Abstract:
BACKGROUND AND PURPOSE:Percutaneous nephrolithotomy for staghorn calculi is reported to have a residual stone rate of 28%, while shockwave lithotripsy alone results in residual stones in approximately 50% of cases. Combination therapy, sandwich therapy, and multiple percutaneous accesses have also been advocated for staghorn stones. We believe these stones can often be removed with a staged procedure via a single upper-pole percutaneous access using flexible nephroscopy and the holmium:YAG laser. Our experience is reviewed. PATIENTS AND METHODS:The hospital records of patients having a cumulative stone burden > or =5 cm who underwent percutaneous nephrolithotripsy (PCNL) for a single complex staghorn calculus were reviewed. There were 15 male and 34 female patients having 45 complete and 7 partial staghorn calculi constituting a mean stone burden of 6.7 cm (range 5.0-10.0 cm). A calix was punctured that would provide access to the majority of the involved calices. Thirty-five renal units were approached through a single upper-pole percutaneous access, and four and six renal units were accessed through single middle or lower-pole calices, respectively. The remaining seven renal units were treated with multiple percutaneous accesses. RESULTS:In the renal units having only a single access, a mean of 1.6 (range 1-3) procedures were required to achieve stone-free status. The mean operating room time was 2.9 hours (range 2.0-3.5 hours). For the second PCNL, the mean operating room time was 63 minutes (range 30-90 minutes). Two patients (two renal units) had residual stones <1 cm in diameter. One refused additional surgery, and the other is awaiting further treatment. The mean estimated blood loss was 238 mL (range 50-800 mL), with only one procedure (2.2%) necessitating a blood transfusion. One (2.8%) hydrothorax developed among the 35 upper-pole puncture cases. Six patients had transient oral temperature readings >101 degrees F with negative blood cultures. Other early complications included single cases of leg cellulitis, atrial fibrillation, and noncardiac chest pain. There were no delayed surgical complications. Patients were discharged from the hospital a mean 2 days (range 1-10 days) after the first PCNL. CONCLUSION:Use of flexible nephroscopy with holmium:YAG laser lithotripsy and Nitinol basket stone extraction has allowed us to render staghorn-containing renal units stone free in a mean of 1.6 procedures. Of the 45 renal units treated through a single percutaneous access, 43 (95%) were rendered stone free. The holmium:YAG laser appears to be a safe lithotrite for the kidney, as no complications occurred from its use.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Wong C,Leveillee RJdoi
10.1089/089277902760367430subject
Has Abstractpub_date
2002-09-01 00:00:00pages
477-81issue
7eissn
0892-7790issn
1557-900Xjournal_volume
16pub_type
杂志文章abstract:PURPOSE:We evaluated complications of urologic laparoscopic surgery at our institution. PATIENTS AND METHODS:From December 1991 to January 2009, 1017 urologic laparoscopic surgical procedures were performed in Kansai Medical University, including 277 radical prostatectomies, 13 donor nephrectomies, 74 partial nephrect...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0322
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Several kinds of flexible ureteroscopes are in use for the removal of kidney stones. This study evaluated and compared the characteristics of four new-generation flexible ureteroscopes. MATERIALS AND METHODS:The flexible ureteroscopes studied were: the ACMI Dur-8 Elite, the Storz Flex-X2 the Oly...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0371
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:Clinical studies have shown beneficial role of oral alpha-blockers for ureteral stent-related morbidity. However, the in vivo effects of oral alpha-blockers on a stented ureter are unclear. We evaluated the effects of alpha-blockade on ureteral dynamics in a stented porcine ureter. METHODS:Twenty-seven fe...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0251
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hemodynamic changes during abdominal laparoscopic procedures have been described as multifactorial phenomena. We report the possible occurrence of bradycardia and asystolic cardiac arrest during insufflation of the balloon trocar as a rare and serious but reversible complication during endoscopic...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0139
更新日期:2009-02-01 00:00:00
abstract:PURPOSE:To assess whether our ureteroscopic real-time navigation system has the possibility to reduce radiation exposure and improve performance of ureteroscopic maneuvers in surgeons of various ages and experience levels. MATERIALS AND METHODS:Our novel ureteroscopic navigation system used a magnetic tracking device ...
