Objective:To explore the efficacy,safety,and feasibility of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts.Methods:From September 2012 to February 2019,a total of ...Objective:To explore the efficacy,safety,and feasibility of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts.Methods:From September 2012 to February 2019,a total of 18 patients,aged from 28 to 62(meanstandard deviation[SD]:46.50±9.14)years,were diagnosed with parapelvic renal cysts and treated by holmium laser flexible ureteroscopic intrapelvic drainage.There were 10 males and eight females.All of the parapelvic renal cysts were unilateral,and two cases were complicated with pyelolithiasis.The diameters of the cysts ranged from 4.1 cm to 8.2 cm.Results:All the patients completed the operation successfully in one stage without conversion to open surgery;in two cases,it was difficult to find the cysts during the operation,and the localization was completed by B-ultrasound and percutaneous injection of methylene blue.The mean operative time was 33.89(SD:9.68;range:22-54)min,and the mean hospitalization time was 2.67(SD:0.91;range:2-5)days.Three months and 6 months of follow-up were performed after surgery.The cysts disappeared in 13(72%)cases,and the diameter of the cysts in five(28%)cases decreased by more than 50%.Conclusion:Holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts is simple,safe,and effective,and can be used as the first choice for the treatment of parapelvic renal cysts.展开更多
Objective:In second-stage percutaneous nephrolithotomy(PCNL),because the hydronephrosis has been decompressed,the dilated renal pelvis has resolved and the space is small.Consequently,introduction of the tip of the Am...Objective:In second-stage percutaneous nephrolithotomy(PCNL),because the hydronephrosis has been decompressed,the dilated renal pelvis has resolved and the space is small.Consequently,introduction of the tip of the Amplatz dilator can cause injury to the opposite side of the renal-pelvic mucosa.In this study,we report the experimental and initial clinical performance of a spherical-headed fascial dilator developed specifically for second-stage PCNL.Methods:The novel spherical-headed dilator was compared with existing tapered-headed dilators in configuration and in puncture resistance utilizing a static puncture test.Subsequently,a pilot clinical study was conducted during which patients scheduled to undergo second-stage PCNL from June 2019 to October 2019 in our center were enrolled.A typical ultrasound guided PCNL procedure was performed with the exception that the new spherical-headed fascial dilator was substituted for a tapered-headed one.Results:Experimentally,stab resistance against polyethylene film was significantly increased using the novel spherical-headed dilator compared to the traditional tapered-headed dilators(p<0.005).In the clinical study,the novel dilators were successfully introduced into the renal pelvis and passed down the collecting system in all eight second-stage PCNL cases.There were no cases of renal pelvic perforation or brisk hemorrhage nor need for transfusion.展开更多
During the postoperative management of urinary diseases,oral or intravenous administration of drugs and implanting ureteral stents are usually required,making localized drug delivery by ureteral stent a precise and ef...During the postoperative management of urinary diseases,oral or intravenous administration of drugs and implanting ureteral stents are usually required,making localized drug delivery by ureteral stent a precise and effective medication strategy.In the traditional drug loading method,the drug was premixed in the implants in production lines and the versatility of drugs was restricted.However,the complex situation in the urinary system fails the possibility of finding a“one fits all”medication plan,and the intraoperative drug-loading of implants is highly desired to support customized therapy.Here,we designed an ultrathin(8μm),elastic,and self-adhesive nanofiber bio-tape(NFBT)that can easily encapsulate drugs on the stent surface for controllable localized drug delivery.The NFBT exhibited high binding strength to a ureteral stent,a sustained release over 7 d in PBS for hydrophilic drug,and a zero-order release curve over 28 days for the hydrophobic drug nitrofurantoin(NFT).Further in vivo experiments using a porcine ureteral tract infection model demonstrated that NFBT loaded with NFT could significantly reduce the bacterial concentration in urine.The total amount of NFT delivered by the NFBT was about 2.68 wt%of the recommended dose for the systemic administration.展开更多
Objective The objective of this study is to assess the effectiveness and safety of ureteroscopic lithotripsy and flexible ureteroscopy(fURS)for treating patients on anticoagulant(AC)or antiplatelet(AP)medications.Pati...Objective The objective of this study is to assess the effectiveness and safety of ureteroscopic lithotripsy and flexible ureteroscopy(fURS)for treating patients on anticoagulant(AC)or antiplatelet(AP)medications.Patients and Methods The study included 213 patients with urinary stones who underwent ureteroscopic lithotripsy or fURS between January 2019 and October 2022 at the Shanghai Municipal Hospital Urology Specialist Alliance.Among these patients,15 received AC therapy,193 received AP therapy,and 5 received both AC and AP therapy.Patients were divided into 3 groups based on the real-world management of antithrombotic drugs:the continuation group(n=62),the discontinuation group(n=91),and the discontinuation and bridge heparin group(n=60).Intraoperative and postoperative outcomes were compared among the 3 groups.Results Age,sex,body mass index,stone location,stone size,stone side,and residual fragments were not different among the groups.None of the patients received blood transfusions or had thromboembolic events,emergencies for gross hematuria,significant bleeding-related complications,or unplanned secondary ureteroscopic surgery.The mean duration of hospital stay of the continuation group(3.97 days)was significantly lower than that of the discontinuation group(5.99 days)and the discontinuation and bridge heparin group(5.75 days)(p<0.001).Conclusions Ureteroscopic lithotripsy and fURS can be performed safely and effectively in patients on AC or AP drugs,resulting in reduced duration of hospital stay.展开更多
文摘Objective:To explore the efficacy,safety,and feasibility of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts.Methods:From September 2012 to February 2019,a total of 18 patients,aged from 28 to 62(meanstandard deviation[SD]:46.50±9.14)years,were diagnosed with parapelvic renal cysts and treated by holmium laser flexible ureteroscopic intrapelvic drainage.There were 10 males and eight females.All of the parapelvic renal cysts were unilateral,and two cases were complicated with pyelolithiasis.The diameters of the cysts ranged from 4.1 cm to 8.2 cm.Results:All the patients completed the operation successfully in one stage without conversion to open surgery;in two cases,it was difficult to find the cysts during the operation,and the localization was completed by B-ultrasound and percutaneous injection of methylene blue.The mean operative time was 33.89(SD:9.68;range:22-54)min,and the mean hospitalization time was 2.67(SD:0.91;range:2-5)days.Three months and 6 months of follow-up were performed after surgery.The cysts disappeared in 13(72%)cases,and the diameter of the cysts in five(28%)cases decreased by more than 50%.Conclusion:Holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts is simple,safe,and effective,and can be used as the first choice for the treatment of parapelvic renal cysts.
