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Clinical study on the minimally invasive percutaneous nephrolithotomy treatment of upper urinary calculi

World Journal of Clinical Cases 2022年第4期10卷 1198-1205页

作者： Xiao-Jian Xu Jun Zhang Miao Li Jian-Quan Hou Department of Urology The First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina

BACKGROUND Upper urinary tract stones are very common in my country,with an incidence of 1%to 5%in the North and an even higher incidence of 5%to 10%in the south.The incidence rate in the south is higher than that in the north,mainly due to the water quality,climate and eating habits of the region.From the perspective of sex,incidence is more likely in males than females.In the high-incidence population,young adults are most prone to stones.Men in the age range of 25 to 40 years are more likely to have stones.AIM To observe the therapeutic effect of minimally invasive percutaneous nephrolithotomy(mPCNL)on upper urinary tract stones and its influence on the renal function of patients.METHODS Patients with upper urinary tract stones who were treated in our hospital from February 2017 to March 2018 were selected as research subjects and were divided into the PCNL group and the mPCNL group according to the random number table method.The general conditions of the two groups of patients were observed during the perioperative period,and the differences in stone clearance,pain,renal function indicators and complication rates were compared between the two groups to determine which were statistically significant(P<0.05).RESULTS The operation time of the mPCNL group was longer than that of the PCNL group(t=-34.392,P<0.001),and the intraoperative blood loss of the mPCNL group was more than that of the PCNL group(t=34.090,P<0.001).There was no difference in renal function indices between the two groups of patients before treatment,and there was no difference in the levels of serum creatinine,β2 microglobulin or retinol binding protein in the mPCNL group after treatment.The visual analog scale score of patients in the mPCNL group was lower than that of the PCNL group(t=12.191,P<0.001),and there was no significant difference in the stone clearance rate between the two groups(χ2 value=1.013,P=0.314).There was no significant difference in the incidence of urine extravasation,dyspnea and peripheral organ damage between the two gro

关键词： Percutaneous nephrolithotomy Minimally invasive percutaneous nephrolithotomy Upper urinary calculi calculi Renal function Complications

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The burden of prostatic calculi is more important than the presence

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Asian Journal of Andrology 2017年第4期19卷 482-485页

作者： Bumsoo Park Seol Ho Choo Department of Urology Kangnam General Hospital Yongin Korea Department of Family Medicine Henry Ford Hospital Wayne State University School of Medicine Detroit MI United States Department of Urology Ajou University School of Medicine Suwon Korea

Prostatic calculi are a common finding on transrectal prostate ultrasound. However, it remains unclear whether they are significantly associated with lower urinary tract symptoms （LUTS）. Our objective was to evaluate the association between prostatic calculi and LUTS with a focus on ＂calculi burden＂ because no studies have investigated prostatic calculi using ＂calculi burden＂ as an indicator. A total of 606 participants who received transrectal prostate ultrasound were divided into two groups according to the presence of prostatic calculi. ＂calculi burden＂ was defined as the sum of the transverse diameters of all visible calculi within the prostate. The International Prostatic Symptom Score （IPSS） and a quality of life （QoL） score were collected. Both groups were compared, and a multivariate analysis was performed to predict moderate/severe LUTS. Linear correlation was evaluated between calculi burden and IPSS in the calculi group. No differences in total IPSS, voiding IPSS, or QoL score were detected between the two groups, but storage IPSS was significantly higher in the calculi group than that of controls. The multivariate analysis showed that the presence of prostatic calculi was not an independent predictor of moderate/severe LUTS. A positive linear correlation was detected between calculi burden and storage IPSS in calculi group （r = O. 148）. However, no correlation was found between calculi burden and total IPSS, voiding IPSS, or QoL score. Our results showed that the presence of prostatic calculi was not a significant factor predicting moderate/severe LUTS. However, an increased calculi burden may be associated with aggravating storage symptoms.

关键词： calculi lower urinary tract symptoms prostate prostatitis

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Extensive prostatic calculi in alkaptonuria:An unusual manifestation of rare disease

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Asian Journal of Urology 2015年第3期2卷 179-181页

作者： Gaurav Sali Appu Thomas Ginil Kumar Balagopalan Nair Kalvampara Sanjeevan Georgie Mathew Kannan Nair Department of Urology Amrita Institute of Medical Sciences and Research CentrePonekkaraP.O KochiKeralaIndia

Extensive prostatic calculi in a young man should always elicit the suspicion of alkaptonuria.Although prostatic calculi are seen in chronic prostatitis,chronic pelvic pain syndrome and benign prostate hyperplasia,none of these have prostatic calculi or calcification as extensive as in alkaptonuria.A 36 years young man who had severed obstructive lower urinary tract symptoms with extensive prostatic calculi was found to be alkaptonuric on further evaluation.

