Proposal for a Simple Anatomical Classification of the Pelvicaliceal System for Endoscopic Surgery

Takazawa, Ryoji; Kitayama, Sachi; Uchida, Yusuke; Yoshida, Satoshi; Kohno, Yusuke; Tsujii, Toshihiko

doi:10.1089/end.2018.0218

Cited by 13 publications

(16 citation statements)

References 14 publications

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“…21 Type II PCS anatomy is characterized by the pelvis bifurcating into the upper and lower branches, and the bifurcation point is located between the upper and middle calyces. 12 A divided pelvis seems to be a significant risk factor for Upper pole puncture has some advantages including direct access to the upper calyceal stones and easy access to many calyces due to better manipulation of the nephoscope along the long axis of the kidney. Amaresh et al documented that upper pole puncture was more efficacious in achieving a complete SF rate with a shorter surgery time than lower pole puncture.…”

Section: Discussionmentioning

confidence: 99%

“…29 On the other hand, Binbay et al documented that only the pelvicalyceal volume significantly affected the success rate of PCNL, while PCS anatomy did not affect outcomes. 30 In this study, we divided the PCS anatomy into two groups using the Takazawa classification, 12 and some reports have proposed the classification of pelvicalyceal patterns. In 1954, Graves et al 31 defined PCS classification according to the shape of the renal pelvis along with calyceal protrusion.…”

Section: Discussionmentioning

confidence: 99%

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Impact of pelvicalyceal anatomical variation on surgical outcomes of endoscopic combined intrarenal surgery

et al. 2022

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Objectives: The objective of this work is to investigate the impact of the pelvicalyceal anatomical system (PCS) on calyceal stone formation and surgical outcomes of endoscopic combined intrarenal surgery (ECIRS) for renal and/or proximal ureteral stones with a diameter >15 mm.Patients and methods: PCS was classified as Type I (single pelvis) or Type II (divided pelvis) according to the simple anatomical Takazawa classification. Using prospectively collected data from January 2016 to April 2020, 219 patients were retrospectively reviewed. After excluding patients who underwent a staged procedure, had hydronephrosis greater than grade 2, prior nephrostomy tubes, and failed to access the renal collecting system, 115 patients (Type I: 81, Type II: 34) were included, and the distribution of calyceal stones and surgical outcomes in ECIRS were compared between Types I and II PCS. Results:The median number of renal stone calyces in the Type II group was significantly more than that in the Type I group (p = 0.016). In particular, the Type II group possessed more upper stone calyces. Multivariate logistic regression analysis revealed that Type II PCS was associated with an increased odds ratio (OR) for the presence of upper stone calyces (OR: 2.93, p = 0.018). The stone-free (SF) status at 1 month after surgery, confirmed by abdominal plain radiography, was significantly higher in the Type I group compared with that in Type II (67.9% vs. 39.4%, respectively; p = 0.006). The requirement for additional surgical interventions was significantly higher in the Type II group compared with that in Type I (35.4% vs. 7.4%, respectively; p < 0.001). Multivariate analysis revealed that the number of stone calyces (OR: 4.26; p = 0.001) and Type II PCS (OR: 3.43; p = 0.009) were independent predictors of residual stones after ECIRS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of pelvicalyceal anatomical variation on surgical outcomes of endoscopic combined intrarenal surgery

et al. 2022

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“…As the main advantage of our current study, we were able to provide parameters that will be predictive for the final outcome of this prıocedure in advance. [ 21 ] These observations indicate the importance of the anatomical characteristics of the renal collecting system, which may closely affect the outcomes of stone treatment with this approach. Unfavorable anatomical characteristics of the lower pole with narrow infundibulopelvic angle along with high stone density and obesity could be major concerns for this treatment alternative.…”

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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“…In recent years, Japanese scholars Ryoji Takazawa et al (17) proposed a nomenclature for renal calices, and simplified morphological classifications of the renal pelvis suitable for endourological surgery. The classification proposed by Ryoji Takazawa et al makes up for the limitations of previous studies on renal pelvis and calyces, they classified minor calyx into five levels : top, upper, middle, lower, and bottom, which make it possible to share common intrarenal information.…”

Section: Discussionmentioning

confidence: 99%

Modified Takazawa anatomical classification of renal pelvicalyceal system based on three-dimensional virtual reconstruction models

et al. 2021

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Background: Previous classification of renal pelvicalyceal anatomical structure may be difficult to intuitively understand and unpractical for endourological surgery. We aim to put forward a modified Takazawa anatomical classification of renal pelvicalyceal system based on three-dimensional (3D) virtual reconstruction models for endourological surgery.Methods: We retrospectively collected data on 225 patients (320 kidneys) in total between Apr. 2017 and Dec. 2020, spatial anatomical structure of renal pelvis and calyces were modeled and corresponding morphological parameters were measured after 3D virtual reconstruction of computed tomography urography (CTU). The modified Takazawa renal pelvicalyceal anatomical classification was advanced based on the renal pelvicalyceal morphological parameters [bifurcated branches of renal pelvis, cross sectional area of renal pelvis and ureteropelvic junction (UPJ), infundibuloureteral angle (IUA), lower pole infundibular calyceal length (IL)] by 3D virtual reconstruction models, and comparison of renal pelvicalyceal system morphological parameters were performed to evaluate the differences in various classification types of renal pelvis and calyces.Results: Anatomical structure of renal pelvis and calyces were divided into two main types (Type A and Type B) according to renal pelvic branch patterns. A single pelvis without bifurcated branch was regarded as Type A (62%) and subclassified into three subtypes: Type A1 (22%), Type A2 (27%) and Type A3 (13%), the slimline pelvis was classified as Type A1, the typical pelvis as Type A2 and the broad pelvis as Type A3. A divided pelvis with bifurcated branches was seen as Type B (38%) and subclassified into two subtypes: Type B1 (15%) with the wide and flat lower calyx branch, Type B2 (23%) with the narrow and steep lower calyx branch.Conclusions: Previous studies have reported that the visualization and classification of renal pelvicalyceal anatomical structure by endocast, autopsy, ultrasonography and excretory urography, the modified Takazawa classification system based on 3D virtual reconstruction models enables to standardized different anatomical morphology of renal pelvicalyceal system and provide intuitive and concise information on anatomy, thus leading to the improvement in treatment modality.

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Proposal for a Simple Anatomical Classification of the Pelvicaliceal System for Endoscopic Surgery

Cited by 13 publications

References 14 publications

Impact of pelvicalyceal anatomical variation on surgical outcomes of endoscopic combined intrarenal surgery

Impact of pelvicalyceal anatomical variation on surgical outcomes of endoscopic combined intrarenal surgery

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

Modified Takazawa anatomical classification of renal pelvicalyceal system based on three-dimensional virtual reconstruction models

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