Skip to main content
Erschienen in:

20.01.2022 | Original Paper

Retrograde intrarenal surgery in lateral position for lower pole stone: an initial experience from Single Academic Hospital

verfasst von: Linjie Peng, Zexian Zheng, Jiandong Xu, Wen Zhong

Erschienen in: Urolithiasis | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Retrograde intrarenal surgery (RIRS) was generally challenging in management of lower pole stone (LPS) since the unfavorable anatomy. Theoretically, LPS was prone to fall out and down to renal pelvis when patients turned to lateral position, thus to facilitate lithotripsy. The aim of the present study was to report our initial experience of RIRS in lateral position for LPS. From January 2020 to February 2021, 21 patients with LPS received RIRS in lateral position. The intraoperative finding, operation time, complications and stone-free rate (SFR) were recorded and analyzed. The mean stone size was 16.7 ± 2.4 mm, multiple stones in lower pole were noted in 38.1% (8/21) cases. The mean infundibular-pelvic angle (IPA) was 35.2 ± 6.9°, IPA less than 30° was noted in six cases (28.6%, 6/21). Mean operation time was 43.5 ± 6.3 min. Obvious stone fragments dropping from the lower calyx to renal pelvis during the lithotripsy were noted in 17 cases (81.0%). Only one case (4.8%) suffered postoperative fever (Clavien I), no severe complication (> Clavien II) was noted. Hospital stay was 1.1 ± 0.3 days, the SFR in postoperative 1 month was 85.7%. LPS was prone to fall out and down to renal pelvis when patients in lateral position, thus to facilitate the lithotripsy. RIRS in lateral position was feasible for the management of LPS; however, RCT with large sample was required to certify our initial finding.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Zeng G, Mai Z, Xia S et al (2017) Prevalence of kidney stones in China: an ultrasonography based cross-sectional study. BJU Int 120:109–116CrossRef Zeng G, Mai Z, Xia S et al (2017) Prevalence of kidney stones in China: an ultrasonography based cross-sectional study. BJU Int 120:109–116CrossRef
2.
Zurück zum Zitat Sorokin I, Mamoulakis C, Miyazawa K et al (2017) Epidemiology of stone disease across the world. World J Urol 35:1301–1320CrossRef Sorokin I, Mamoulakis C, Miyazawa K et al (2017) Epidemiology of stone disease across the world. World J Urol 35:1301–1320CrossRef
3.
Zurück zum Zitat Trinchieri A, Ostini F, Nespoli R et al (1999) A prospective study of recurrence rate and risk factors for recurrence after a first renal stone. J Urol 162:27–30CrossRef Trinchieri A, Ostini F, Nespoli R et al (1999) A prospective study of recurrence rate and risk factors for recurrence after a first renal stone. J Urol 162:27–30CrossRef
4.
Zurück zum Zitat Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69:475–482CrossRef Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69:475–482CrossRef
5.
Zurück zum Zitat Zhao Z, Fan J, Sun H et al (2019) Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: evidence from a randomised controlled trial. BJU Int 124:496–503CrossRef Zhao Z, Fan J, Sun H et al (2019) Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: evidence from a randomised controlled trial. BJU Int 124:496–503CrossRef
6.
Zurück zum Zitat Sabnis RB, Ganesamoni R, Doshi A et al (2013) Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial. BJU Int 112:355–361CrossRef Sabnis RB, Ganesamoni R, Doshi A et al (2013) Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial. BJU Int 112:355–361CrossRef
7.
Zurück zum Zitat Karim SS, Hanna L, Geraghty R et al (2020) Role of pelvicalyceal anatomy in the outcomes of retrograde intrarenal surgery (RIRS) for lower pole stones: outcomes with a systematic review of literature. Urolithiasis 48:263–270CrossRef Karim SS, Hanna L, Geraghty R et al (2020) Role of pelvicalyceal anatomy in the outcomes of retrograde intrarenal surgery (RIRS) for lower pole stones: outcomes with a systematic review of literature. Urolithiasis 48:263–270CrossRef
8.
Zurück zum Zitat Jessen JP, Honeck P, Knoll T et al (2014) Flexible ureterorenoscopy for lower pole stones: influence of the collecting system’s anatomy. J Endourol 28:146–151CrossRef Jessen JP, Honeck P, Knoll T et al (2014) Flexible ureterorenoscopy for lower pole stones: influence of the collecting system’s anatomy. J Endourol 28:146–151CrossRef
9.
Zurück zum Zitat Resorlu B, Unsal A, Gulec H et al (2012) A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: the “resorlu-unsal stone score.” Urology 80:512–518CrossRef Resorlu B, Unsal A, Gulec H et al (2012) A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: the “resorlu-unsal stone score.” Urology 80:512–518CrossRef
10.
Zurück zum Zitat Grasso M, Ficazzola M (1999) Retrograde ureteropyeloscopy for lower pole caliceal calculi. J Urol 162:1904–1908CrossRef Grasso M, Ficazzola M (1999) Retrograde ureteropyeloscopy for lower pole caliceal calculi. J Urol 162:1904–1908CrossRef
11.
Zurück zum Zitat Zeng G, Zhang T, Agrawal M et al (2018) Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery for the treatment of 1–2 cm lower-pole renal calculi: an international multicentre randomised controlled trial. BJU Int 122:1034–1040CrossRef Zeng G, Zhang T, Agrawal M et al (2018) Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery for the treatment of 1–2 cm lower-pole renal calculi: an international multicentre randomised controlled trial. BJU Int 122:1034–1040CrossRef
12.
Zurück zum Zitat Peng L, Wen J, Zhong W, Zeng G (2020) Is physical therapy effective following extracorporeal shockwave lithotripsy and retrograde intrarenal surgery: a meta-analysis and systematic review. BMC Urol 20:93CrossRef Peng L, Wen J, Zhong W, Zeng G (2020) Is physical therapy effective following extracorporeal shockwave lithotripsy and retrograde intrarenal surgery: a meta-analysis and systematic review. BMC Urol 20:93CrossRef
13.
Zurück zum Zitat Cui Y, Chen J, Zeng F et al (2019) Tamsulosin as a medical expulsive therapy for ureteral stones: a systematic review and meta-analysis of randomized controlled trials. J Urol 201:950–955CrossRef Cui Y, Chen J, Zeng F et al (2019) Tamsulosin as a medical expulsive therapy for ureteral stones: a systematic review and meta-analysis of randomized controlled trials. J Urol 201:950–955CrossRef
14.
Zurück zum Zitat Wu W, Yang Z, Xu C et al (2017) External physical vibration lithecbole promotes the clearance of upper urinary stones after retrograde intrarenal surgery: a prospective, multicenter, randomized controlled trial. J Urol 197:1289–1295CrossRef Wu W, Yang Z, Xu C et al (2017) External physical vibration lithecbole promotes the clearance of upper urinary stones after retrograde intrarenal surgery: a prospective, multicenter, randomized controlled trial. J Urol 197:1289–1295CrossRef
15.
Zurück zum Zitat Scoffone CM, Cracco CM, Cossu M et al (2008) Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: a new standard for percutaneous nephrolithotomy? Eur Urol 54:1393–1403CrossRef Scoffone CM, Cracco CM, Cossu M et al (2008) Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: a new standard for percutaneous nephrolithotomy? Eur Urol 54:1393–1403CrossRef
16.
Zurück zum Zitat Cracco CM, Scoffone CM (2011) ECIRS (Endoscopic Combined Intrarenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery? World J Urol 29:821–827CrossRef Cracco CM, Scoffone CM (2011) ECIRS (Endoscopic Combined Intrarenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery? World J Urol 29:821–827CrossRef
17.
Zurück zum Zitat Bozzini G, Verze P, Arcaniolo D et al (2017) A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience A better understanding on the treatment options for lower pole stones. World J Urol 35:1967–1975CrossRef Bozzini G, Verze P, Arcaniolo D et al (2017) A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience A better understanding on the treatment options for lower pole stones. World J Urol 35:1967–1975CrossRef
18.
Zurück zum Zitat Kilicarslan H, Kaynak Y, Kordan Y et al (2015) Unfavorable anatomical factors influencing the success of retrograde intrarenal surgery for lower pole renal calculi. Urol J 12:2065–2068PubMed Kilicarslan H, Kaynak Y, Kordan Y et al (2015) Unfavorable anatomical factors influencing the success of retrograde intrarenal surgery for lower pole renal calculi. Urol J 12:2065–2068PubMed
19.
Zurück zum Zitat Peng L, Xu Z, Wen J et al (2021) A quick stone component analysis matters in postoperative fever: a propensity score matching study of 1493 retrograde intrarenal surgery. World J Urol 39:1277–1285CrossRef Peng L, Xu Z, Wen J et al (2021) A quick stone component analysis matters in postoperative fever: a propensity score matching study of 1493 retrograde intrarenal surgery. World J Urol 39:1277–1285CrossRef
Metadaten
Titel
Retrograde intrarenal surgery in lateral position for lower pole stone: an initial experience from Single Academic Hospital
verfasst von
Linjie Peng
Zexian Zheng
Jiandong Xu
Wen Zhong
Publikationsdatum
20.01.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Urolithiasis / Ausgabe 2/2022
Print ISSN: 2194-7228
Elektronische ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-021-01297-9