关键词： Alkaptonuria calculi Lower urinary tract symptoms Prostate Young

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Upper Urinary Tract calculi in Senegal: A Comparative Study between Open Surgery and Endoscopy, a Review of 89 Cases

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Open Journal of Urology 2015年第9期5卷 142-146页

作者： R. Kane Y. Diallo L. Niang A. Ndiaye M. Ndoye M. Jalloh M. Ogoubemy S. M. Gueye Department of Urology Principal Hospital Dakar Senegal Department of Urology Faculty of Health Sciences University of Thies Thies Senegal Department of Urology Grand Yoff Hospital Dakar University Dakar Senegal

Objective: The aim was to assess the place of endourologic intervention in our practice and compare it to open surgery in the management of upper urinary tract calculi in Senegal. Patients and Methods: This was a retrospective study conducted at both the Principal and Grand Yoff Hospitals of Dakar from January 2009 to December 2013 in which 89 patients with upper urinary tract calculi were mobilized. All patients with symptomatic upper urinary tract colic symptoms were included. Results: Eighty-nine were followed up during the study period, 63 men and 36 women (sex of ratio 1.2). The average age was 44 years with extremes 22 - 75 years. Forty two patients, including 28 men and 14 women (sex ratio 1: 2) were treated with open surgery. The mean age was 42.75 years (4 - 75 years). The average duration of hospitalization after open surgery was 8 days (4 - 60 days). The mean stone size in open surgery was 23 mm (5 mm - 45 mm). Complications noted were: 2 cases of urinomas (4.76%), 1 case of lower back fistula (2.38%), 1 case of renal pelvis fistula (2.38%) and 1 case (2.38%) of infection. Forty seven patients including 35 men (55.6%) and 12 women (46.2%) were treated by endourology. The average length of hospital stay was 2 days (2 d - 3 d). The average stone size treated by endourology was 13 mm (5 mm - 40 mm). No complications were observed in this group. The cost of open surgery was a third of that of endourology. Conclusion: Endoscopic surgery, as is observed from industrialized countries occupies a prominent place in the treatment of upper urinary tract calculi in Senegal;however, the only limiting factor encountered is the cost which remains out of reach for patients and burdening the budgets of our hospitals with limited means.

关键词： Upper Urinary Tract calculi Endourology Open Surgery

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Complication and safety of ultrasound guided percutaneous nephrolithotomy in 8 025 cases in China

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Chinese Medical Journal 2014年第24期127卷 4184-4189页

作者： Li Jianxing Xiao Bo Hu Weiguo Yang Bo Chen Liang Hu Hao Wang Xiaofeng Department of Urology Tsinghua Changgung Hospital Beijing 102218 China Department of Urology Peking UniversityPeople's Hospital Beijing 100044 China

Background Percutaneous nephrolithotomy （PCNL） was mostly performed with fluoroscopy and/or ultrasonography. The safety and feasibility of PCNL performed totally under ultrasound are not clearly defined. Therefore, we introduce the 9-year experience of 8 025 ultrasound guided PCNL procedures from multiple centers in China performed by the same surgeon, to evaluate the feasibility and security of this technique. Methods From September 2004 to August 2013, 8 025 cases, 4 398 males （54.8%） and 3 627 females （45.2%）, whose age ranged from 6 months to 85 years old, with upper urinary tract stones, underwent PCNL in our center and the supported hospitals. Puncture site selection and channel dilation were all guided using only Doppler ultrasound. Single stones were treated in 1 356 cases, there were 2 817 cases of multi stones, and 3 852 cases of staghorn calculi. The pre- and post-operative imaging data, the intraoperative findings, operation time, perioperative complications, and related parameters were recorded. Results All procedures were successful. No patients died during the operation. Average operation time was 42 minutes （range 10 to 168 minutes）, 4 cases converted to open surgery, and 2 patients lost the diseased kidney due to refractory bleeding in the early stage of the PCNL. Ninety-four （1.2%） patients received blood transfusions and 20 （0.25%） patients needed highly selective renal artery embolization. Fifteen （0.19%） patients had a pleural injury. 5 457 （68%） cases were completed by a single tract and 2 568 （32%） cases added more tracts. The mean stone size （longest diameter） was 2.8 cm （range 1.2 to 26.5 cm）. The final stone-free rate was 85.5%. Residual stones occurred mainly in patients with renal dysfunction, medullary sponge kidney, and complete staghorn calculi with a slim calyceal neck. Conclusions X-ray free Doppler ultrasound guided percutaneous nephrolithotomy is feasible and safe in a variety of cases of renal and/or upper ureteral stones. The probability of radiation hazard and adjacent organ

