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Comparison of Semirigid and Flexible Ureteroscopy Results in Isolated Kidney Pelvis Stones Smaller than Two Centimeters

Yıl 2021, Cilt: 18 Sayı: 1, 45 - 49, 28.04.2021
https://doi.org/10.35440/hutfd.858497

Öz

Background: In our study, we aimed to compare the efficiency and reliability of using semirigid ureteroscopy (S-URS) and flexible ureteroscopy (F-URS) in the treatment of patients with stones smaller than 2 cm in isolated renal pelvis.
Materials and Methods: The data of 45 patients who underwent ureteroscopic stone treatment for isolated renal pelvis stones smaller than 2 cm were evaluated retrospectively. S-URS was routinely applied to all patients. If the stones can be accessed in the renal pelvis with S-URS, direct treatment with holmium laser was applied. If the stone was not accessible, F-URS was made. Groups were compared in terms of stone-free rates, operation times, hemoglobin reduction, and complications.
Results: S-URS was performed in 24 (53.3%) patients and F-URS in 21 (46.7%) patients. There was no significant difference between the two groups in terms of age, degree of hydronephrosis, mean stone size and stone side. Mean operation time was 64.62 ± 9.34 minutes in the S-URS group and 96.43 ± 14.26 minutes in the F-URS group (p=0.001). There was no statistically significant difference between the groups in terms of postoperative complications (p = 0.548). In the postoperative 1st day and 1st month follow-up, stone-free rates were 79.2% and 83.3% in the S-URS group, and 80.9% and 85.7% in the F-URS group, respectively (p = 0.768 and p = 0.574).
Conclusions: We observed that the use of S-URS and F-URS were very successful and safe methods in kidney stones smaller than 2 cm. S-URS is a safe treatment method that can be applied if the stone in the renal pelvis can be reached without any problem, especially in selected cases.

Kaynakça

  • 1. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016;69(3):468-74.
  • 2. Afane JS, Olweny EO, Bercowsky E, Sundaram CP, Dunn MD, Shalhav AL, et al. Flexible ureteroscopes: a single center evaluation of the durability and function of the new endoscopes smaller than 9Fr. J Urol. 2000;164(4):1164-8.
  • 3. Liu DY, He HC, Wang J, Tang Q, Zhou YF, Wang MW, et al. Ureteroscopic lithotripsy using holmium laser for 187 patients with proximal ureteral stones. Chin Med J. 2012;125(9):1542-6.
  • 4. Slam J, Tricia D. Greene and Mantu Gupta: Treatment of proximal ureteral calculi: Holmium: YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol. 2002;167:1972-6.
  • 5. Kumar A, Nanda B, Kumar N, Kumar R, Vasudeva P, Mohanty NK. A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones <2 cm: A single center experience. J Endourol. 2015;29:47-51.
  • 6. Hughes T, Ho HC, Pietropaolo A, Somani BK. Guideline of guidelines for kidney and bladder stones. Turk J Urol. 2020;46(1) 104-112.
  • 7. Cepeda M, Amón JH, Mainez JA, Rodríguez V, Alonso D, Martínez-Sagarra JM. Flexible ureteroscopy for renal stones. Actas Urol Esp. 2014;38(9):571-5.
  • 8. Bozkurt OF, Resorlu B, Yildiz Y, Can CE, Unsal A. Retrograde intrarenal surgery versus percutaneous nephrolithotomy in the management of lower-pole renal stones with a diameter of 15 to 20 mm. J Endourol. 2011;25(7):1131-5.
  • 9. Palmero JL, Castelló A, Miralles J, Nuño de La Rosa I, Garau C, Pastor JC. Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2 cm. Actas Urol Esp. 2014;38(4):257-62.
  • 10. Resorlu B, Unsal A, Ziypak T, Diri A, Atis G, Guven S, et al. Comparison of retrograde intrarenal surgery, shockwave lithotripsy, and percutaneous nephrolithotomy for treatment of medium-sized radiolucent renal stones. World J Urol. 2013;31(6):1581-6.
  • 11. Hyams ES, Monga M, Pearle MS, Antonelli JA, Semins MJ, Assimos DG, et al. A prospective, multi-institutional study of flexible ureteroscopy for proximal ureteral stones smaller than 2 cm. J Urol. 2015;193(1):165-9.
  • 12. Karadag MA, Demir A, Cecen K, Bagcioglu M, Kocaaslan R, Altunrende F. Flexible ureterorenoscopy versus semirigid ureteroscopy for the treatment of proximal ureteral stones: a retrospective comparative analysis of 124 patients. Urol J. 2014;11(5):1867-72.
  • 13. Miernik A, Schoenthaler M, Wilhelm K, Wetterauer U, Zycz¬kowski M, Paradysz A, et al. Combined semirigid and flexible ureterorenoscopy via a large ureteral access sheath for kidney stones >2 cm: a bicentric prospective assessment. World J Urol. 2014;32:697-702.
  • 14. Mir SA, Best SL, McLeroy S, Donnally CJ 3rd, Gnade B, Hsieh JT, et al. Novel stone-magnetizing microparticles: in vitro toxicity and biologic functionality analysis. J Endourol. 201;25(7):1203-7.
  • 15. Tan YK, Best SL, Donnelly C, Olweny E, Kapur P, Mir SA, et al. Novel iron oxide microparticles used to render stone fragments paramagnetic: assessment of toxicity in a murine model. J Urol. 2012;188(5):1972-7.
  • 16. User HM, Hua V, Blunt LW, Wambi C, Gonzalez CM, Nadler RB. Performance and durability of leading flexible ureteroscopes. J Endourol. 2004;18(8):735-8.
  • 17. Multescu R, Geavlete B, Georgescu D, Geavlete P. Conventional fiberoptic flexible ureteroscope versus fourth generation digital flexible ureteroscope: a critical comparison. J Endorol. 2010;24:17-21.
  • 18. Binbay M, Yuruk E, Akman T, Ozgor F, Seyrek M, Ozkuvanci U, et al. Is there a difference in outcomes between digital and fiberoptic flexible ureterorenoscopy procedures? J Endourol. 2010;24(12):1929-34.
  • 19. Basillote JB, Lee DI, Eichel L, Clayman RV. Ureteroscopes: flexible, rigid, and semirigid. Urol Clin North Am. 2004;31:21-32.
  • 20. Bryniarski P, Paradysz A, Zyczkowski M, Kupilas A, Nowakowski K, Bogacki R. A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol. 2012;26(1):52-7.
  • 21. Süer E, Gülpinar Ö, Özcan C, Göğüş Ç, Kerimov S, Şafak M. Predictive factors for flexible ureterorenoscopy requirement after rigid ureterorenoscopy in cases with renal pelvic stones sized 1 to 2 cm. Korean J Urol. 2015;56(2):138-42.
  • 22. Atis G, Gurbuz C, Arikan O, Canat L, Kilic M, Caskurlu T. Ureteroscopic management with laser lithotripsy of renal pel¬vic stones. J Endourol. 2012;26:983-7.

