Urinary calculi are a common and frequently occurring disease in urology. For patients with kidney stones, especially large, multiple or staghorn stones, percutaneous nephrolithotomy (PCNL) is a preferred treatment me...Urinary calculi are a common and frequently occurring disease in urology. For patients with kidney stones, especially large, multiple or staghorn stones, percutaneous nephrolithotomy (PCNL) is a preferred treatment method. Infection-related complications after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome, and urinary sepsis, especially urinary sepsis, which are considered to be common causes of death after percutaneous nephrolithotomy. Therefore, early identification and timely intervention of biomarkers can reduce the incidence and mortality of postoperative sepsis, as well as the length of hospital stay and hospitalization costs. This article reviews the biomarkers for early identification of urinary tract infection after PCNL, such as traditional inflammatory indicators, new inflammatory indicators, and composite inflammatory indicators.展开更多
AIM To compare the outcomes of retrograde intrarenal surgery(RIRS) and miniaturized percutaneous nephrolithotomy(mini-PCNL) in treating lower pole(LP) renal stones with a diameter of 1.5-2.5 cm.METHODS A total of 216 ...AIM To compare the outcomes of retrograde intrarenal surgery(RIRS) and miniaturized percutaneous nephrolithotomy(mini-PCNL) in treating lower pole(LP) renal stones with a diameter of 1.5-2.5 cm.METHODS A total of 216 patients who underwent mini-PCNL(n = 103) or RIRS n = 113) for LP stones with a diameter of 1.5-2.5 cm were enrolled between December 2015 and April 2017 at the Urology Department of Ningbo Urology and Nephrology Hospital.RESULTS Significant differences were found in the hospital stay(9.39 ± 4.01 vs 14.08 ± 5.26, P < 0.0001) and hospitalization costs(2624.5 ± 513.36 vs 3255.2 ± 976.5, P < 0.0001) between the RIRS and mini-PCNL groups. The mean operation time was not significantly different between the RIRS group(56.48 ± 24.77) and the mini-PCNL group(60.04 ± 30.38, P = 0.345). The stone-free rates at the first postoperative day(RIRS vs mini-PCNL: 90.2% vs 93.2%, P = 0.822) and the second month postoperatively(RIRS vs mini-PCNL: 93.8% vs 95.1%, P = 0.986) were not significantly different.CONCLUSION RIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of 1.5-2.5 cm. RIRS can be considered as an alternative to PCNL for the treatment for LP stones of 1.5-2.5 cm.展开更多
The main goals for urinary stone treatment are to preserve renal function, reduce or avoid complications related to calculi, and to render the patient free of calculi as soon as possible. Anatrophic nephrolithotomy(AN...The main goals for urinary stone treatment are to preserve renal function, reduce or avoid complications related to calculi, and to render the patient free of calculi as soon as possible. Anatrophic nephrolithotomy(ANL) is a valid and useful alternative for conventional staghorn calculi excision. Although excellent stone free rates can be achieved with ANL there are some drawbacks that may be of concern. Morbidity related to intraoperative and postoperative complications isone of them. Another, great concern is the possibility of reduction on renal function related to the procedure itself. This may be related to nephron injury during nephrotomy and parenchymal closure or to ischemic injury. In this review we assess functional results after anatrophic nephrolithotomy.展开更多
Objective The objective of this narrative review was to search the existing literature for studies reporting measures to minimize radiation use during endoscopic management of stone disease and present ways of reducin...Objective The objective of this narrative review was to search the existing literature for studies reporting measures to minimize radiation use during endoscopic management of stone disease and present ways of reducing the exposure of both patients and operating room staff.Methods A literature review in PubMed was performed to identify studies describing protocols or measures to reduce radiation received during endourological procedures from January 1970 to August 2022.Eligible studies were those that reported outcomes for ureteroscopy or percutaneous nephrolithotripsy regarding measures to minimize radiation doses used intraoperatively,performed either in real-life theatres or using phantoms.Both comparative and non-comparative studies were deemed eligible.Results Protection can be achieved initially at the level of diagnosis and follow-up of patients,which should be done following an algorithm and choice of more conservative imaging methods.Certain protocols,which follow principles for minimized fluoroscopy use should be implemented and urologists as well as operating room staff should be continuously trained regarding radiation damage and protection measures.Wearing protective lead