关键词： percutaneous nephrolithotomy ultrasound kidney calculi safety

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A large intrascrotal calculus

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Asian Journal of Andrology 2005年第1期7卷 103-105,页

作者： Gong-HuiLi Xin-DeLi ShengCheng Zhao-DianChen DepartmentofUrology SirRunRunShawHospitalHospitalCollegeofMedicalSciencesZhejiangUniversityHangzhou310016China DepartmentofUrology FirstAffiliatedHospitalCollegeofMedicalSciencesZhejiangUniversityHangzhou310016China

A large stone with 8.7 cm x 7.2 cm x 6.5 cm in size and 420 g in weight dropped down spontaneously from a 93-year-old man's scrotum, who had suffered from left intrascrotal mass and pain for more than 20 years. The component of the stone was magnesium ammonium phosphate. To the best of our knowledge, it is the largest intrascrotal calculus reported in the world. We hereby present the case and discuss the diagnosis and etiology of scrotal calculi.

关键词： calculi scrotum etiology

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Laparoscopic treatment of a calcium fluorophosphate stone within a seminal vesicle cyst

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Asian Journal of Andrology 2008年第2期10卷 337-340页

作者： Ping Han Yu-Ru Yang Xin-Yuan Zhang Qiang Wei Department of Urology West China Hospital Analytical and Testing Center Sichuan University Chengdu 610044 China

Stones in the seminal vesicles are extremely rare. We present a 62-year-old patient with a stone within a seminal vesicle cyst, who was cured by laparoscopic treatment. The operative time was 80 rnin, and the estimated blood loss was 90 mL. Scanning electron microscope examination of the stone showed a compact crystal image externally and sparse spherical crystal structure in kernel. Composition of the stone was calcium fluorophosphate on X-ray diffractometer. The follow-up time was 15 months with no recurrence of cyst or stone. To our knowledge, this case is the first to describe laparoscopic removal of a stone within a seminal vesicle cyst, and the first to describe calcium fluorophosphate as the composition of seminal vesicle stones. （Asian JAndro12008 Mar; 10： 337-340）

关键词： calcium phosphates calculi fluoride laparoscopy seminal vesicles sex organs, accessory, male water pollutants, chemical

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Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years： A Single-center Initial Experience from China

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Chinese Medical Journal 2015年第12期128卷 1596-1600页

作者： Bo Xiao Xin Zhang Wei-Guo Hu Song Chen Yu-Hong Li Yu-Zhe Tang Yu-Bao Liu Jian-Xing Li Department of Urology Beijing Tsinghua Changung Hospital Medical Center Tsinghua University Beijing 102218 China Department of Operating Room Beijing Tsinghua Changung Hospital Medical Center Tsinghua University Beijing 102218 China

Background：Urolithiasis in pediatric population is a serious problem with the incidence increased these years.In the management of larger stones （diameters 〉2 cm）,percutaneous nephrolithotomy （PCNL） is considered to be the gold standard.This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged 〈3 years.Methods：We reviewed 68 patients （80 renal units） aged 〈3 years between August 2006 and December 2014 in Peking University People＆#39;s Hospital and Beijing Tsinghua Changung Hospital,including 36 renal units with a single stone,6 with staghom stones,14 with upper ureteral stones,and 24 with multiple stones.The mean age of the patients was 24.2 months （range 6-36 months）,and the mean maximum stone diameter was 19.2 mm （range 10-35 mm）.The puncture site selection and tract dilation were guided by Doppler ultrasonography solely.All procedures were performed using 12-16 Fr tracts.Stones were fragrnented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.Results：Fifty-six patients with unilateral stones underwent a single session procedure,and 12 patients with bilateral stones underwent two procedures.The mean time to establish access was 2.8 min （range 1.8-5.0 min）,the mean operative time was 36.5 min （range 20-88 min）,the mean decrease in hemoglobin concentration was 8.9 g/L （2-15 g/L）,and the stone-free rate （SFR） at hospital discharge was 94.0%.The mean postoperative hospital stay was 7.1 days （range 3-13 days）.Postprocedure complications included fever （〉38.5℃） in five patients and reactive pleural effusion in one patient.Blood loss requiring transfusion,sepsis,adjacent organ injury,and kidney loss were not observed.Conclusions：This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged 〈3 years,without major complications or radiation exposure.