基金This study was funded by grants from Shanghai Sailing Program(19YF1427200)National Natural Science Foundation of China(81902556)+2 种基金Shanghai Municipal Commission of Health and Family Planning Program(20184Y0151)Shanghai Association of Chinese Integrative Medicine Program(ZHYY-ZXYJHZX-1-03)Shanghai Ninth People’s Hospital Chuangke Projects(CK2018009).
文摘Objective:In second-stage percutaneous nephrolithotomy(PCNL),because the hydronephrosis has been decompressed,the dilated renal pelvis has resolved and the space is small.Consequently,introduction of the tip of the Amplatz dilator can cause injury to the opposite side of the renal-pelvic mucosa.In this study,we report the experimental and initial clinical performance of a spherical-headed fascial dilator developed specifically for second-stage PCNL.Methods:The novel spherical-headed dilator was compared with existing tapered-headed dilators in configuration and in puncture resistance utilizing a static puncture test.Subsequently,a pilot clinical study was conducted during which patients scheduled to undergo second-stage PCNL from June 2019 to October 2019 in our center were enrolled.A typical ultrasound guided PCNL procedure was performed with the exception that the new spherical-headed fascial dilator was substituted for a tapered-headed one.Results:Experimentally,stab resistance against polyethylene film was significantly increased using the novel spherical-headed dilator compared to the traditional tapered-headed dilators(p<0.005).In the clinical study,the novel dilators were successfully introduced into the renal pelvis and passed down the collecting system in all eight second-stage PCNL cases.There were no cases of renal pelvic perforation or brisk hemorrhage nor need for transfusion.
基金the National Science Foundation for Young Scientists of China(No.81902556)the Fundamental Research Funds for the Central Universities(No.2232020G-01)+2 种基金the Fundamental Research Funds for the Central Universities and Graduate Student Innovation Fund of Donghua University(No.CUSF-DH-D-2021019)China Scholarship Council(No.202006630061)111 Project(No.BP0719035).
文摘During the postoperative management of urinary diseases,oral or intravenous administration of drugs and implanting ureteral stents are usually required,making localized drug delivery by ureteral stent a precise and effective medication strategy.In the traditional drug loading method,the drug was premixed in the implants in production lines and the versatility of drugs was restricted.However,the complex situation in the urinary system fails the possibility of finding a“one fits all”medication plan,and the intraoperative drug-loading of implants is highly desired to support customized therapy.Here,we designed an ultrathin(8μm),elastic,and self-adhesive nanofiber bio-tape(NFBT)that can easily encapsulate drugs on the stent surface for controllable localized drug delivery.The NFBT exhibited high binding strength to a ureteral stent,a sustained release over 7 d in PBS for hydrophilic drug,and a zero-order release curve over 28 days for the hydrophobic drug nitrofurantoin(NFT).Further in vivo experiments using a porcine ureteral tract infection model demonstrated that NFBT loaded with NFT could significantly reduce the bacterial concentration in urine.The total amount of NFT delivered by the NFBT was about 2.68 wt%of the recommended dose for the systemic administration.
基金Shanghai Municipal Hospital Urology Specialist Alliance(grant no.SHDC22021314-A,SHDC22021314-B)Scientific and Technological Innovative Action Plan from Science and Technology Commission of Shanghai Municipality(grant nos.20Y11904600 and 23141902100)+1 种基金Shanghai Pujiang Program(grant no.2020PJD046)Science and Technology Foundation of Songjiang District(grant no.18sjkjgg13).
文摘Objective The objective of this study is to assess the effectiveness and safety of ureteroscopic lithotripsy and flexible ureteroscopy(fURS)for treating patients on anticoagulant(AC)or antiplatelet(AP)medications.Patients and Methods The study included 213 patients with urinary stones who underwent ureteroscopic lithotripsy or fURS between January 2019 and October 2022 at the Shanghai Municipal Hospital Urology Specialist Alliance.Among these patients,15 received AC therapy,193 received AP therapy,and 5 received both AC and AP therapy.Patients were divided into 3 groups based on the real-world management of antithrombotic drugs:the continuation group(n=62),the discontinuation group(n=91),and the discontinuation and bridge heparin group(n=60).Intraoperative and postoperative outcomes were compared among the 3 groups.Results Age,sex,body mass index,stone location,stone size,stone side,and residual fragments were not different among the groups.None of the patients received blood transfusions or had thromboembolic events,emergencies for gross hematuria,significant bleeding-related complications,or unplanned secondary ureteroscopic surgery.The mean duration of hospital stay of the continuation group(3.97 days)was significantly lower than that of the discontinuation group(5.99 days)and the discontinuation and bridge heparin group(5.75 days)(p<0.001).Conclusions Ureteroscopic lithotripsy and fURS can be performed safely and effectively in patients on AC or AP drugs,resulting in reduced duration of hospital stay.
