Abstract:
OBJECTIVES:To determine the accuracy of the surgeon's impression as to the stone-free rate at the end of percutaneous nephrolithotomy (PCNL), and to evaluate predictors for inaccurate estimation. MATERIALS AND METHODS:A prospective study conducted between 2010 and 2015. Surgeon's impression, categorized as "insignificant residual fragments (RFs)" (<4 mm) or "significant RF" (>4 mm), was recorded at the end of PCNL, and was compared with postoperative imaging results, using CT or a combination of US and kidney, ureter, and bladder radiograph for radiolucent and radio-opaque stones, respectively. The association between missed significant RF and the patient and operative variables was evaluated with univariable and multivariable logistic regression analysis. RESULTS:The study cohort included 312 patients. Significant RFs were found in 75 (24%) patients, comprising all 22 patients in whom RFs were suspected (100%) and 53 patients who were considered stone free (18.6%). The sensitivity, specificity, and positive and negative predictive value of the surgeon's estimation for the absence of significant RFs were 100%, 39%, 0.83, and 1 for radiopaque stones, and 100%, 12.5%, 0.75, and 1 for radiolucent stones. On multivariate analysis, multiple stones (OR = 4, 95% CI: 1.85-8.7, p < 0.001) and cumulative stone size (OR = 1.04, 95% CI: 1.02-1.1, p = 0.005) were independent predictors for missed RFs. CONCLUSION:In approximately fifth of the patients undergoing PCNL, the surgeon's impression of "insignificant RF" may be inaccurate. Stone size and number were independently associated with higher miss rate. These data should be shared with the patients when the postoperative drainage method and the option for an auxiliary procedure are discussed.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Nevo A,Holland R,Schreter E,Gilad R,Baniel J,Cohen A,Lifshitz DAdoi
10.1089/end.2018.0005subject
Has Abstractpub_date
2018-06-01 00:00:00pages
471-475issue
6eissn
0892-7790issn
1557-900Xjournal_volume
32pub_type
杂志文章abstract:INTRODUCTION:Ureteroscopic laser lithotripsy is becoming the most commonly utilized treatment for patients with urinary calculi. The Holmium:YAG (yttrium aluminum garnet) laser is integral to the operation and is the preferred flexible intracorporeal lithotrite. In recent years, there has been increasing interest in ex...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2017.0641
更新日期:2018-01-01 00:00:00
abstract::Laparoscopy has become the essential surgical approach to the adrenal gland at many institutions, including ours. At the Cleveland Clinic, laparoscopic adrenalectomy for benign and malignant adrenal neoplasms can be performed by either the transperitoneal or the retroperitoneal approach. Herein, we present our techniq...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277901750299302
更新日期:2001-06-01 00:00:00
abstract::A 42-year-old man undergoing bilateral laparoscopic hernia repair requested vasectomy for family planning purposes. Bilateral vasectomy was done by a laparoscopic approach at the time of extraperitoneal hernia repair, and a separate scrotal incision was avoided. In addition to reporting a case of laparoscopic vasectom...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/089277902753619618
更新日期:2002-03-01 00:00:00
abstract::In a 14-year-old boy with bladder augmentation, Mitrofanoff appendicovesicostomy, Malone antegrade enema stoma, and bladder neck reconstruction, urinary continence was restored by injection of Teflon with a Veress needle and the aid of a 2-mm laparoscopic port. The method has since been used for nine treatments in six...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903765444401
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Single-system ectopic ureter draining a dysplastic kidney is a rare urologic abnormality. In this study, we evaluated our own experience using laparoscopy for the simultaneous identification and removal of such ureterorenal units. PATIENTS AND METHODS:Between February 1999 and August 2001, four ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277902760261392
更新日期:2002-08-01 00:00:00
abstract:PURPOSE:To conduct a study to assess the association between calculus location and size and the incidence of both microhematuria and symptoms of urolithiasis in a urology office environment. PATIENTS AND METHODS:After Institutional Review Board approval, a prospective study was conducted with data from 100 consecutive...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0265
更新日期:2011-12-01 00:00:00
abstract:PURPOSE:To determine factors affecting patients' discomfort during the period self-retaining ureteral stents are in place. PATIENTS AND METHODS:Between April 2001 and May 2003, 58 male and 42 female patients underwent temporary double-pigtail stenting. The indications were endopyelotomy in 39 patients, ureteroscopy in...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.33
更新日期:2006-01-01 00:00:00
abstract:: Introduction: Calcium oxalate (CaOx) is the predominate component within renal calculi and can be divided into two subtypes: CaOx-monohydrate (COM) and CaOx-dihydrate (COD). COM and COD form in differing urinary environments, which suggest differential underlying metabolic...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0245
更新日期:2019-09-01 00:00:00
abstract::The identification of calcium-binding proteins in urine and kidney stones has led to a closer look at the role of matrix proteins in urolithiasis. We analyzed five struvite stones for protein content and identified two bands (8 and 14 KDa) that were confirmed by gel electrophoresis and amino acid sequencing to be calg...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.95
更新日期:1994-04-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277902753483718
更新日期:2002-02-01 00:00:00
abstract:: Objectives: To investigate the feasibility and efficacy of live renal ultrasonography to guide Double-J ureteral stent placement at the bedside. Patients and Methods: Between April 12 and June 5, 2020, patients presenting with ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0954
更新日期:2020-12-17 00:00:00
abstract:BACKGROUND AND PURPOSE:Despite the frequency at which urologists endoscopically estimate lesion size, their accuracy has not been established. Our objectives were to determine the accuracy of cystoscopic and ureteroscopic estimates of lesion size using in vitro models of the urinary tract and to assess potential impact...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2013.0214
更新日期:2013-09-01 00:00:00
abstract::Port placement for robot-assisted laparoscopic urologic surgery can be critical to effective completion of the minimally invasive procedure. An ideal port template would allow unhampered access to all critical structures during surgery, easy access for the bedside assistant, and minimization of arm collision with the ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0578
