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Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results

Asian Journal of Urology 2023年第1期10卷 58-63页

作者： Dor Golomb Hanan Goldberg Shlomi Tapiero Yariv Stabholz Paz Lotan Abd Elhalim Darawsha Ronen Holland Yaron Ehrlich David Lifshitz Department of Urology Rabin Medical Center-Beilinson HospitalPetach TikvaSackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael Department of Urology State University of New York Upstate Medical UniversitySyracuseNYUSA

Objective:To evaluate the long-term stone-free rate(SFR)of retrograde intrarenal surgery(RIRS)in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free ***:All consecutive patients undergoing RIRS lower pole renal calculi at a single highvolume tertiary center were analyzed *** pole stones were relocated to the upper pole,where laser lithotripsy was *** patients were followed up in the clinic following the surgery and yearly *** stone-free status was assessed with a combination of an abdominal ultrasound and abdominal X-ray,or an abdominal non-contrast computed tomography if the stones were known to be ***:A total of 480 consecutive patients who underwent RIRS for treatment of lower pole renal calculi,between January 2012 and December 2018,were analyzed from a prospectively maintained database of 3000 *** a median follow-up time of 18.6 months,the mean SFR was 94.8%.The procedures were unsuccessful in 26(5.4%)patients due to unreachable *** median stone size of the unreachable stones was 12 mm(range 10e30 mm).Multivariable logistic regression analysis revealed two predictors of SFR for lower pole stones:a small cumulative stone burden(odds ratio[OR]:0.903,95%confidence interval[CI]:0.867e0.941,plower pole stones with basket displacement with appropriate patient selection is high.

关键词： Ureteroscopy lower pole stones Retrograde intrarenal surgery Stone-free rate Basketing

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Present indications and techniques of percutaneous nephrolithotomy:What the future holds?

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Asian Journal of Urology 2018年第4期5卷 287-294页

作者： Itay M.Sabler Ioannis Katafigiotis Ofer N.Gofrit Mordechai Duvdevani Department of Urology Hadassah Hebrew University HospitalEin KaremJerusalemIsrael

The purpose of the review was to present the latest updates on percutaneous nephrolithotomy(PCNL)procedure in terms of indications and evolving techniques,and to identify the advantages and disadvantages of each *** data for this review were collected after a thorough PubMed search in core clinical journals in English *** key words included“PCNL”and“PNL”in combination with“indications”,“techniques”,“review”and“miniaturized PCNL”.Publications relevant to the subject were retrieved and critically *** European and American Urology Association Nephrolithiasis Guidelines were included as *** indications for standard PCNL have been changed through the past *** evolution of the procedure,innovations and the development of new technical approaches,the indications for miniaturized PCNL have not been standardized *** is a need for well-constructed randomized trials to explore the indications,complications and results for each evolving approach.A continuous reduction of tract size is not the only revolution of the last *** is constant ongoing interest in developing new efficient miniature instruments,intracorporeal lithotripters and sophisticated tract creation *** can summarize that,PCNL represents a valuable well-known tool in the field of *** should be open minded to future changes in surgical approaches and technological improvements.

关键词： Percutaneous nephrolithotomy Nephrolithiasis Intracorporeal lithotripsy Lasers Tract creation Renal access Horseshoe kidney Calyceal diverticulum lower pole stones

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