIP in the CT-scan between HK versus CUD (p= 0.003), and HK versus the control group (p= 0.035), we observed statistical difference. Conclusions: The knowledge of spatial anatomy of lower pole is of utmost importance during endourologic procedures in patients with kidney anomalies. In the present study we observed that horseshoe kidneys had more restrictive anatomic factors in lower pole than the complete ureteral duplication.

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Influence of the renal lower pole anatomy and mid-renal-zone classification in successful approach to the calices during flexible ureteroscopy

Abstract: Collecting system with kidney midzone drained by crossed calices presented the lower accessibility rate during FUR.

Cited by 10 publications

References 18 publications

The impact of the pelvicalyceal anatomy characteristics on the prediction of flexible ureteroscopy outcomes

The impact of the pelvicalyceal anatomy characteristics on the prediction of flexible ureteroscopy outcomes

Factors affecting fluoroscopy time during percutaneous nephrolithotomy: Impact of stone volume distribution in renal collecting system

Lower pole anatomy of horseshoe kidney and complete ureteral duplication: Anatomic and radiologic study applied to endourology

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