equipment remains a cornerstone for personnel protection,while configuration of the operating room and adjusting X-ray machine settings can also significantly reduce radiation energy.Conclusion There are specific measures,which can be implemented to reduce radiation exposure.These include avoiding excessive use of computed tomography scans and X-rays during diagnosis and follow-up of urolithiasis patients.Intraoperative protocols with minimal fluoroscopy use can be employed.Staff training regarding dangers of radiation plays also a major role.Use and maintenance of protective equipment and setting up the operating room properly also serve towards this goal.Machine settings can be customized appropriately and finally continuously monitoring of exposure with dosimeters can be adopted.展开更多
Objective: to study the efficacy of ureteroscopic holmium laser lithotripsy (FURSL) and minimally invasive percutaneous nephrolithotripsy (MPCNL) in the treatment of 2 to 3 cm kidney stones. Methods: 160 urology patie...Objective: to study the efficacy of ureteroscopic holmium laser lithotripsy (FURSL) and minimally invasive percutaneous nephrolithotripsy (MPCNL) in the treatment of 2 to 3 cm kidney stones. Methods: 160 urology patients from January 2017 to January 2020 were 80 patients with ureteral stones of 2 to 3 cm, 80 patients (n80) and VAS80) before and after surgery, including renal function, change in infection index, pain visual simulation score (VAS). Conclusions: the 2dBUN, PCT and MPCNL groups after the P U R S L group (P <0.05) were lower than the MPCNL group (P <0.05). The postoperative 2dBUN and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). The postoperative 2dBUN, PCT, and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). In the PCT group, the postoperative 2dBUN, PCT, and PCT group (P <0.05) were all lower than those in the MPCNL group (P <0.05). No postoperative 2dBUN, PCT and PCT groups (P <0.05) (P <0.05);After surgery of the FURSL group, the 2dBUN, PCT and PCT group (P <0.05) were all lower than those of the MPCNL group (P <0.05). None of the results were statistically significant. The ureteroscopic holmium laser lithotripsy group applied natural cavity technology without surgical incision, which causes small harm to the patient, the patient recovers quickly after the operation, will not cause serious kidney damage, and the patient need not bear severe pain after surgery, and the chance of complications is relatively low. Compared with minimally invasive percutaneous nephrolithotripsy, the time will be longer for 2 to 3 cm, and the first surgical stone clearance is lower than that of minimally invasive percutaneous nephrolithotripsy. The time of treatment should also be determined by the state of the patients condition.展开更多
文摘Urinary calculi are a common and frequently occurring disease in urology. For patients with kidney stones, especially large, multiple or staghorn stones, percutaneous nephrolithotomy (PCNL) is a preferred treatment method. Infection-related complications after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome, and urinary sepsis, especially urinary sepsis, which are considered to be common causes of death after percutaneous nephrolithotomy. Therefore, early identification and timely intervention of biomarkers can reduce the incidence and mortality of postoperative sepsis, as well as the length of hospital stay and hospitalization costs. This article reviews the biomarkers for early identification of urinary tract infection after PCNL, such as traditional inflammatory indicators, new inflammatory indicators, and composite inflammatory indicators.
基金Supported by the Ningbo Medical Science and Technology Project,No.2014A33
文摘AIM To compare the outcomes of retrograde intrarenal surgery(RIRS) and miniaturized percutaneous nephrolithotomy(mini-PCNL) in treating lower pole(LP) renal stones with a diameter of 1.5-2.5 cm.METHODS A total of 216 patients who underwent mini-PCNL(n = 103) or RIRS n = 113) for LP stones with a diameter of 1.5-2.5 cm were enrolled between December 2015 and April 2017 at the Urology Department of Ningbo Urology and Nephrology Hospital.RESULTS Significant differences were found in the hospital stay(9.39 ± 4.01 vs 14.08 ± 5.26, P < 0.0001) and hospitalization costs(2624.5 ± 513.36 vs 3255.2 ± 976.5, P < 0.0001) between the RIRS and mini-PCNL groups. The mean operation time was not significantly different between the RIRS group(56.48 ± 24.77) and the mini-PCNL group(60.04 ± 30.38, P = 0.345). The stone-free rates at the first postoperative day(RIRS vs mini-PCNL: 90.2% vs 93.2%, P = 0.822) and the second month postoperatively(RIRS vs mini-PCNL: 93.8% vs 95.1%, P = 0.986) were not significantly different.CONCLUSION RIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of 1.5-2.5 cm. RIRS can be considered as an alternative to PCNL for the treatment for LP stones of 1.5-2.5 cm.