更新日期:2017-12-01 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:BACKGROUND AND PURPOSE:The introduction of radiofrequency ablation (RFA) into other fields of surgery has fueled the interest to study its application in small renal masses (SRM). Some controversies remain, however, regarding its oncologic efficacy. We review technical factors and tissue characteristics that influence ...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2009.0677
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There have been several reports of rhabdomyolysis occurring after prolonged laparoscopic procedures in the flank position. Accordingly, we evaluated interface pressures between the skin and three commonly used operating room table surfaces. The aim of our study was to determine if pressure change...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0047
更新日期:2008-06-01 00:00:00
abstract:PURPOSE:We assessed whether high shock number is associated with higher rates of acute complication development after extracorporeal shockwave lithotripsy (SWL). PATIENTS AND METHODS:A retrospective chart review of 372 patients who underwent 436 SWL procedures at 24 kV using a Medstone STS-T lithotripter (Medstone Int...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0025
更新日期:2013-08-01 00:00:00
abstract:: Introduction and Objectives: After transurethral prostatectomy, erectile dysfunction and ejaculatory dysfunction are significant concerns for patients. We compared ejaculatory hood-sparing technique in patients who underwent photoselective vaporization of the prostate usin...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0558
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:To assess the effectiveness of palladium-103 brachytherapy in stage T1 and T2 adenocarcinoma of the prostate. PATIENTS AND METHODS:The charts of 1048 patients treated between 1991 and 1999 with transperineal realtime ultrasound-guided (103)Pd (Theraseed) implants were reviewed to assess the effects on serum pr...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2000.14.343
更新日期:2000-05-01 00:00:00
abstract::The treatment results obtained in children using an unmodified Dornier HM3 or a Medstone STS lithotripter for renal and ureteral stones were compared. The Dornier HM3 was used to treat 28 renal and 10 ureteral stones, while the Medstone STS was used to treat 73 renal and 34 ureteral stones. The treatment results were ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1996.10.493
更新日期:1996-12-01 00:00:00
abstract:PURPOSE:To evaluate the utility of two ipsilateral ureteral stents placed for benign and malignant ureteral obstruction. METHODS:We performed a retrospective analysis of all cases of tandem ureteral stent (TUS) insertion at our institution from July 2007 through January 2013. Student t, Fisher exact, and log-rank test...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0281
更新日期:2013-10-01 00:00:00
abstract:: Background: To examine the impact of the Mayo adhesive probability (MAP) score on the surgical complexity of exposing the tumor during laparoscopic partial nephrectomy (LPN). Patients and Methods: Our study included 318 patient...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0687
更新日期:2020-05-01 00:00:00
abstract::Laser systems used for prostatectomy may be right-angle (sidefiring) devices, which are either refractive or reflective, or contact devices. The tissue physics of these systems differ, and as a result, there are very real differences in the optimal exposure techniques. An understanding of the device being used is esse...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1995.9.85
更新日期:1995-04-01 00:00:00
abstract::Percutaneous renal access is an integral step in percutaneous renal drainage and percutaneous nephrolithotomy. Urologists are increasingly obtaining access themselves, as this eliminates reliance on a second "surgeon" and increases flexibility with respect to procedure timing and the location of the access tract. Surp...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2007.9981
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:The purpose is to report our 10-year experience with surgical management of large or symptomatic adrenal myelolipoma. PATIENTS AND METHODS:Patients receiving surgical treatment for adrenal myelolipoma between December 2001 and September 2011 in our institution were retrospectively reviewed. Patients were div...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0283
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Current urologic laparoscopic procedures include preservation of locoregional nerve fibers. The use of electrical coagulation is limited because of tissue conductance of current and heat production. While ultrasonic coagulation does not use electricity, heat is still produced. We designed an anim...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0031
更新日期:2010-11-01 00:00:00
abstract:PURPOSE:To review the management approach to and results of severely encrusted retained ureteral stents and analyze predictive risk factors. PATIENTS AND METHODS:Medical records from January 1996 to March 2006 were reviewed for Double-J stent complications and their final outcome. A total of 876 stents were inserted i...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.0250
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Among patients with renal insufficiency secondary to autosomal dominant polycystic kidney disease (ADPKD), the onset of refractory urinary infection, hypertension, pain, or hematuria often necessitates a nephrectomy. However, the huge size of these kidneys makes a standard laparoscopic approach difficult, an...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/089277904323056942
更新日期:2004-05-01 00:00:00
abstract:PURPOSE:We present our experience in the design and development of a training program in laparoscopic radical prostatectomy (LRP), and the validation of the first steps of the program by objective measurement of the attendants' skills improvement and subjective evaluation of its contents. MATERIALS AND METHODS:Our tra...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0050
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Holmium:YAG lithotripsy of uric acid calculi produces cyanide. The laser and stone parameters required to produce cyanide are poorly defined. In this study, we tested the hypotheses that cyanide production: (1) varies with holmium:YAG power settings; (2) varies among holmium:YAG, pulsed-dye, and ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2000.14.169
更新日期:2000-03-01 00:00:00