Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

Hamed, Ahmed Mamdouh Abd El; Elmoghazy, Hazem; Mohamed, Abdimajid; Riad, Ahmed Mahmoud; Mostafa, Mohammed Mahmoud; Farag, Fawzy; Gamal, Wael

doi:10.5152/tud.2017.61257

Cited by 18 publications

(10 citation statements)

References 23 publications

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“…14 Interestingly, Abd el Hamed et al, showed that the SFR following a single session of RIRS for management of 2-3 renal stones, was 67%; however, when they analyzed the patients based on the stone density, the SFR was 95 vs 40% for patients with HU of ˂1000 and ˃1000, respectively. 15 Our results supported these findings, where only 38.7% of patients in the current series had stones with HU ˃1000 and the SFR for this group of patients was 50% compared to 89.9% for stones with HU of ˂1000. Likewise, a systematic review of the studies considering RIRS for the management of large renal stones >2.5 cm, demonstrated a SFR of 89.3%, which is higher than the SFR in our series.…”

Section: Discussionsupporting

confidence: 89%

Retrograde intrarenal surgery in the management of solitary large renal stones, 2-3 cm: a single center experience

et al. 2021

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Background: Nephrolithiasis represents a major health burden worldwide. Several treatment options are available for renal stones such as open stone surgery, percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shockwave lithotripsy. PCNL is considered the gold standard treatment for large renal stones (>2 cm); however, it is associated with higher blood loss, complication rates, and longer hospitalization. In this setting, we aimed to assess the value of RIRS in the management of single large renal stones between 2-3 cm. Methods: The database of our center was reviewed to include all the patients who underwent RIRS for single large renal stone (2-3 cm) between February 2018 and April 2019. All the patients were evaluated by preoperative computed tomography to evaluate the stone size, site, and density. Furthermore, the following variables were also collected; pre- and post-operative hemoglobin and creatinine, the operative time, stone free rate (SFR), and duration of hospital stay. All the statistical analysis was performed using SPSS version 20.Results: Overall, the data of 31 patients were retrieved for the current study. The mean age of the patients was 56.9±12.9 years, and the mean stone size was 22.6±7 mm. The mean operative time was 96.4±37.3 minutes and the SFR was 74.2% after single session of RIRS. No major postoperative complications were reported in the current series.Conclusions: RIRS is a safe and efficient alternative to PCNL in the management of single renal stones between 2-3 cm; however, further prospective studies are required to confirm these findings.

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Section: Discussionsupporting

confidence: 89%

Retrograde intrarenal surgery in the management of solitary large renal stones, 2-3 cm: a single center experience

et al. 2021

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“…The success rate for FURS may depend on many factors, such as the location of stone, size, density, years, gender, side and BMI. Pervious, One study showed that the total average operating time in the hard stones group was significantly longer [27]. However, in our study, the results were compared between the LDS group and the HDS group, showing that the total operating time in the LDS group is significantly longer.…”

Section: Discussioncontrasting

confidence: 58%

“…FURS has been gradually accepted by patients and doctors in the treatment of larger renal stones (≧2 cm) as it can achieve a satisfactory free stone rate but rarely complications [27]. Because of some patients who cannot tolerate PCNL, the introduction of a new generation of YAG laser or thulium fiber laser and the development of endoscopic technology.…”

Section: Discussionmentioning

confidence: 99%

The stone density does not affect the stone-free rate of kidney pelvic stones (2-3 cm) treated with flexible ureterorenoscopy

Bai

Dai

et al. 2020

Preprint

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Objectives To compare the efficacy of retrograde flexible ureterorenoscopy (FURS) in the treatment of low-density stone (LDS) and high-density stone (HDS).Patients and Methods From January 2017 to March 2019, 241 patients with 2–3 cm kidney pelvic stones were treated with retrograde flexible ureterorenoscopy. The relevant study parameter for all patients, including patients age, body mass index (BMI), gender, stone density values (Hounsfield units [HU]), stone size, stone location, operative time, hospitalization time, stone free rate (SFR), complications were evaluated. The results were assessed one month after the FURS and the follow-up time is 6 months.Results Effectively, 241 patients finish the whole process and are divided into two groups (LDS and HDS). The postoperative hemoglobin (Hb) was 13.31±1.06 vs. 13.21±1.14 g/dL (p=0.50). The mean total operating time was 83.91±13.7 vs. 130.65±19.8 min (p<0.01), respectively. The hospitalization time was 3.4±1.1 vs 3.2±1.1 days (p=0.33), respectively. The free stone rate was 91.5% vs. 93.5% (p=0.54) and the street stone rate was 12(10%) vs. 3(2.4%) (χ2=6.173 a , p=0.01) in the LDS and HDS groups.Conclusions We concluded that FURS is safe and effective for the treatment of large renal pelvic stones 2-3 cm. There is no difference in the SFR between LDS and HDS group after the FURS operation. Density (as measured by non-contrast CT) of the renal calculus can help predict the treatment outcome before FURS. For appropriate patients, FURS should be chosen as a common approach in the treatment of renal pelvic calculus.

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“…Recently, minimally invasive treatment modalities including miniaturized percutaneous nephrolithotomy (mPNL) and flexible ureterorenoscopy (f‐URS) are widely performed with acceptable stone‐free and complication rates. The combination of modern flexible ureterorenoscopes and holmium laser assure effective stone fragmentation while using natural orifices [3]. Other size, access through 14F–20F is called mPNL and mPNL provides less hemorrhagic complications and postoperative morbidity compared with conventional percutaneous nephrolithotomy (cPNL) [4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of miniaturized percutaneous nephrolithotomy and flexible ureterorenoscopy for moderate size renal stones in elderly patients

Özgör

Yanaral

Savun

et al. 2017

The Kaohsiung J of Med Scie

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Life expectancy has become longer, thus the number of elderly people who require treatment for nephrolithiasis has increased. We aimed to analyze the efficacy of flexible ureterorenoscopy (f-URS) and miniaturized percutaneous nephrolithotomy (mPNL) in the management of 10 and 30 mm renal stones in patients aged >60 years. In prospective non-randomized series, the data of patients who underwent f-URS or mPNL for kidney stones between July 2013 and July 2016 were analyzed. The procedure was accepted as successful if the patient was achieved complete stone clearance according to CT imaging between 1-3 months postoperatively. In total 60 patients and 58 patients were underwent f-URS and mPNL, respectively. The mean operation time, fluoroscopy time and hospitalization time were significantly shorter for the f-URS (p < 0.001, p < 0.001, p < 0.001, respectively). According to Clavien classification system, complication rates were not significantly different between the groups (p = 0.673). The stone-free rate was 81.7% for the f-URS group and 77.6% for the mPNL group after a single-session procedure (p = 0.747). Calcium oxalate monohydrate stones were the most common stone type in both groups. In multivariate analysis, multiple stones localization was only independent factor to predict complications. Our study had showed that both f-URS and mPNL are effective treatment modalities for 10-30-mm renal stones in elderly patients. Additionally, presence of stones in multiple location was the only predictive factor for complication development.

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Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

Cited by 18 publications

References 23 publications

Retrograde intrarenal surgery in the management of solitary large renal stones, 2-3 cm: a single center experience

Retrograde intrarenal surgery in the management of solitary large renal stones, 2-3 cm: a single center experience

The stone density does not affect the stone-free rate of kidney pelvic stones (2-3 cm) treated with flexible ureterorenoscopy

Comparison of miniaturized percutaneous nephrolithotomy and flexible ureterorenoscopy for moderate size renal stones in elderly patients

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