Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases
Urinary system calculi|更新时间:2025-10-22
|
Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases
Journal of Chongqing Medical UniversityVol. 49, Issue 6, Pages: 665-668(2024)
Deng Guoxian,Xia Xiaowen,Yan Jun’an.Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases[J].Journal of Chongqing Medical University,2024,49(6):665-668.
Deng Guoxian,Xia Xiaowen,Yan Jun’an.Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases[J].Journal of Chongqing Medical University,2024,49(6):665-668. DOI: 10.13406/j.cnki.cyxb.003512.
Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases
To investigate the safety and efficacy of staged flexible ureteroscopy with holmium laser lithotripsy(FURL)for the treatment of complex nephrolithiasis.
Methods
2
We retrospectively analyzed 389 patients with unilateral large renal stones(≥4 cm in diameter)who had undergone staged FURL from January 2013 to December 2023. We analyzed the number and duration of procedures performed,the length of hospital stay,the cost of hospitalization,the stone clearance rate,and the incidence of complications(fever,urosepsis,severe hemorrhage,steinstrasse,
etc.
).
Results
2
Each patient underwent at least two procedures,and 22 patients underwent three procedures. The mean duration of stage-1 procedures was(84.60±21.34) minutes. The mean duration of stage-2 procedures was (89.70±19.17) minutes,with a stone clearance rate of 94.60%. The mean duration of stage-3 procedures was (72.50±17.30) minutes,with a stone clearance rate of 90.90%. There were 21 events of fever(7 cases of urosepsis),76 events of steinstrasse,and 30 events of gross hematuria.
Conclusion
2
Staged FURL is safe and effective for treating large stones in the kidney,but its high cost is a concern to the patients.
Hyams ES , Munver R , Bird VG , et al . Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 Cm:a multi-institutional experience [J ] . J Endourol , 2010 , 24 ( 10 ): 1583 - 1588 .
Dreger NM , Degener S , Ahmad-Nejad P , et al . Urosepsis—etiology,diagnosis,and treatment [J ] . Deutsches Ärzteblatt Int , 2015 : 837 - 848 .
Thapa BB , Niranjan V . Mini PCNL over standard PCNL:what makes it better? [J ] . Surg J , 2020 , 6 ( 1 ): e19 - e23 .
Gadzhiev N , Malkhasyan V , Akopyan G , et al . Percutaneous nephrolithotomy for staghorn calculi:Troubleshooting and managing complications [J ] . Asian J Urol , 2020 , 7 ( 2 ): 139 - 148 .
El-Anany FG , Hammouda HM , Maghraby HA , et al . Retrograde ureteropyeloscopic holmium laser lithotripsy for large renal calculi [J ] . BJU Int , 2001 , 88 ( 9 ): 850 - 853 .
Cohen J , Cohen S , Grasso M . Ureteropyeloscopic treatment of large,complex intrarenal and proximal ureteral calculi [J ] . BJU Int , 2013 , 111 ( 3 Pt B ): E127 - E131 .
Sugihara T , Yasunaga H , Horiguchi H , et al . A nomogram predicting severe adverse events after ureteroscopic lithotripsy:12 372 patients in a Japanese national series [J ] . BJU Int , 2013 , 111 ( 3 ): 459 - 466 .
Karagöz MA , Erihan IB , Doluoğlu ÖG , et al . Efficacy and safety of fURS in stones larger than 20 mm:is it still the threshold? [J ] . Cent European J Urol , 2020 , 73 ( 1 ): 49 - 54 .
Yang B , Liu SQ , Mi Y , et al . The impact of watching real-time videos of flexible ureteroscopic lithotripsy on anxiety and depression in patients [J ] . Int Urol Nephrol , 2022 , 54 ( 5 ): 1009 - 1015 .
Yan JA . The effect of anesthetic methods on perioperative period of minimally invasive calculus [J ] . J Mod Med Health , 2018 , 34 ( 5 ): 663 - 664 .
Koutsogiannaki S , Schaefers MM , Okuno T , et al . Prolonged exposure to volatile anesthetic isoflurane worsens the outcome of polymicrobial abdominal sepsis [J ] . Toxicol Sci , 2016 :kfw261.
Hiltebrand LB , Krejci V , TenHoevel ME , et al . Redistribution of microcirculatory blood flow within the intestinal wall during sepsis and general anesthesia [J ] . Anesthesiology , 2003 , 98 ( 3 ): 658 - 669 .
He QS , Song ZY , Wang XR , et al . Influencing factors of massive hemorrhage and high-grade renal vascular injury after PCNL:a retrospective comparative study [J ] . Int J Clin Pract , 2023 , 2023 : 5521691 .
Hughes SF , Moyes AJ , Jones K , et al . Pre- and peri-operative clinical information,physiological observations and outcome measures following flexible ureterorenoscopy (FURS),for the treatment of kidney stones. A single-centre observational clinical pilot-study in 51 patients [J ] . BMC Urol , 2022 , 22 ( 1 ): 104 .
Checcucci E , Amparore D , Volpi G , et al . Percutaneous puncture during PCNL:new perspective for the future with virtual imaging guidance [J ] . World J Urol , 2022 , 40 ( 3 ): 639 - 650 .
Efficacy and safety of a tip-flexible suctioning ureteral access sheath combined with flexible ureteroscopy under local anesthesia in treatment of kidney stones with a diameter of ≥3 cm
Related Author
Tang Wei
Chang Hai
Wang Linfeng
Luo Shengjun
Peng Yueqiang
Zhang Gaojie
Guo Jinan
Yu Zhou
Related Institution
Department of Urology,The First Affiliated Hospital of Chongqing Medical University
Department of Urology,Shenzhen People’s Hospital,the Second Clinical Medical College of Jinan University,Shenzhen Urology Minimally Invasive Engineering Center
Department of Urology,Peking University Third Hospital
Department of Urology,The First Hospital Affiliated to Army Medical University
Department of Urology,The First Affiliated Hospital of Chongqing Medical University