İki Santimetreden Küçük İzole Böbrek Pelvis Taşlarında Semirijid ve Fleksibl Üreteroskopi Sonuçlarının Karşılaştırması

Yıl 2021, Cilt: 18 Sayı: 1, 45 - 49, 28.04.2021
https://doi.org/10.35440/hutfd.858497

Öz

Amaç: Çalışmamızda böbrek pelvisinde izole 2 cm’den küçük taşı olan hastaların tedavisinde semirijid ureteroskopi (S-URS) ve fleksibl üreteroskopi (F-URS) kulanımının etkinlik ve güvenilirliklerini karşılaştırmayı amaçladık.
Materyal ve Metod: İki cm’den küçük izole böbrek pelvis taşı nedeniyle üreteroskopik taş tedavisi uygulanan toplam 45 hastanın verileri retrospektif olarak değerlendirildi. S-URS tüm hastalara rutin olarak uygulandı. S-URS ile taşlara böbrek pelvisinde erişilebiliyorsa doğrudan holmiyum lazer ile tedavi uygulandı. Taş erişilebilir değilse F-URS yapıldı. Gruplar taşsızlık oranları, operasyon süreleri, hemoglobin düşüşü ve komplikasyonlar bakımından karşılaştırıldı.
Bulgular: 24 (%53,3) hastaya S-URS ve 21 (%46,7) hastaya F-URS yapıldı. İki grup arasında yaş, hidronefroz derecesi, ortalama taş boyutu ve taş tarafı bakımından anlamlı farklılık yoktu. Ortalama operasyon süresi S-URS grubunda 64,62±9,34 dakika, F-URS grubunda 96,43±14,26 dakika idi (p=0,001). Gruplar arasında postoperatif komplikasyonlar açısından istatistiksel olarak anlamlı fark yoktu (p=0,548). Postoperatif 1. gün ve 1. ay takipte taşsızlık oranları S-URS grubunda sırasıyla %79,2 ve %83,3 ve F-URS grubunda %80,9 ve %85,7 idi (p=0,768 ve p=0,574).
Sonuç: İki cm'den küçük böbrek taşlarında S-URS ve F-URS kullanımının oldukça başarılı ve güvenli yöntemler olduğunu gözlemledik. S-URS özellikle seçilmiş olgularda böbrek pelvisinde taşa sorunsuz bir şekilde ulaşılabiliyorsa uygulanabilecek güvenli bir tedavi yöntemidir.

