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Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater.
Int J Urol. 2012 Mar; 19(3):264-7.IJ

Abstract

Although percutaneous nephrolithotomy has been recommended as the first-line treatment for renal stones larger than 2 cm, its major complication rate is not negligible and less invasive approaches are to be explored. Thanks to the recent advances in endoscopic technology, flexible ureteroscopy has become another option in this setting. Herein we report our most recent experience with flexible ureteroscopy for large renal stones. Between September 2008 and May 2011, 20 patients with renal stones ≥ 2 cm underwent a total of 28 procedures of ureteroscopy with holmium laser lithotripsy, using the Olympus URF-P5 and a ureteral access sheath. The number of procedures, operative time, stone-free rates, stone compositions and complications were evaluated. Stone-free status was defined as the absence of fragments or fragments of ≤ 4 mm. Mean stone size was 3.1 cm (range 2.0-5.0). The average number of procedures was 1.4. One, two and three procedures were required in 13, six and one patients, respectively. Overall, the stone-free rate was 90%. The stone-free rate for preoperative stone size of 2 to ≤ 4 cm and >4 cm was 100% (14/14) and 67% (4/6), respectively. No major intraoperative complications were identified. Postoperative high-grade fever was observed in three patients, including one patient who developed sepsis. All these patients were successfully treated conservatively. Our findings suggest that ureteroscopy represents a favorable option for selected patients with renal stones, especially those 2 to ≤ 4 cm in size.

Authors+Show Affiliations

Department of Urology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan. r-tauro-o@ohtsuka-hospital.toshima.tokyo.jpNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22145599

Citation

Takazawa, Ryoji, et al. "Successful Outcome of Flexible Ureteroscopy With Holmium Laser Lithotripsy for Renal Stones 2 Cm or Greater." International Journal of Urology : Official Journal of the Japanese Urological Association, vol. 19, no. 3, 2012, pp. 264-7.
Takazawa R, Kitayama S, Tsujii T. Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater. Int J Urol. 2012;19(3):264-7.
Takazawa, R., Kitayama, S., & Tsujii, T. (2012). Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater. International Journal of Urology : Official Journal of the Japanese Urological Association, 19(3), 264-7. https://doi.org/10.1111/j.1442-2042.2011.02931.x
Takazawa R, Kitayama S, Tsujii T. Successful Outcome of Flexible Ureteroscopy With Holmium Laser Lithotripsy for Renal Stones 2 Cm or Greater. Int J Urol. 2012;19(3):264-7. PubMed PMID: 22145599.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater. AU - Takazawa,Ryoji, AU - Kitayama,Sachi, AU - Tsujii,Toshihiko, Y1 - 2011/12/06/ PY - 2011/12/8/entrez PY - 2011/12/8/pubmed PY - 2012/6/26/medline SP - 264 EP - 7 JF - International journal of urology : official journal of the Japanese Urological Association JO - Int J Urol VL - 19 IS - 3 N2 - Although percutaneous nephrolithotomy has been recommended as the first-line treatment for renal stones larger than 2 cm, its major complication rate is not negligible and less invasive approaches are to be explored. Thanks to the recent advances in endoscopic technology, flexible ureteroscopy has become another option in this setting. Herein we report our most recent experience with flexible ureteroscopy for large renal stones. Between September 2008 and May 2011, 20 patients with renal stones ≥ 2 cm underwent a total of 28 procedures of ureteroscopy with holmium laser lithotripsy, using the Olympus URF-P5 and a ureteral access sheath. The number of procedures, operative time, stone-free rates, stone compositions and complications were evaluated. Stone-free status was defined as the absence of fragments or fragments of ≤ 4 mm. Mean stone size was 3.1 cm (range 2.0-5.0). The average number of procedures was 1.4. One, two and three procedures were required in 13, six and one patients, respectively. Overall, the stone-free rate was 90%. The stone-free rate for preoperative stone size of 2 to ≤ 4 cm and >4 cm was 100% (14/14) and 67% (4/6), respectively. No major intraoperative complications were identified. Postoperative high-grade fever was observed in three patients, including one patient who developed sepsis. All these patients were successfully treated conservatively. Our findings suggest that ureteroscopy represents a favorable option for selected patients with renal stones, especially those 2 to ≤ 4 cm in size. SN - 1442-2042 UR - https://www.unboundmedicine.com/medline/citation/22145599/Successful_outcome_of_flexible_ureteroscopy_with_holmium_laser_lithotripsy_for_renal_stones_2_cm_or_greater_ L2 - https://doi.org/10.1111/j.1442-2042.2011.02931.x DB - PRIME DP - Unbound Medicine ER -