Tags

Type your tag names separated by a space and hit enter

Multi-session retrograde endoscopic lithotripsy of large renal calculi in obese patients.
Can J Urol. 2009 Dec; 16(6):4915-20.CJ

Abstract

OBJECTIVES

To establish the safety and efficacy of planned multi-session retrograde endoscopic lithotripsy (REL) for the treatment of large renal calculi in the morbidly obese.

METHODS

We retrospectively reviewed charts of patients who underwent multi-session REL procedures from 2003 to 2008. Inclusion criteria included body mass index > 35, total linear stone diameter > 2.0 cm, and patients with a preoperative plan to perform multi-session ureteroscopy. A total of nine patients (six with staghorn calculi) underwent 21 separate procedures. Stone size was measured on preoperative imaging and was defined as length in greatest diameter. Stone free was defined as the complete absence of residual stone on postoperative imaging.

RESULTS

Mean body mass index of the patients was 47.8 kg/m2. Mean total linear stone diameter was 3.8 cm. Three of nine patients (33%) were stone free after their final treatment. Mean decrease in stone size from preoperative imaging was 3.3 cm (83%). There were no intraoperative complications. Mean length of follow up was 0.88 years.

CONCLUSIONS

Multi-session REL is a safe alternative to percutaneous nephrolithotomy (PCNL) in obese patients with very large stones, including staghorn calculi. We recognize that the stone free rate in this series is lower than would be expected with REL for smaller stone burdens or with PCNL. Due to the limitations imposed by both the patient's general medical conditions as well as technical considerations, these patients are left with few options for treatment. Our experience is that management with staged ureteroscopy offers a reduction in stone burden and in some patients a stone free status that provides an acceptable patient outcome.

Authors+Show Affiliations

Department of Urology, University of Michigan Health System, Ann Arbor, Michigan 48109-5330, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20003667

Citation

Wheat, Jeffery C., et al. "Multi-session Retrograde Endoscopic Lithotripsy of Large Renal Calculi in Obese Patients." The Canadian Journal of Urology, vol. 16, no. 6, 2009, pp. 4915-20.
Wheat JC, Roberts WW, Wolf JS. Multi-session retrograde endoscopic lithotripsy of large renal calculi in obese patients. Can J Urol. 2009;16(6):4915-20.
Wheat, J. C., Roberts, W. W., & Wolf, J. S. (2009). Multi-session retrograde endoscopic lithotripsy of large renal calculi in obese patients. The Canadian Journal of Urology, 16(6), 4915-20.
Wheat JC, Roberts WW, Wolf JS. Multi-session Retrograde Endoscopic Lithotripsy of Large Renal Calculi in Obese Patients. Can J Urol. 2009;16(6):4915-20. PubMed PMID: 20003667.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multi-session retrograde endoscopic lithotripsy of large renal calculi in obese patients. AU - Wheat,Jeffery C, AU - Roberts,William W, AU - Wolf,J Stuart,Jr PY - 2009/12/17/entrez PY - 2009/12/17/pubmed PY - 2010/9/4/medline SP - 4915 EP - 20 JF - The Canadian journal of urology JO - Can J Urol VL - 16 IS - 6 N2 - OBJECTIVES: To establish the safety and efficacy of planned multi-session retrograde endoscopic lithotripsy (REL) for the treatment of large renal calculi in the morbidly obese. METHODS: We retrospectively reviewed charts of patients who underwent multi-session REL procedures from 2003 to 2008. Inclusion criteria included body mass index > 35, total linear stone diameter > 2.0 cm, and patients with a preoperative plan to perform multi-session ureteroscopy. A total of nine patients (six with staghorn calculi) underwent 21 separate procedures. Stone size was measured on preoperative imaging and was defined as length in greatest diameter. Stone free was defined as the complete absence of residual stone on postoperative imaging. RESULTS: Mean body mass index of the patients was 47.8 kg/m2. Mean total linear stone diameter was 3.8 cm. Three of nine patients (33%) were stone free after their final treatment. Mean decrease in stone size from preoperative imaging was 3.3 cm (83%). There were no intraoperative complications. Mean length of follow up was 0.88 years. CONCLUSIONS: Multi-session REL is a safe alternative to percutaneous nephrolithotomy (PCNL) in obese patients with very large stones, including staghorn calculi. We recognize that the stone free rate in this series is lower than would be expected with REL for smaller stone burdens or with PCNL. Due to the limitations imposed by both the patient's general medical conditions as well as technical considerations, these patients are left with few options for treatment. Our experience is that management with staged ureteroscopy offers a reduction in stone burden and in some patients a stone free status that provides an acceptable patient outcome. SN - 1195-9479 UR - https://www.unboundmedicine.com/medline/citation/20003667/Multi_session_retrograde_endoscopic_lithotripsy_of_large_renal_calculi_in_obese_patients_ L2 - http://www.canjurol.com/abstract.php?ArticleID=&version=1.0&PMID=20003667 DB - PRIME DP - Unbound Medicine ER -