关键词： calculi Infant Kidney Percutaneous Nephrolithotorny Ultrasonography

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Efficacy of pancreatoscopy for pancreatic duct stones:A systematic review and meta-analysis

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World Journal of Gastroenterology 2020年第34期26卷 5207-5219页

作者： Syed M Saghir Harmeet S Mashiana Babu P Mohan Banreet S Dhindsa Amaninder Dhaliwal Saurabh Chandan Neil Bhogal Ishfaq Bhat Shailender Singh Douglas G Adler Department of Internal Medicine University of Nevada Las Vegas School of MedicineLas VegasNV 89102United States Division of Gastroenterology and Hepatology University of Nebraska School of MedicineOmahaNE 68198-2000United States Division of Gastroenterology and Hepatology University of Utah HealthSalt Lake CityUT 84132United States

BACKGROUND Pancreatic duct stones can lead to significant abdominal pain for patients.Per oral pancreatoscopy(POP)-guided intracorporal lithotripsy is being increasingly used for the management of main pancreatic duct calculi(PDC)in chronic pancreatitis.POP uses two techniques:Electrohydraulic lithotripsy(EHL)and laser lithotripsy(LL).Data on the safety and efficacy are limited for this procedure.We performed a systematic review and meta-analysis with a primary aim to calculate the pooled technical and clinical success rates of POP.The secondary aim was to assess pooled rates of technical success,clinical success for the two individual techniques,and adverse event rates.AIM To perform a systematic review and meta-analysis of POP,EHL and LL for management of PDC in chronic pancreatitis.METHODS We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed,EMBASE,Cochrane,Google Scholar and Web of Science databases(from 1999 to October 2019)to identify studies with patient age greater than 17 and any gender that reported on outcomes of POP,EHL and LL.The primary outcome assessed involved the pooled technical success and clinical success rate of POP.The secondary outcome included the pooled technical success and clinical success rate for EHL and LL.We also assessed the pooled rate of adverse events for POP,EHL and LL including a subgroup analysis for the rate of adverse event subtypes for POP:Hemorrhage,post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP),perforation,abdominal pain,fever and infections.Technical success was defined as the rate of clearing pancreatic duct stones and clinical success as the improvement in pain.Randomeffects model was used for analysis.Heterogeneity between study-specific estimates was calculated using the Cochran Q statistical test and I2 statistics.Publication bias was ascertained,qualitatively by visual inspection of funnel plot and quantitatively by the Egger test.RESULTS A total of 16 studies including 383 patients

关键词： Electrohydraulic shockwave lithotripsy Laser lithotripsy Chronic pancreatitis calculi Extracorporeal shockwave lithotripsy Endoscopic retrograde cholangiopancreatography Systematic review Meta-analysis Outcome

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One-phase treatment for calculous pyonephrosis by percutaneous nephrolithotomy assisted by EMS LithoClast master

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Chinese Medical Journal 2013年第8期126卷 1584-1586页

作者： WANG Jian ZHOU Da-qing HE Meng LI Wen-gang PANG Xiang YU Xiao-xiang JIANG Bo Department of Urology 303th Hospital of People's LiberationArmy Nanning Guangxi 530021 China

The one-phase therapy for calculous pyonephrosis through percutaneous nephrolithotomy （PCNL） iscurrently vigorously debated. After a definite preoperative diagnosis of pyonephrosis, the traditional approach1 has been initial drainage through puncture and nephrostomy. Upon the stabilization of symptoms, a second-phase operation is performed. If pus is discovered during an intra-operative puncture, a nephrostomy tube is deposited until a second elective operation. With the advancements of science and technology, the third generation EMS LithoClast master is capable of not only efficiently crushing and removing the stones, but also lowering the intra-pelvic pressure through vacuum suction. Thus the surgical risks have been greatly reduced so that many one-phase operations for calculous pyonephrosis may be completed.2

关键词： percutaneous nephrolithotomy calculi pyonephrosis pressure

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