journal_title:Journal of endourology
pub_type: 杂志文章,多中心研究
doi:10.1089/end.2015.0054
更新日期:2015-09-01 00:00:00
abstract:INTRODUCTION:Open nephrectomy is associated with significant morbidity. For several years, minimally invasive alternatives have been developed such as laparoscopic nephrectomy or transarterial renal ablation. This paper focuses on the different principles of vaso-occlusion and further improvements of the technique such...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.9826
更新日期:2008-04-01 00:00:00
abstract:PURPOSE:This study evaluates the feasibility, perioperative, and renal functional outcomes with total, selective, and nonarterial clamping techniques during minimally invasive partial nephrectomy. METHODS:A retrospective review of laparoscopic and robot-assisted partial nephrectomies by a single surgeon from January 2...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0304
更新日期:2012-02-01 00:00:00
abstract::We report an unusual ureteral foreign body resulting from a complication of pulsed-dye laser lithotripsy: a retained laser fiber fragment. It was removed with two endoscopic procedures without long-term problems. ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.29
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Transurethral resection of the bladder (TURB), the first step in treatment of patients with urothelial bladder cancers, is limited by technicalities, surgeon skill, and random chance. When high-risk superficial diseases are discovered, a repeated TURB is indicated. We reviewed current literature ...
journal_title:Journal of endourology
pub_type: 杂志文章,meta分析,评审
doi:10.1089/end.2011.0081
更新日期:2011-11-01 00:00:00
abstract:PURPOSE:To present the combination of laparoscopy and nephroscopy for the treatment of stones in pelvic ectopic kidneys. PATIENTS AND METHODS:The series included seven male and four female patients (mean age 43 +/- 9 years). Laparoscopy-assisted percutaneous nephrolithotomy (PCNL) was performed for caliceal stones in ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.9930
更新日期:2007-10-01 00:00:00
abstract::The authors have developed an ultrasonic aspirator to assist in urologic endoscopic surgery. It appeared that ultrasonic aspiration of bladder tumors was clinically efficient in transurethral surgery. Tumors 1 to 2 cm in diameter could be aspirated completely with this instrument alone. The application of the ultrason...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.285
更新日期:1994-08-01 00:00:00
abstract:PURPOSE:To evaluate the feasibility of using the potassium titanyl phosphate (KTP) laser to perform laparoscopic partial nephrectomy in a porcine model, with saline irrigation to reduce intraoperative smoke formation. MATERIALS AND METHODS:A high-power (80 W) KTP laser was used without hilar occlusion in 14 laparoscop...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.1096
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Helical CT has become the preferred method for imaging urinary calculi, and so it would be useful if data from helical CT could also be used to predict the number of shockwaves (SWs) needed to break a given stone. METHODS AND MATERIALS:We measured the number of SWs required to comminute calcium ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2000.14.471
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Laparoscopic radical cystectomy is confined to centers where advanced laparoscopy is performed, and its role is not yet well clear. Our aim was to evaluate, through a prospective comparative study, the advantages of the laparoscopic compared with an open approach. PATIENTS AND METHODS:From Novem...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2006.0224
更新日期:2007-03-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVES:We evaluated patients who underwent treatment for prostate cancer and then subsequent robotic radical cystectomy (RARC). Our objective was to understand clinical, pathologic, and survival outcomes in these patients. MATERIALS AND METHODS:A total of 333 male patients underwent RARC with stan...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0627
更新日期:2020-12-02 00:00:00
abstract::Renal excursion during breathing is inevitable and is a cause of poor localization during extracorporeal shock-wave lithotripsy (SWL), which in theory might lead to poor treatment results. Eighty-one patients underwent lithotripsy treatment with and without the use of an image enhancement system designed for use with ...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1089/end.1996.10.335
更新日期:1996-08-01 00:00:00
abstract:: Purpose: To review the literature on optimal methods of drainage for obstructive urolithiasis in adult patients, comparing percutaneous nephrostomy (PCN) with retrograde ureteral catheterization (Double J [JJ]) regarding success of procedure, efficacy, complications, quali...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2019.0309
更新日期:2019-10-01 00:00:00
