Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"
Yıl: 2017 Cilt: 43 Sayı: 2 Sayfa Aralığı: 158 - 161 Metin Dili: İngilizce DOI: 10.5152/tud.2017.61257 İndeks Tarihi: 15-01-2019
Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"
Öz: Objective: To evaluate the stone hardness in predicting the need for single or two sessions of retrograde intrarenalsurgery (RIRS) for renal pelvis stones of 2-3 cm in size.Material and methods: Ninety-six patients (64 male and 32 female) with only renal stones (2.5±0.3 cm)underwent RIRS using flexible 7.5 Fr ureteroscope (FURS). The stone hardness was evaluated by preoperativenon-contrast computed tomography (NCCT). The patients were divided into two groups based on stonehardness: Group I (n=54) (hard stones - Hounsfield Unit (HU) >1000) and group II (n=42) (not hard stone - HU<1000). The stone- free rate, the operative time, any intra or postoperative complications and the need for secondsessions of RIRS were evaluated.Results: All stones were successfully accessed. Intraoperative complications were not reported. The initialstone- free rate was 40% in Group I and 95% in Group II after a single session (p=0.01). A second sessionFURS was needed in 32 cases of Group I (40%) where postoperative CT showed significant residual stonefragments of 6±2 mm, and stone-free rate up to 100 percent. On the contrary only 2 cases from Group IIunderwent second session FURS (p=0.01). The operative times were 75±15 minutes in Group I and 55±13minutes in Group II (p<0.01). Six patients (4 in group I and 2 in group II) had postoperative high- grade fever(Clavien Grade II).Conclusion: Stone hardness had a significant impact on the decision of performing single versus two sessionsof FURS for renal pelvic stones of 2-3 cm rather than the stone size alone.
Anahtar Kelime: Konular:
Çapı 2-3 cm arasında böbrek pelvis taşları için tek ve iki seansta bükülebilir üreteroskopi: Taşın büyüklük veya sertliği uygulanan seans sayısında rol oynar mı?
Öz: Amaç: Çapı 2-3 cm arasında olan böbrek pelvis taşları için tek veya iki seans retrograt intrarenal cerrahi (RİRC) gereksinmesini belirlemede taş sertliğinin rolünü değerlendirmek. Gereç ve yöntemler: Sadece böbrek pelvis taşları (2,5±0,3 cm) olan 96 hastaya (64 erkek ve 32 kadın) 7,5 Fr fleksibl üreteroskopi (FÜRS) kullanarak RİRC uygulanmıştır. Preoperatif kontrastsız bilgisayarlı tomografi (BT) ile taşın sertliği değerlendirilmiştir. Hastalar taşın sertliğine göre iki gruba ayrılmıştır: Grup I (n=54) (sert taşlar - Hounsfield Ünitesi (HU) >1000) ve Grup II (n=42) (sert olmayan taşlar - HU <1000). Taşsızlık oranı, ameliyat süresi, herhangi bir intra- veya postoperatif komplikasyon ve ikinci seans RİRC gerekliliği değerlendirilmiştir. Bulgular: Taşların tümüne başarıyla ulaşılmıştır. Herhangi bir intraoperatif komplikasyon bildirilmemiştir. Başlangıçta birinci seanstan sonra taşsızlık oranı Grup I’de %40 ve Grup II’de %95 idi (p=0,01). Grup I’de 32 (%40) olguda yapılan postoperatif BT'de saptanan 6±2 mm'lik ciddi rezidü taşlar nedeniyle ikinci seans FÜRS gerekmiş ve %100'lük taşsızlık oranına ulaşılmıştır. Aksine Grup II’de yalnızca 2 olguya ikinci seans FÜRS uygulanmıştır (p=0,01). Ortalama ameliyat süresi Grup 1’de 75±15 dakika, Grup II’de 55±13 dakika idi (p<0,01). Altı hastada (Grup I’de 4 ve Grup II’de 2 hasta) postoperatif dönemde yüksek ateş (Clavien Grade II) gözlenmiştir. Sonuç: Çapı 2-3 cm arasında olan böbrek pelvisi taşlarında tek veya iki seans FÜRS uygulama kararını vermede tek başına taşın büyüklüğünden ziyade taşın sertliği de önemli derecede etkilidir
