Unfavorable factors in accessing the pelvicalyceal system during retrograde flexible ureteroscopy (fURS)

Geavlete, B.; Mareș, Cristian; Popescu, R.; Multescu, R.; Ene, C.; Geavlete, P.

doi:10.25122/jml-2023-0005

Cited by 3 publications

(1 citation statement)

References 72 publications

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“…Technological advances have made this procedure safe, and efficient, and provided excellent results in the benefit-safety ratio. Some characteristics of the intrarenal anatomy as the infundibulum pelvic angle and infundibular length must be considered before any procedure ( 44 ).…”

Section: Angle Between the Inferior Infundibulum And Renal Pelvismentioning

confidence: 99%

Kidney collecting system anatomy applied to endourology - a narrative review

Morais,

Favorito,

Sampaio

2024

Int. braz j urol.

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Objective: To evaluate the surgical anatomy of the kidney collecting system through a narrative review of the literature, highlighting its importance during diagnosis and its approach during surgical procedures for the treatment of renal stones. Material and Methods: We carried out a review about the anatomy of the kidney collecting system. We analyzed papers published in the past 40 years in the databases Pubmed, Embase and Scielo, and we included only papers in English and excluded case reports, editorials and opinions of specialists. Results: Renal collecting system could be divided in four groups: A1 – kidney midzone (KM), drained by minor calyx that are dependent on the superior or the inferior caliceal groups; A2 – KM drained by crossed calyx, one draining into the superior caliceal group and another draining into the inferior caliceal group; B1 – KM drained by a major caliceal group independent of both the superior and inferior groups; and B2 – KM drained by minor calyx entering directly into the renal pelvis. Some details and anatomic variations of the collecting system are related to clinical and radiological aspects, particularly perpendicular calyces, interpyelocalyx space, position of calyces in relation to renal border, classification of the renal collecting system, infundibular diameter and the angle between the lower infundibulum and renal pelvis. Conclusion: The knowledge of intra-renal collecting system divisions and variations as the angle between the renal pelvis and lower infundibula, position of the calices in relationship with renal edge and the diameter and position of the calyces are important for the planning of minimally invasive renal surgeries.

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Section: Angle Between the Inferior Infundibulum And Renal Pelvismentioning

confidence: 99%

Kidney collecting system anatomy applied to endourology - a narrative review

Morais,

Favorito,

Sampaio

2024

Int. braz j urol.

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RIRS with FV-UAS vs. ESWL for the management of 1–2-cm lower pole renal calculi in obese patients: a prospective study

Zhang,

Wang,

et al. 2024

Preprint

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Objective To evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) combined with fexible vacuum-assisted ureteral access sheath (FV-UAS) versus extracorporeal shock wave lithotripsy (ESWL) for the management of 1–2 cm lower pole renal calculi (LPC) in obese patients. Patients and methods This prospective, randomized study included 149 obese patients with 1-2 cm LPC. Patients were allocated into two groups: 76 patients underwent RIRS with FV-UAS, and 73 patients received ESWL.The parameters assessed included stone-free rate (SFR), retreatment rate, complications, operative time, and pain intensity measured by the Visual Analog Scale (VAS).Stone-free status was defined as the absence of stones on computed tomography or residual fragments smaller than 4 mm at 4 weeks post-procedure. Results The baseline characteristics of the two groups were comparable.The SFR was significantly higher in the RIRS group, reaching 86.8%, compared to 63.0% in the ESWL group (P = 0.034). Furthermore, the retreatment rate was significantly lower in the RIRS group, at 5.2%, versus 24.7% in the ESWL group (P < 0.001). The average operative time for RIRS was notably longer, at 65.3 ± 6.4 minutes, compared to 25.3 ± 7.8 minutes for ESWL (P < 0.001). The complication rates were 9.2% for the RIRS group and 6.8% for the ESWL group, with no statistically significant difference (P = 0.326). All complications were classified as Grade I or II according to the modified Clavien classification system. No significant differences were observed between the two groups regarding pain VAS scores and the composition of the stones. Conclusions RIRS with FV-UAS demonstrated superior efficacy, evidenced by a higher SFR and reduced retreatment rates compared to ESWL, despite a longer operative duration. Both treatment modalities showed comparable safety profiles. RIRS with FV-UAS emerges as a viable, effective, and reproducible intervention for managing 1-2 cm LPC in obese patients, providing significant clinical advantages.

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RIRS with FV-UAS vs. ESWL for the management of 1–2 cm lower pole renal calculi in obese patients: a prospective study

Men,

Xu,

Zhang

et al. 2024

Front. Med.

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ObjectiveTo evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) combined with flexible vacuum-assisted ureteral access sheath (FV-UAS) versus extracorporeal shock wave lithotripsy (ESWL) for the management of 1–2 cm lower pole renal calculi (LPC) in obese patients.Patients and methodsThis prospective, randomized study included 149 obese patients with 1–2 cm LPC. Patients were allocated into two groups: 76 patients underwent RIRS with FV-UAS, and 73 patients received ESWL. The parameters assessed included stone-free rate (SFR), retreatment rate, complications, operative time, and pain intensity measured by the visual analog scale (VAS). Stone-free status was defined as the absence of stones on computed tomography or residual fragments smaller than 4 mm at 4 weeks post-procedure.ResultsThe baseline characteristics of the two groups were comparable. The SFR was significantly higher in the RIRS group, reaching 86.8%, compared to 63.0% in the ESWL group (p = 0.034). Furthermore, the retreatment rate was significantly lower in the RIRS group, at 5.2%, versus 24.7% in the ESWL group (p < 0.001). The average operative time for RIRS was notably longer, at 65.3 ± 6.4 min, compared to 25.3 ± 7.8 min for ESWL (p < 0.001). The complication rates were 9.2% for the RIRS group and 6.8% for the ESWL group, with no statistically significant difference (p = 0.326). All complications were classified as Grade I or II according to the modified Clavien classification system. No significant differences were observed between the two groups regarding pain VAS scores and the composition of the stones.ConclusionRIRS with FV-UAS demonstrated superior efficacy, evidenced by a higher SFR and reduced retreatment rates compared to ESWL, despite a longer operative duration. Both treatment modalities showed comparable safety profiles. RIRS with FV-UAS emerges as a viable, effective, and reproducible intervention for managing 1–2 cm LPC in obese patients, providing significant clinical advantages.

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Unfavorable factors in accessing the pelvicalyceal system during retrograde flexible ureteroscopy (fURS)

Cited by 3 publications

References 72 publications

Kidney collecting system anatomy applied to endourology - a narrative review

Kidney collecting system anatomy applied to endourology - a narrative review

RIRS with FV-UAS vs. ESWL for the management of 1–2-cm lower pole renal calculi in obese patients: a prospective study

RIRS with FV-UAS vs. ESWL for the management of 1–2 cm lower pole renal calculi in obese patients: a prospective study

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