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Effect of stone composition on operative time during ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy with active fragment retrieval.
Urology. 2012 Oct; 80(4):790-4.U

Abstract

OBJECTIVE

To assess whether the stone composition affects the operative time of ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy (ULL) with active fragment retrieval. The chemical composition of a calculus is known to affect the efficacy with which it is fragmented by a device, such as pneumatic, laser, or shock wave lithotripter. Previous studies examining the efficacy of holmium:yttrium-aluminum-garnet laser lithotripsy have been performed in vitro, but it is not known whether the operative time is significantly affected by the chemical composition of a patient's stone.

METHODS

We selected all patients who had undergone ULL for stone disease from July 2008 to January 2011 for a retrospective chart review. We used a standardized operative technique of fragmentation and active retrieval of all fragments identified on full inspection of the entire collecting system using rigid and flexible endoscopes. The stone composition was defined as the presence of a single predominant (>51%) component. Statistical analysis was performed on a per-procedure basis relative to the stone burden, as measured in minutes of operative time per gram of stone.

RESULTS

A total of 187 cases of unilateral ULL with active retrieval of stone fragments confirmed to have a single predominant chemical composition met the inclusion criteria. When accounting for the weight of the recovered stone, no difference was found in the operative time among the apatite, brushite, cystine, calcium oxalate monohydrate, calcium oxalate dihydrate, and uric acid stones.

CONCLUSION

Although stone composition is widely recognized as an important procedural variable, especially for shock wave lithotripsy, it appears to have little effect on the overall operative time for holmium:yttrium-aluminum-garnet lithotripsy when using active fragment retrieval.

Authors+Show Affiliations

Department of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22854140

Citation

Wiener, Scott V., et al. "Effect of Stone Composition On Operative Time During Ureteroscopic Holmium:yttrium-aluminum-garnet Laser Lithotripsy With Active Fragment Retrieval." Urology, vol. 80, no. 4, 2012, pp. 790-4.
Wiener SV, Deters LA, Pais VM. Effect of stone composition on operative time during ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy with active fragment retrieval. Urology. 2012;80(4):790-4.
Wiener, S. V., Deters, L. A., & Pais, V. M. (2012). Effect of stone composition on operative time during ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy with active fragment retrieval. Urology, 80(4), 790-4. https://doi.org/10.1016/j.urology.2012.05.040
Wiener SV, Deters LA, Pais VM. Effect of Stone Composition On Operative Time During Ureteroscopic Holmium:yttrium-aluminum-garnet Laser Lithotripsy With Active Fragment Retrieval. Urology. 2012;80(4):790-4. PubMed PMID: 22854140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of stone composition on operative time during ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy with active fragment retrieval. AU - Wiener,Scott V, AU - Deters,Levi A, AU - Pais,Vernon M,Jr Y1 - 2012/07/31/ PY - 2011/12/19/received PY - 2012/04/25/revised PY - 2012/05/29/accepted PY - 2012/8/3/entrez PY - 2012/8/3/pubmed PY - 2013/1/1/medline SP - 790 EP - 4 JF - Urology JO - Urology VL - 80 IS - 4 N2 - OBJECTIVE: To assess whether the stone composition affects the operative time of ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy (ULL) with active fragment retrieval. The chemical composition of a calculus is known to affect the efficacy with which it is fragmented by a device, such as pneumatic, laser, or shock wave lithotripter. Previous studies examining the efficacy of holmium:yttrium-aluminum-garnet laser lithotripsy have been performed in vitro, but it is not known whether the operative time is significantly affected by the chemical composition of a patient's stone. METHODS: We selected all patients who had undergone ULL for stone disease from July 2008 to January 2011 for a retrospective chart review. We used a standardized operative technique of fragmentation and active retrieval of all fragments identified on full inspection of the entire collecting system using rigid and flexible endoscopes. The stone composition was defined as the presence of a single predominant (>51%) component. Statistical analysis was performed on a per-procedure basis relative to the stone burden, as measured in minutes of operative time per gram of stone. RESULTS: A total of 187 cases of unilateral ULL with active retrieval of stone fragments confirmed to have a single predominant chemical composition met the inclusion criteria. When accounting for the weight of the recovered stone, no difference was found in the operative time among the apatite, brushite, cystine, calcium oxalate monohydrate, calcium oxalate dihydrate, and uric acid stones. CONCLUSION: Although stone composition is widely recognized as an important procedural variable, especially for shock wave lithotripsy, it appears to have little effect on the overall operative time for holmium:yttrium-aluminum-garnet lithotripsy when using active fragment retrieval. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/22854140/Effect_of_stone_composition_on_operative_time_during_ureteroscopic_holmium:yttrium_aluminum_garnet_laser_lithotripsy_with_active_fragment_retrieval_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(12)00634-6 DB - PRIME DP - Unbound Medicine ER -