Neu im Fachgebiet Urologie

Wechsel von Zugangsroute und Biopsiesteuerung: Erfahrungen eines Zentrums

Geht der Switch zur transperinealen gezielten Prostatabiopsie auf Kosten der diagnostischen Qualität? Nein, urteilen norwegische Urologinnen und Urologen nach Durchsicht von Daten aus ihrer Einrichtung.

Warum werden Hodenprothesen so selten angeboten?

Forschende aus Großbritannien haben untersucht, wie häufig eine Hodenprothese bei krebsbedingter radikaler Orchidektomie angeboten wird. Vor allem die Gründe, warum kein Implantat zur Wahl gestellt wird, sind erstaunlich. 

Genügt die biparametrische MRT für die Prostatadiagnostik?

Die multiparametrische Magnetresonanztomografie hat einen festen Platz im Screening auf klinisch signifikante Prostatakarzinome. Ob auch ein biparametrisches Vorgehen ausreicht, ist in einer Metaanalyse untersucht worden.

Große Trinkmengen bei Blasentumoren möglicherweise von Nachteil

Beim nicht-muskelinvasiven Blasenkrebs scheint eine hohe Flüssigkeitszufuhr keinen schützenden Effekt in Bezug auf das Risiko eines Rezidivs oder einer Krankheitsprogression zu haben. Eine niederländische Studie legt sogar nahe, dass große Trinkmengen das Fortschreiten der Erkrankung begünstigen könnten.

Update Urologie

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