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Breda A, Angerri O. Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol 2014;24:179-83. [CrossRef]
- Akman T, Binbay M, Ozgor F, Ugurlu M, Tekinarslan E, Kezer C, et al. Comparison of percutaneous nephrolithotomy and retrograde flexible nephrolithotripsy for the management of 2-4 cm stones: a matched-pair analysis. BJU Int 2012;109:1384-9. [CrossRef]
- Ito H, Kuroda S, Kawahara T, Makiyama K, Yao M, Matsuzaki J. Clinical factors prolonging the operative time of flexible ureteroscopy for renal stones: a single-center analysis. Urolithiasis 2015;43:467-75. [CrossRef]
- Dretler SP, Spencer BA. CT and stone fragility. J Endourol 2001;15:31- 6. [CrossRef]
- Newhouse JH, Prien EL, Amis ES, Jr., Dretler SP, Pfister RC. Computed tomographic analysis of urinary calculi. AJR Am J Roentgenol 1984;142:545-8. [CrossRef]
- De S, Autorino R, Kim FJ, Zargar H, Laydner H, Balsamo R, et al. Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis. Eur Urol 2015;67:125-37. [CrossRef]
- Pan J, Chen Q, Xue W, Chen Y, Xia L, Chen H, et al. FURS versus mPCNL for single renal stone of 2-3 cm: clinical outcome and costeffective analysis in Chinese medical setting. Urolithiasis 2013;41:73-8. [CrossRef]
- Monga M, Best S, Venkatesh R, Ames C, Lee C, Kuskowski M, et al. Durability of flexible ureteroscopes: a randomized, prospective study. J Urol 2006;176:137-41. [CrossRef]
- Motley G, Dalrymple N, Keesling C, Fischer J, Harmon W. Hounsfield unit density in the determination of urinary stone composition. Urology 2001;58:170-3. [CrossRef]
- Mostafavi MR, Ernst RD, Saltzman B. Accurate determination of chemical composition of urinary calculi by spiral computerized tomography. J Urol 1998;159:673-5. [CrossRef]
- Hidas G, Eliahou R, Duvdevani M, Coulon P, Lemaitre L, Gofrit ON, et al. Determination of renal stone composition with dual-energy CT: In Vivo analysis and comparison with X-ray diffraction. Radiology 2010;257:394-401. [CrossRef]
- Nakasato T, Morita J, Ogawa Y. Evaluation of Hounsfield Units as a predictive factor for the outcome of extracorporeal shock wave lithotripsy and stone composition. Urolithiasis 2015;43:69-75. [CrossRef]
- Xue YQ, Zhang P, Yang XJ, Chong T. The effect of stone composition on the efficacy of retrograde intrarenal surgery: kidney stones 1-3 cm in diameter. J Endourol 2015;29:537-41. [CrossRef]
- Hyams ES, Bruhn A, Lipkin M, Shah O. Heterogeneity in the reporting of disease characteristics and treatment outcomes in studies evaluating treatments for nephrolithiasis. J Endourol 2010;24:1411-4. [CrossRef]
- Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y, et al. The most reliable preoperative assessment of renal stone burden as a predictor of stone-free status after flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. Urology 2012;80:524-8. [CrossRef]
- Riley JM, Stearman L, Troxel S. Retrograde ureteroscopy for renal stones larger than 2.5 cm. J Endourol 2009;23:1395-8. [CrossRef]
- Aboumarzouk OM, Monga M, Kata SG, Traxer O, Somani BK. Flexible ureteroscopy and laser lithotripsy for stones > 2 cm: a systematic review and meta-analysis. J Endourol 2012;26:1257-63. [CrossRef]
- Cohen J, Cohen S, Grasso M. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi. BJU Int 2013;111:E127-E31. [CrossRef]
- Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y, et al. Evaluation of preoperative measurement of stone surface area as a predictor of stone-free status after combined ureteroscopy with holmium laser lithotripsy: a single-center experience. J Endourol 2013;27:715-21. [CrossRef]
