Residual stone fragments: clinical implications and technological innovations.

Abstract:

PURPOSE OF REVIEW:To summarize the recent literature on the topic of residual stone fragments in particular novel developments in this field. RECENT FINDINGS:The urological position towards residual fragments has shifted in recent years from observation, to active retrieval with innovative methods, to algorithm-based predictions of surgical outcomes. Novel technologies have been described to extract residual fragments through magnetism, a polyethylene endoscopic pouch and a biocompatible stone adhesive. In an effort to have a tighter grip over the outcome of residual fragments, artificial neural networks (ANNs) have been developed to accurately predict surgical outcomes in terms of stone clearance and secondary procedures. SUMMARY:Growing evidence continues to show the term clinically insignificant residual fragments (CIRF) for residual fragments of 4 mm or less to be a misnomer. In fact, only a third of CIRF is spontaneously cleared from the kidney after surgery and may become a cause for reintervention being both costly and significantly affecting patients' well being. Several novel methods which have been developed to extract residual fragments require further in-vivo investigations to confirm their safety and efficacy. ANNs algorithms are increasingly being used to predict surgical outcomes in stone therapy and assist in preoperative patient counselling and decision-making.

journal_name

Curr Opin Urol

authors

Suarez-Ibarrola R,Hein S,Miernik A

doi

10.1097/MOU.0000000000000571

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

129-134

issue

2

eissn

0963-0643

issn

1473-6586

journal_volume

29

pub_type

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