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

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.2016.05.090

Cited by 971 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: 96%

“…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%

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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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Section: Implications For Clinical Practicementioning

confidence: 59%

Section: Implications For Clinical Practicementioning

confidence: 96%

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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“…Both European Urology Association and American Urological Association guidelines recommend PCNL as the treatment option for larger renal calculi [3,4].…”

Section: Introductionmentioning

confidence: 99%

Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)

et al. 2017

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E U R O P E A N U R O L O G Y X X X ( 2 0 1 7 ) X X X -X X X a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m Article info AbstractBackground: Puncture of the renal collecting system represents a challenging step in percutaneous nephrolithotomy (PCNL). Limitations related to the use of standard fluoroscopic-based and ultrasound-based maneuvers have been recognized. Objectives: To describe the technique and early clinical outcomes of a novel navigation system for percutaneous kidney access. Design, setting, and participants: This was a proof-of-concept study (IDEAL phase 1) conducted at a single academic center. Ten PCNL procedures were performed for patients with kidney stones. Surgical procedure: Flexible ureterorenoscopy was performed to determine the optimal renal calyx for access. An electromagnetic sensor was inserted through the working channel. Then the selected calyx was punctured with a needle with a sensor on the tip guided by real-time three-dimensional images observed on the monitor. Outcome measurements and statistical analysis: The primary endpoints were the accuracy and clinical applicability of the system in clinical use. Secondary endpoints were the time to successful puncture, the number of attempts for successful puncture, and complications. Results and limitations: Ten patients were enrolled in the study. The median age was 47.1 yr (30-63), median body mass index was 22.85 kg/m 2 (19-28.3), and median stone size was 2.13 cm (1.5-2.5 cm). All stones were in the renal pelvis. The Guy's stone score was 1 in nine cases and 2 in one case. All 10 punctures of the collecting system were successfully completed at the first attempt without X-ray exposure. The median time to successful puncture starting from insertion of the needle was 20 s (range . No complications occurred. Conclusions: We describe the first clinical application of a novel navigation system using real-time electromagnetic sensors for percutaneous kidney access. This new technology overcomes the intrinsic limitations of traditional methods of kidney access, allowing safe, precise, fast, and effective puncture of the renal collecting system. Patient summary: We describe a new technology allowing safe and easy puncture of the kidney without radiation exposure. This could significantly facilitate one of the most challenging steps in percutaneous removal of kidney stones.

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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

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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 I

Cited by 971 publications

References 30 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

Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)

Tratamento da Litíase Renal com Ureterorrenoscopia: Experiência de um centro

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