Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II

Assimos, Dean G.; Krambeck, Amy E.; Miller, Nicole L.; Monga, Manoj; Murad, M. Hassan; Nelson, Caleb P.; Pace, Kenneth T.; Pais, Vernon M.; Pearle, Margaret S.; Preminger, Glenn M.; Razvi, Hassan; Shah, Ojas; Matlaga, Brian R.

doi:10.1016/j.juro.2016.05.091

Cited by 575 publications

(446 citation statements)

References 35 publications

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“…Counterbalancing for URS's higher SFRs, SWL is associated with the least morbidity and lower complication rates [65][66][67]. In this current systematic review, Clavien-Dindo grade complications were, if reported, less frequent in patients treated with SWL.…”

Section: Implications For Clinical Practicementioning

confidence: 59%

“…However, for stones >10 mm, SFR were comparable for URS and SWL (74% vs 79%) in the proximal ureter [64]. The current, 2016 American Urological Association Guidelines state that URS for proximal ureteral stones has a greater SFR in a single procedure compared with SWL, regardless of stone size [65,66], albeit the importance of informing patients on the higher morbidity and complications risk compared with SWL. All in all, URS can be recommended as the first treatment option for proximal ureteral stones >10 mm, but for stones 10 mm the EAU Urolithiasis Guidelines panel consensus is that either treatment options are viable as first choice and should be presented to patients [67].…”

Section: Implications For Clinical Practicementioning

confidence: 97%

“…However, for all patients with ureteral stones, when residual fragments are present, especially if initial SWL fails, urologists should offer endoscopic procedures to render the patients stone free. Success rates for PCNL and URS as secondary procedures after failed SWL are reported as 86-100% and 62-100%, respectively [65,66].…”

Section: Implications For Clinical Practicementioning

confidence: 99%

See 2 more Smart Citations

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

et al. 2017

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Section: Implications For Clinical Practicementioning

confidence: 59%

Section: Implications For Clinical Practicementioning

confidence: 97%

Section: Implications For Clinical Practicementioning

confidence: 99%

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What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

et al. 2017

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“…1 With stone-free rates ranging from 75% to 95%, PCNL has proven to be an efficacious treatment for large calculi, staghorn, stones in kidneys with abnormal anatomy, and stones in more complicated patient groups. [2][3][4][5][6] Despite the advantages, incidence of complications is reported from 16% to 83%, with major complications representing 4.7% in tertiary referral centers.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Postoperative Complications after Percutaneous Nephrolithotomy

Basnet

Shrestha

et al. 2018

J Nepal Health Res Council

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Background:To identify the perioperative factors associated with complications after percutaneous nephrolithotomy by classification of complications according to the modified Clavien scoring system and evaluation of the minor and major complications related to the procedure. Methods:A prospective study of all the percutaneous nephrolithotomy performed by standard technique within 1.5 years at Bir Hospital was made. Possible demographic, preoperative and intraoperative variables were included in the study and patients were followed up postoperatively for any complications. All complications were classified according to modified Clavien scoring system and analyzed to identify the prognostic variables.Results: Two hundred and forty six percutaneous nephrolithotomy done within the study period were analyzed. Although 41.06 % of the study population developed complications, only 9.35 % had major complications. Age, body mass index, gender, clinical presentation, history of previous surgery and ASA score did not correlate with complications. Diabetes was the only comorbidity associated (p = 0.0482). Preoperatively estimated stone burden (p = 0.0023), number of calyces involved by the stones (p = 0.0002), and presence of staghorn calculi were significantly associated with development of postoperative complications. Multiple tracts were required (p = 0.0151) and operative time was longer (p < 0001) in the patients who developed complications. Conclusions:Percutaneous nephrolithotomy has lesser complications. Diabetic patients are more prone to develop complications. Larger stone burden, involvement of multiple calyces by stones and staghorn calculi are associated with need of multiple tracts and longer operative time, thus predisposing to higher incidence of complications.

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“…Em relação ao controlo imagiológico pós-operatório, registámos o tempo até este, qual o tipo de exame utilizado e a presença ou ausência de litíase residual superior a 3 mm. 7,8 No caso de falência, avaliada pelo controlo imagiológico, registámos a abordagem adotada posteriormente em termos de terapêutica (Fig.1).…”

Section: Introductionunclassified

Tratamento da Litíase Renal com Ureterorrenoscopia: Experiência de um centro

Cerqueira¹,

Cerqueira²,

Dinis³

2017

aup

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ResumoIntrodução: No presente estudo, analisámos os resultados iniciais desta técnica no nosso centro, com o objetivo de avaliar a eficácia e segurança da cirurgia intra-renal retrógrada no tratamento de cálculos renais e fatores preditores do seu sucesso. Material e Métodos: Após a recolha dos dados dos processos clínicos e exames de imagem dos doentes submetidos a cirurgia intra-renal retrógrada para tratamento de cálculos renais em 2014 e 2015 no Centro Hospitalar de São João, e aplicação dos critérios de exclusão, analisámos os dados relativos a 138 doentes (total de 179 cirurgia intra-renal retrógrada). Os nossos desfechos primários foram a taxa de sucesso imediata, avaliada pela perceção do cirurgião, e a taxa de sucesso pós-operatória, avaliada pela imagiologia de controlo, considerando como litíase residual significativa cálculos > 3 mm. Resultados: A taxa de sucesso global foi de 67,0% tendo em conta a perceção do cirurgião. Considerando o controlo imagiológico, a taxa de sucesso foi de 66,7% nos cálculos < 150 mm 2 fora do grupo calicial inferior, mas menor nas restantes localizações ou carga litiásica maior. Na análise univariada, a carga litiásica, o número de cálculos e a localização foram estatisticamente significativos como preditores do sucesso da cirurgia intra-renal retrógrada. Não foram registadas complicações major. Conclusão: A localização no grupo calicial inferior foi considerada um preditor do insucesso da cirurgia intra-renal retrógrada, sendo que neste grupo calicial a eficácia foi maior nos cálculos com <150 mm 2 ; esta diferença não se verificou nos cálculos fora desta localização. É uma intervenção segura, permitindo a sua utilização seriada.

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Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II

Cited by 575 publications

References 35 publications

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

Risk Factors for Postoperative Complications after Percutaneous Nephrolithotomy

Tratamento da Litíase Renal com Ureterorrenoscopia: Experiência de um centro

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