文摘The main goals for urinary stone treatment are to preserve renal function, reduce or avoid complications related to calculi, and to render the patient free of calculi as soon as possible. Anatrophic nephrolithotomy(ANL) is a valid and useful alternative for conventional staghorn calculi excision. Although excellent stone free rates can be achieved with ANL there are some drawbacks that may be of concern. Morbidity related to intraoperative and postoperative complications isone of them. Another, great concern is the possibility of reduction on renal function related to the procedure itself. This may be related to nephron injury during nephrotomy and parenchymal closure or to ischemic injury. In this review we assess functional results after anatrophic nephrolithotomy.
文摘Objective The objective of this narrative review was to search the existing literature for studies reporting measures to minimize radiation use during endoscopic management of stone disease and present ways of reducing the exposure of both patients and operating room staff.Methods A literature review in PubMed was performed to identify studies describing protocols or measures to reduce radiation received during endourological procedures from January 1970 to August 2022.Eligible studies were those that reported outcomes for ureteroscopy or percutaneous nephrolithotripsy regarding measures to minimize radiation doses used intraoperatively,performed either in real-life theatres or using phantoms.Both comparative and non-comparative studies were deemed eligible.Results Protection can be achieved initially at the level of diagnosis and follow-up of patients,which should be done following an algorithm and choice of more conservative imaging methods.Certain protocols,which follow principles for minimized fluoroscopy use should be implemented and urologists as well as operating room staff should be continuously trained regarding radiation damage and protection measures.Wearing protective lead equipment remains a cornerstone for personnel protection,while configuration of the operating room and adjusting X-ray machine settings can also significantly reduce radiation energy.Conclusion There are specific measures,which can be implemented to reduce radiation exposure.These include avoiding excessive use of computed tomography scans and X-rays during diagnosis and follow-up of urolithiasis patients.Intraoperative protocols with minimal fluoroscopy use can be employed.Staff training regarding dangers of radiation plays also a major role.Use and maintenance of protective equipment and setting up the operating room properly also serve towards this goal.Machine settings can be customized appropriately and finally continuously monitoring of exposure with dosimeters can be adopted.
文摘Objective: to study the efficacy of ureteroscopic holmium laser lithotripsy (FURSL) and minimally invasive percutaneous nephrolithotripsy (MPCNL) in the treatment of 2 to 3 cm kidney stones. Methods: 160 urology patients from January 2017 to January 2020 were 80 patients with ureteral stones of 2 to 3 cm, 80 patients (n80) and VAS80) before and after surgery, including renal function, change in infection index, pain visual simulation score (VAS). Conclusions: the 2dBUN, PCT and MPCNL groups after the P U R S L group (P <0.05) were lower than the MPCNL group (P <0.05). The postoperative 2dBUN and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). The postoperative 2dBUN, PCT, and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). In the PCT group, the postoperative 2dBUN, PCT, and PCT group (P <0.05) were all lower than those in the MPCNL group (P <0.05). No postoperative 2dBUN, PCT and PCT groups (P <0.05) (P <0.05);After surgery of the FURSL group, the 2dBUN, PCT and PCT group (P <0.05) were all lower than those of the MPCNL group (P <0.05). None of the results were statistically significant. The ureteroscopic holmium laser lithotripsy group applied natural cavity technology without surgical incision, which causes small harm to the patient, the patient recovers quickly after the operation, will not cause serious kidney damage, and the patient need not bear severe pain after surgery, and the chance of complications is relatively low. Compared with minimally invasive percutaneous nephrolithotripsy, the time will be longer for 2 to 3 cm, and the first surgical stone clearance is lower than that of minimally invasive percutaneous nephrolithotripsy. The time of treatment should also be determined by the state of the patients condition.
