Percutaneous Management of Caliceal Diverticuli

Krambeck, Amy E.; Lingeman, James E.

doi:10.1089/end.2009.1541

Cited by 31 publications

(20 citation statements)

References 45 publications

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“…Among various available options like SWL, PCNL, URS, and laparoscopy, percutaneous management offers the highest symptomatic relief and stone-free rates. [ 6 7 10 11 12 ] Jones et al .,[ 10 ] compared the result of SWL and PCNL. In SWL only group, 1 of 26 patients (4%) became completely stone free, although 9 (36%) became asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] In the era of minimally invasive surgery, various procedures like shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopic surgery (URS), and laparoscopy have been described for the treatment of this entity, but the stone-free and symptom-free rates are found to be best with PCNL. [ 5 6 7 8 ] During PCNL, in order to prevent urinary stasis and recurrent stone formation, either the diverticular neck is dilated or the wall is fulgurated. [ 1 6 9 ] There is scant literature regarding the outcome, complications, and recurrence rates using these two methods.…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 6 7 8 ] During PCNL, in order to prevent urinary stasis and recurrent stone formation, either the diverticular neck is dilated or the wall is fulgurated. [ 1 6 9 ] There is scant literature regarding the outcome, complications, and recurrence rates using these two methods. We present our experience with caliceal diverticular stones managed with PCNL and describe the outcomes of these two techniques to deal with diverticula after stone retrieval.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous management of renal caliceal diverticular stones: Ten-year experience of a tertiary care center with different techniques to deal with diverticula after stone extraction

et al. 2013

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Introduction:Caliceal diverticulae are a frequent surgical problem. We present our experience with caliceal diverticular stones (CDS) managed with percutaneous nephrolithotomy (PCNL) and describe the two different techniques to deal with diverticula after stone retrieval.Materials and Methods:We retrospectively analyzed 10-year data of 44 consecutive patients who underwent PCNL for CDS. During PCNL, if the guide wire could be negoted through the neck of the diverticula, we dilated and stented it. If we couldnot find the neck, we fulgurated the diverticular walls. Follow-up included intravenous urogram at 3 months and annual plain films thereafter. We analyzed the outcome, complications, and recurrence rate.Results:Total stone clearance was obtained in 40 (90.90%) patients. We dilated and stented the diverticula in 35 (79.5%) patients and fulgurated the walls in nine (20.5%) patients. Complications occurred in three patients. The postoperative intravenous urogram showed obliteration of diverticula in seven patients and the improved drainage in 37 patients. At the average follow-up of 2 years, 41 (93.18%) patients were asymptomatic and two (4.5%) patients showed the recurrence of stone.Conclusions:PCNL can clear calculi from caliceal diverticula in most cases with minimal morbidity. After stone retrieval, the diverticula may be drained into the pyelocaliceal system, if the neck is negotiable and fulgurated if the neck cannot be dilated.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Percutaneous management of renal caliceal diverticular stones: Ten-year experience of a tertiary care center with different techniques to deal with diverticula after stone extraction

et al. 2013

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“…As symptomatic calyceal diverticula with stones is a rare disease there is no consensus on treatment. With improving experience and advancements in technology, various available minimally invasive modalities offer the highest symptomatic relief and stone-free rates [6][7][8]. Open surgical treatment has been largely replaced by a number of less invasive surgical and nonsurgical modalities.…”

Section: Discussionmentioning

confidence: 99%

Retrograde intrarenal surgery in the management of symptomatic calyceal diverticular stones: a single center experience

Chen

Dai

et al. 2015

Urolithiasis

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To evaluate the outcome of RIRS in managing symptomatic calyceal diverticular as a minimally invasive option, we retrospectively reviewed the records of 43 patients who underwent RIRS from 2005 to 2014 for symptomatic calyceal diverticular stones. A month after the initial operation, the success rate was (81.4%, 35 patients) of which 21 (48.83%) patients were stone free and 14 (32.6%) patients had clinically insignificant residual fragments (CIRFs), and 90% patients were symptom free. Eight patients (16.6%) had significant residual fragments (>3 mm), five of them became completely stone free after the second procedure, other three patients were symptom free and underwent a routine follow-up. The final treatment success rate was 93.0%. The initial success rate in the lower calyx was significantly lower than the other calices (P = 0.040). In addition, the association between the stone size and the initial treatment success was significant (P = 0.036). There was no association between any of our other variables and the success rate. The mean first operative time was 60.95 ± 12.43 min (range 34-92). No major complication (Clavien III-V) occurred, although there were five minor complications (11.6%) (Clavien I-II). There were no admissions to intensive care or deaths in our series, the mean hospitalization time was 1.77 ± 0.80 days. The management of calyceal diverticular calculus with RIRS is highly effective and can be accomplished with low morbidity.

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“…These cases are very delicate. 12,13 The author's usual approach has been to start with a nephrostogram, so as to opacify the diverticulum and collecting system. However the diverticulum is targeted, an 18-gauge needle is used for puncture, because the needle has some directability once the tip is in the diverticulum and because of its stiffness it will not buckle in the tract.…”

Section: Calyceal Diverticulamentioning

confidence: 99%

Planning and Execution of Access for Percutaneous Renal Stone Removal in a Community Hospital Setting

Springer

2015

Semin intervent Radiol

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Percutaneous Management of Caliceal Diverticuli

Abstract: Percutaneous management of caliceal diverticula using cavity ablation is a minimally invasive technique that offers long-term symptomatic relief with minimal complications.

Cited by 31 publications

References 45 publications

Percutaneous management of renal caliceal diverticular stones: Ten-year experience of a tertiary care center with different techniques to deal with diverticula after stone extraction

Percutaneous management of renal caliceal diverticular stones: Ten-year experience of a tertiary care center with different techniques to deal with diverticula after stone extraction

Retrograde intrarenal surgery in the management of symptomatic calyceal diverticular stones: a single center experience

Planning and Execution of Access for Percutaneous Renal Stone Removal in a Community Hospital Setting

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