Kaynakça

  • 1. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016;69(3):468-74.
  • 2. Afane JS, Olweny EO, Bercowsky E, Sundaram CP, Dunn MD, Shalhav AL, et al. Flexible ureteroscopes: a single center evaluation of the durability and function of the new endoscopes smaller than 9Fr. J Urol. 2000;164(4):1164-8.
  • 3. Liu DY, He HC, Wang J, Tang Q, Zhou YF, Wang MW, et al. Ureteroscopic lithotripsy using holmium laser for 187 patients with proximal ureteral stones. Chin Med J. 2012;125(9):1542-6.
  • 4. Slam J, Tricia D. Greene and Mantu Gupta: Treatment of proximal ureteral calculi: Holmium: YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol. 2002;167:1972-6.
  • 5. Kumar A, Nanda B, Kumar N, Kumar R, Vasudeva P, Mohanty NK. A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones <2 cm: A single center experience. J Endourol. 2015;29:47-51.
  • 6. Hughes T, Ho HC, Pietropaolo A, Somani BK. Guideline of guidelines for kidney and bladder stones. Turk J Urol. 2020;46(1) 104-112.
  • 7. Cepeda M, Amón JH, Mainez JA, Rodríguez V, Alonso D, Martínez-Sagarra JM. Flexible ureteroscopy for renal stones. Actas Urol Esp. 2014;38(9):571-5.
  • 8. Bozkurt OF, Resorlu B, Yildiz Y, Can CE, Unsal A. Retrograde intrarenal surgery versus percutaneous nephrolithotomy in the management of lower-pole renal stones with a diameter of 15 to 20 mm. J Endourol. 2011;25(7):1131-5.
  • 9. Palmero JL, Castelló A, Miralles J, Nuño de La Rosa I, Garau C, Pastor JC. Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2 cm. Actas Urol Esp. 2014;38(4):257-62.
  • 10. Resorlu B, Unsal A, Ziypak T, Diri A, Atis G, Guven S, et al. Comparison of retrograde intrarenal surgery, shockwave lithotripsy, and percutaneous nephrolithotomy for treatment of medium-sized radiolucent renal stones. World J Urol. 2013;31(6):1581-6.
  • 11. Hyams ES, Monga M, Pearle MS, Antonelli JA, Semins MJ, Assimos DG, et al. A prospective, multi-institutional study of flexible ureteroscopy for proximal ureteral stones smaller than 2 cm. J Urol. 2015;193(1):165-9.
  • 12. Karadag MA, Demir A, Cecen K, Bagcioglu M, Kocaaslan R, Altunrende F. Flexible ureterorenoscopy versus semirigid ureteroscopy for the treatment of proximal ureteral stones: a retrospective comparative analysis of 124 patients. Urol J. 2014;11(5):1867-72.
  • 13. Miernik A, Schoenthaler M, Wilhelm K, Wetterauer U, Zycz¬kowski M, Paradysz A, et al. Combined semirigid and flexible ureterorenoscopy via a large ureteral access sheath for kidney stones >2 cm: a bicentric prospective assessment. World J Urol. 2014;32:697-702.
  • 14. Mir SA, Best SL, McLeroy S, Donnally CJ 3rd, Gnade B, Hsieh JT, et al. Novel stone-magnetizing microparticles: in vitro toxicity and biologic functionality analysis. J Endourol. 201;25(7):1203-7.
  • 15. Tan YK, Best SL, Donnelly C, Olweny E, Kapur P, Mir SA, et al. Novel iron oxide microparticles used to render stone fragments paramagnetic: assessment of toxicity in a murine model. J Urol. 2012;188(5):1972-7.
  • 16. User HM, Hua V, Blunt LW, Wambi C, Gonzalez CM, Nadler RB. Performance and durability of leading flexible ureteroscopes. J Endourol. 2004;18(8):735-8.
  • 17. Multescu R, Geavlete B, Georgescu D, Geavlete P. Conventional fiberoptic flexible ureteroscope versus fourth generation digital flexible ureteroscope: a critical comparison. J Endorol. 2010;24:17-21.
  • 18. Binbay M, Yuruk E, Akman T, Ozgor F, Seyrek M, Ozkuvanci U, et al. Is there a difference in outcomes between digital and fiberoptic flexible ureterorenoscopy procedures? J Endourol. 2010;24(12):1929-34.
  • 19. Basillote JB, Lee DI, Eichel L, Clayman RV. Ureteroscopes: flexible, rigid, and semirigid. Urol Clin North Am. 2004;31:21-32.
  • 20. Bryniarski P, Paradysz A, Zyczkowski M, Kupilas A, Nowakowski K, Bogacki R. A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol. 2012;26(1):52-7.
  • 21. Süer E, Gülpinar Ö, Özcan C, Göğüş Ç, Kerimov S, Şafak M. Predictive factors for flexible ureterorenoscopy requirement after rigid ureterorenoscopy in cases with renal pelvic stones sized 1 to 2 cm. Korean J Urol. 2015;56(2):138-42.
  • 22. Atis G, Gurbuz C, Arikan O, Canat L, Kilic M, Caskurlu T. Ureteroscopic management with laser lithotripsy of renal pel¬vic stones. J Endourol. 2012;26:983-7.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Osman Barut 0000-0002-8296-9717

Sefa Resim 0000-0003-1652-4792

Yayımlanma Tarihi 28 Nisan 2021
Gönderilme Tarihi 11 Ocak 2021
Kabul Tarihi 13 Şubat 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 18 Sayı: 1

Kaynak Göster

Vancouver Barut O, Resim S. İki Santimetreden Küçük İzole Böbrek Pelvis Taşlarında Semirijid ve Fleksibl Üreteroskopi Sonuçlarının Karşılaştırması. Harran Üniversitesi Tıp Fakültesi Dergisi. 2021;18(1):45-9.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty