Skip to main content
Erschienen in: World Journal of Urology 6/2013

01.12.2013 | Original Article

Treatment of large impacted proximal ureteral stones: randomized comparison of minimally invasive percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy

verfasst von: Gu Xiao-jian, Lu Jian Lin, Xu Yan

Erschienen in: World Journal of Urology | Ausgabe 6/2013

Einloggen, um Zugang zu erhalten

Abstract

Objective

To provide appropriate evidence for treatment planning of patients with an impacted proximal ureteral stones ≥1.5 cm in size, by analyzing the therapeutic outcomes for those undergoing minimally invasive percutaneous antegrade ureterolithotripsy and retrograde ureterolithotripsy.

Patients and methods

From September 2010 to November 2011, eligible patients with impacted proximal ureteral stones ≥1.5 cm in size referred to our institute were considered for this study. The closed envelope method was used to randomize the enrolled patients to mini-PCNL (30) or retrograde ureterolithotripsy (29). The efficiency quotient (EQ) was calculated to specifically address the efficiency for both the techniques. All preoperative and postoperative data for both groups were recorded.

Results

The initial stone-free rate was 93.3 % in the mini-PCNL group and 41.4 % in the URSL group (p < 0.001). However, the overall stone-free rate at the 1-month follow-up visit after initial treatment was 100 % in the mini-PCNL group and 89.7 % in the URSL group (p = 0.07). The EQs for the mini-PCNL and URSL groups were 0.83 and 0.50, respectively.

Conclusions

Our study shows that mini-PCNL removal of large impacted proximal ureteral calculi can achieve higher stone-free rates and safe.
Literatur
1.
Zurück zum Zitat Scarpa RM, DeLisa A, Porru D, Usai E (1999) Holmium:YAG laser ureterolithotripsy. Eur Urol 35:233PubMedCrossRef Scarpa RM, DeLisa A, Porru D, Usai E (1999) Holmium:YAG laser ureterolithotripsy. Eur Urol 35:233PubMedCrossRef
2.
Zurück zum Zitat Dretler SP (2006) Prevention of retrograde stone migration during ureteroscopy. Nat Clin Pract Urol 3:60–61PubMedCrossRef Dretler SP (2006) Prevention of retrograde stone migration during ureteroscopy. Nat Clin Pract Urol 3:60–61PubMedCrossRef
3.
Zurück zum Zitat Salem HK (2009) A prospective randomized study comparing shock wave lithotripsy and semirigid ureteroscopy for the management of upper ureteral calculi. Urology 74:1216–1221PubMedCrossRef Salem HK (2009) A prospective randomized study comparing shock wave lithotripsy and semirigid ureteroscopy for the management of upper ureteral calculi. Urology 74:1216–1221PubMedCrossRef
4.
Zurück zum Zitat Preminger GM, Tiselius H, Assimos DG et al (2007) 2007 guideline for the management of ureteral calculi. Eur Urol 52:1610–1631PubMedCrossRef Preminger GM, Tiselius H, Assimos DG et al (2007) 2007 guideline for the management of ureteral calculi. Eur Urol 52:1610–1631PubMedCrossRef
5.
Zurück zum Zitat Lam JS, Greene TD, Gupta M (2002) Treatment of proximal ureteral calculi: holmium:YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol 167:1972–1976PubMedCrossRef Lam JS, Greene TD, Gupta M (2002) Treatment of proximal ureteral calculi: holmium:YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol 167:1972–1976PubMedCrossRef
6.
Zurück zum Zitat Preminger GM, Tiselius HG, Assimos DG et al (2007) 2007 guideline for the management of ureteral calculi. J Urol 178:2418–2434PubMedCrossRef Preminger GM, Tiselius HG, Assimos DG et al (2007) 2007 guideline for the management of ureteral calculi. J Urol 178:2418–2434PubMedCrossRef
7.
Zurück zum Zitat Araki M, Wong C (2007) Direct comparison of fiberoptic and digital ureteroscopy for upper urinary tract lithotripsy. J Urol 4(suppl):V1826 Araki M, Wong C (2007) Direct comparison of fiberoptic and digital ureteroscopy for upper urinary tract lithotripsy. J Urol 4(suppl):V1826
8.
Zurück zum Zitat Nahas AR, Eraky I, el-Assmy AM et al (2006) Percutaneous treatment of large upper tract stones after urinary diversion. Urology 68:500–504PubMedCrossRef Nahas AR, Eraky I, el-Assmy AM et al (2006) Percutaneous treatment of large upper tract stones after urinary diversion. Urology 68:500–504PubMedCrossRef
9.
Zurück zum Zitat Li X, He Z, Wu K et al (2009) Chinese minimally invasive percutaneous nephrolithotomy: the Guangzhou experience. J Endourol 23:1693–1697PubMedCrossRef Li X, He Z, Wu K et al (2009) Chinese minimally invasive percutaneous nephrolithotomy: the Guangzhou experience. J Endourol 23:1693–1697PubMedCrossRef
10.
Zurück zum Zitat Seitz C, Tanovic E, Kikic Z, Fajkovic H (2007) Impact of stone size, location, composition, impaction, and hydronephrosis on the efficacy of holmium:YAG-laser ureterolithotripsy. Eur Urol 52:1751–1759PubMedCrossRef Seitz C, Tanovic E, Kikic Z, Fajkovic H (2007) Impact of stone size, location, composition, impaction, and hydronephrosis on the efficacy of holmium:YAG-laser ureterolithotripsy. Eur Urol 52:1751–1759PubMedCrossRef
11.
Zurück zum Zitat Sofer M, Watterson JD, Wollin TA, Nott L, Razvi H, Denstedt JD (2002) Holmium:YAG laser lithotripsy for upper urinary tract calculi in 598 patients. J Urol 167:31–34PubMedCrossRef Sofer M, Watterson JD, Wollin TA, Nott L, Razvi H, Denstedt JD (2002) Holmium:YAG laser lithotripsy for upper urinary tract calculi in 598 patients. J Urol 167:31–34PubMedCrossRef
12.
Zurück zum Zitat Kijvikai K, Haleblian GE, Preminger GM et al (2007) Shock wave lithotripsy or ureteroscopy for the management of proximal ureteral calculi: an old discussion revisited. J Urol 178:1157–1163PubMedCrossRef Kijvikai K, Haleblian GE, Preminger GM et al (2007) Shock wave lithotripsy or ureteroscopy for the management of proximal ureteral calculi: an old discussion revisited. J Urol 178:1157–1163PubMedCrossRef
13.
14.
Zurück zum Zitat Jiang H, Wu Z, Ding Q, Zhang Y (2007) Ureteroscopic treatment of ureteral calculi with holmium:YAG laser lithotripsy. J Endourol 21:151–154PubMedCrossRef Jiang H, Wu Z, Ding Q, Zhang Y (2007) Ureteroscopic treatment of ureteral calculi with holmium:YAG laser lithotripsy. J Endourol 21:151–154PubMedCrossRef
15.
Zurück zum Zitat Leijte JA, Oddens JR, Lock TM (2008) Holmium laser lithotripsy for ureteral calculi: predictive factors for complications and success. J Endourol 22:257–260PubMedCrossRef Leijte JA, Oddens JR, Lock TM (2008) Holmium laser lithotripsy for ureteral calculi: predictive factors for complications and success. J Endourol 22:257–260PubMedCrossRef
16.
Zurück zum Zitat Eisner BH, Dretler SP (2009) Use of the Stone Cone for prevention of calculus retropulsion during holmium:YAG laser lithotripsy: case series and review of the literature. Urol Int 82:356–360PubMedCrossRef Eisner BH, Dretler SP (2009) Use of the Stone Cone for prevention of calculus retropulsion during holmium:YAG laser lithotripsy: case series and review of the literature. Urol Int 82:356–360PubMedCrossRef
17.
Zurück zum Zitat Johnson GB, Portela D, Grasso M (2006) Advanced ureteroscopy: wireless and sheathless. J Endourol 20:552–555PubMedCrossRef Johnson GB, Portela D, Grasso M (2006) Advanced ureteroscopy: wireless and sheathless. J Endourol 20:552–555PubMedCrossRef
18.
Zurück zum Zitat Goel R, Aron M, Kesarwani PK et al (2005) Percutaneous antegrade removal of impacted upper-ureteral calculi: still the treatment of choice in developing countries. J Endourol 19:54–57PubMedCrossRef Goel R, Aron M, Kesarwani PK et al (2005) Percutaneous antegrade removal of impacted upper-ureteral calculi: still the treatment of choice in developing countries. J Endourol 19:54–57PubMedCrossRef
19.
Zurück zum Zitat Li LY, Gao X, Yang M et al (2010) Does a smaller tract in percutaneous nephrolithotomy contribute to less invasiveness? A prospective comparative study. Urology 75:56–61PubMedCrossRef Li LY, Gao X, Yang M et al (2010) Does a smaller tract in percutaneous nephrolithotomy contribute to less invasiveness? A prospective comparative study. Urology 75:56–61PubMedCrossRef
20.
Zurück zum Zitat Jackman SV, Docimo SG, Cadeddu JA et al (1998) The “mini-perc” technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 16:371–374PubMedCrossRef Jackman SV, Docimo SG, Cadeddu JA et al (1998) The “mini-perc” technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 16:371–374PubMedCrossRef
21.
Zurück zum Zitat Fu YM, Chen QY, Zhao ZS et al (2011) Ultrasound-guided minimally invasive percutaneous nephrolithotomy in flank position for management of complex renal calculi. Urology 77:40–44 Fu YM, Chen QY, Zhao ZS et al (2011) Ultrasound-guided minimally invasive percutaneous nephrolithotomy in flank position for management of complex renal calculi. Urology 77:40–44
22.
Zurück zum Zitat Sun X, Xia S, Lu J et al (2008) Treatment of large impacted proximal ureteral stones: randomized comparison of percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy. J Endourol 22:913–917PubMedCrossRef Sun X, Xia S, Lu J et al (2008) Treatment of large impacted proximal ureteral stones: randomized comparison of percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy. J Endourol 22:913–917PubMedCrossRef
23.
Zurück zum Zitat Lahme S, Bichler KH, Strohmaier WL et al (2001) Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol 40:619–624PubMedCrossRef Lahme S, Bichler KH, Strohmaier WL et al (2001) Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol 40:619–624PubMedCrossRef
24.
Zurück zum Zitat Wu CF, Shee JJ, Lin WY et al (2004) Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol 172:1899–1902PubMedCrossRef Wu CF, Shee JJ, Lin WY et al (2004) Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol 172:1899–1902PubMedCrossRef
25.
Zurück zum Zitat Lee YH, Tsai JY, Jiaan BP et al (2006) Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology 67:480–484PubMedCrossRef Lee YH, Tsai JY, Jiaan BP et al (2006) Prospective randomized trial comparing shock wave lithotripsy and ureteroscopic lithotripsy for management of large upper third ureteral stones. Urology 67:480–484PubMedCrossRef
26.
Zurück zum Zitat Pardalidis NP, Papatsoris AG, Kapotis CG, Kosmaoglou EV (2006) Treatment of impacted lower third ureteral stones with the use of the ureteral access sheath. Urol Res 34:211–214PubMedCrossRef Pardalidis NP, Papatsoris AG, Kapotis CG, Kosmaoglou EV (2006) Treatment of impacted lower third ureteral stones with the use of the ureteral access sheath. Urol Res 34:211–214PubMedCrossRef
27.
Zurück zum Zitat Matlaga BR, Jansen JP, Meckley LM (2012) et al.Treatment of ureteral and renal stones: a systematic review and meta-analysis of randomized, controlled trials. J Urol 188(1):130–137PubMedCrossRef Matlaga BR, Jansen JP, Meckley LM (2012) et al.Treatment of ureteral and renal stones: a systematic review and meta-analysis of randomized, controlled trials. J Urol 188(1):130–137PubMedCrossRef
28.
Zurück zum Zitat Bostanci Y, Ozden E, Atac F et al (2012) The double wire technique: an alternative method for difficult ureteroscopic access. Urol Res 40:783–784 Bostanci Y, Ozden E, Atac F et al (2012) The double wire technique: an alternative method for difficult ureteroscopic access. Urol Res 40:783–784
29.
Zurück zum Zitat Khairy-Salem H, el-Ghoneimy M et al (2011) Semirigid ureteroscopy in management of large proximal ureteral calculi: is there still a role in developing countries? Urology 77(5):1064–1068PubMedCrossRef Khairy-Salem H, el-Ghoneimy M et al (2011) Semirigid ureteroscopy in management of large proximal ureteral calculi: is there still a role in developing countries? Urology 77(5):1064–1068PubMedCrossRef
Metadaten
Titel
Treatment of large impacted proximal ureteral stones: randomized comparison of minimally invasive percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy
verfasst von
Gu Xiao-jian
Lu Jian Lin
Xu Yan
Publikationsdatum
01.12.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 6/2013
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-013-1026-2

Weitere Artikel der Ausgabe 6/2013

World Journal of Urology 6/2013 Zur Ausgabe

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.