abstract::Radical nephroureterectomy, including en bloc excision of the ureter with a bladder cuff, is the standard treatment for upper tract transitional-cell carcinoma (TCC). This procedure requires either a flank and lower abdominal incision or an extended flank incision. Laparoscopic surgery for TCC has been used at several...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/089277901300189394
更新日期:2001-05-01 00:00:00
abstract::Surgical removal with radical prostatectomy has been a cornerstone for the treatment of prostate cancer and is associated with level 1 evidence for survival advantage compared with watchful waiting. Since the first structured robotic program was launched in 2000, robot-assisted radical prostatectomy (RARP) has had a r...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0585
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Magnesium (Mg(2+)) has been shown to be a kidney stone inhibitor; however, the exact mechanism of its effect is unknown. Using theoretical models, the interactions of calcium and oxalate were examined in the presence of Mg(2+). METHODS:Molecular dynamics simulations were performed with NAMD and ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0173
更新日期:2013-12-01 00:00:00
abstract::Extracorporal shockwave lithotripsy of lower caliceal stones is often unrewarding because of the difficulty of passing stone fragments. We report our results in SWL of lower pole stones in 219 patients and compare them with the results of SWL of middle (82 patients) and upper pole (85 patients) stones. The stone-free ...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.1995.9.439
更新日期:1995-12-01 00:00:00
abstract:: Aims: To investigate whether spinal anesthesia with an obturator nerve block (SA+ONB) can be effectively used for transurethral resection of bladder tumor (TURBT) during the coronavirus disease 2019 (COVID-19) pandemic to improve patient outcomes while also avoiding aeroso...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.1054
更新日期:2020-12-22 00:00:00
abstract::The da Vinci Surgical Robotic System has recently been added to the armamentarium of minimally invasive surgeon and has been shown to be useful to urologists in performing complex operations. We report the first case of detrusor myotomy performed using the da Vinci, describe the novel technique, and review the indicat...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.476
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Renal cysts are common in the adult population. Symptomatic cysts traditionally have been treated by percutaneous aspiration with injection of sclerosant agents. Our aim was to compare the efficacy and side effects of ethanol and sodium tetradecyl sulfate (STDS) as sclerosants for symptomatic sim...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2006.0462
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To assess the feasibility and efficacy of percutaneous nephrolithotomy (PCNL) in patients with spinal deformities. PATIENTS AND METHODS:Between 1999 and 2008, eight patients (nine renal units) with spinal deformities underwent 10 PCNLs. Mean stone burden was 372 mm(2) (160-840 mm(2)). Preoperati...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0095
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of color-coded Doppler sonography (CCDS) in the assessment of internal ureteral stent patency. PATIENTS AND METHODS:We compared micturating cystography (MC) and CCDS in 48 patients with internal ureteral stents. Forty-five of these patients had pyelocaliectasis on renal sonography. RESU...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.1999.13.199
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There is a continuing reluctance among transplant surgeons to procure a right-kidney allograft laparoscopically. We describe our experience with right laparoscopic donor nephrectomy (RLDN) by three techniques. PATIENTS AND METHODS:We retrospectively analyzed all seven RLDNs performed at our cent...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.309
更新日期:2006-05-01 00:00:00
abstract:PURPOSE:To determine the effects on semen of extracorporeal shockwave lithotripsy for distal-ureteral stones. PATIENTS AND METHODS:We examined the semen of 62 patients 1 day before and 1 week and 3 months after SWL for distal-ureteral stones. The results were compared with those of 62 patients similarly treated for up...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.483
更新日期:2006-07-01 00:00:00
abstract::Seventy-four consecutive cases of ureteral stones listed for ureteroscopic lithotripsy were studied prospectively. In all cases, the Wolf 7.5F or 9F ureteroscope was used in conjunction with the Swiss Lithoclast system. Dormia baskets were employed on four occasions to prevent forward propulsion of fragments. Ureteros...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1998.12.341
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence of preoperative anemia and the impact of preoperative anemia and blood transfusion requirement on 30- and 90-day complications in a cohort of patients undergoing robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC). PATIENTS AND METHODS:IRARC was performed...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0730
更新日期:2017-02-01 00:00:00