- Nuno de la Rosa I, Palmero JL, Miralles J, Pastor JC, Benedicto A. A comparative study of percutaneous nephrolithotomy in supine position and endoscopic combined intrarenal surgery with flexible instrument. Actas Urol Esp 2014;38:14-20. [CrossRef]
- Unsal A, Resorlu B, Atmaca AF, Diri A, Goktug HNG, Can CE, et al. Prediction of morbidity and mortality after percutaneous nephrolithotomy by using the charlson comorbidity index. Urology 2012;79:55-60. [CrossRef]
| APA | ABD EL HAMED A, ELMOGHAZY H, ALDAHSHOURY M, RİAD A, MOSTAFA M, FARAG F, GAMAL W (2017). Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". , 158 - 161. 10.5152/tud.2017.61257 |
| Chicago | ABD EL HAMED Ahmed Mamdouhd,ELMOGHAZY Hazem,ALDAHSHOURY Mohamed,RİAD Ahmed,MOSTAFA Mohammed,FARAG Fawzy,GAMAL Wael Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". (2017): 158 - 161. 10.5152/tud.2017.61257 |
| MLA | ABD EL HAMED Ahmed Mamdouhd,ELMOGHAZY Hazem,ALDAHSHOURY Mohamed,RİAD Ahmed,MOSTAFA Mohammed,FARAG Fawzy,GAMAL Wael Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". , 2017, ss.158 - 161. 10.5152/tud.2017.61257 |
| AMA | ABD EL HAMED A,ELMOGHAZY H,ALDAHSHOURY M,RİAD A,MOSTAFA M,FARAG F,GAMAL W Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". . 2017; 158 - 161. 10.5152/tud.2017.61257 |
| Vancouver | ABD EL HAMED A,ELMOGHAZY H,ALDAHSHOURY M,RİAD A,MOSTAFA M,FARAG F,GAMAL W Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". . 2017; 158 - 161. 10.5152/tud.2017.61257 |
| IEEE | ABD EL HAMED A,ELMOGHAZY H,ALDAHSHOURY M,RİAD A,MOSTAFA M,FARAG F,GAMAL W "Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"." , ss.158 - 161, 2017. 10.5152/tud.2017.61257 |
| ISNAD | ABD EL HAMED, Ahmed Mamdouhd vd. "Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"". (2017), 158-161. https://doi.org/10.5152/tud.2017.61257 |
| APA | ABD EL HAMED A, ELMOGHAZY H, ALDAHSHOURY M, RİAD A, MOSTAFA M, FARAG F, GAMAL W (2017). Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". Turkish Journal of Urology, 43(2), 158 - 161. 10.5152/tud.2017.61257 |
| Chicago | ABD EL HAMED Ahmed Mamdouhd,ELMOGHAZY Hazem,ALDAHSHOURY Mohamed,RİAD Ahmed,MOSTAFA Mohammed,FARAG Fawzy,GAMAL Wael Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". Turkish Journal of Urology 43, no.2 (2017): 158 - 161. 10.5152/tud.2017.61257 |
| MLA | ABD EL HAMED Ahmed Mamdouhd,ELMOGHAZY Hazem,ALDAHSHOURY Mohamed,RİAD Ahmed,MOSTAFA Mohammed,FARAG Fawzy,GAMAL Wael Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". Turkish Journal of Urology, vol.43, no.2, 2017, ss.158 - 161. 10.5152/tud.2017.61257 |
| AMA | ABD EL HAMED A,ELMOGHAZY H,ALDAHSHOURY M,RİAD A,MOSTAFA M,FARAG F,GAMAL W Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". Turkish Journal of Urology. 2017; 43(2): 158 - 161. 10.5152/tud.2017.61257 |
| Vancouver | ABD EL HAMED A,ELMOGHAZY H,ALDAHSHOURY M,RİAD A,MOSTAFA M,FARAG F,GAMAL W Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?". Turkish Journal of Urology. 2017; 43(2): 158 - 161. 10.5152/tud.2017.61257 |
| IEEE | ABD EL HAMED A,ELMOGHAZY H,ALDAHSHOURY M,RİAD A,MOSTAFA M,FARAG F,GAMAL W "Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"." Turkish Journal of Urology, 43, ss.158 - 161, 2017. 10.5152/tud.2017.61257 |
| ISNAD | ABD EL HAMED, Ahmed Mamdouhd vd. "Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"". Turkish Journal of Urology 43/2 (2017), 158-161. https://doi.org/10.5152/tud.2017.61257 |
