Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi
OBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithot...
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| Format: | Article |
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Sociedade Brasileira de Urologia
2008-03-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382008000200003 |
| _version_ | 1819175660410634240 |
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| author | Marcello Cocuzza Jose R. Colombo Jr Antonio L. Cocuzza Frederico Mascarenhas Fabio Vicentini Eduardo Mazzucchi Miguel Srougi |
| author_facet | Marcello Cocuzza Jose R. Colombo Jr Antonio L. Cocuzza Frederico Mascarenhas Fabio Vicentini Eduardo Mazzucchi Miguel Srougi |
| author_sort | Marcello Cocuzza |
| collection | DOAJ |
| description | OBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithotripsy were evaluated. Renal stones were associated with collecting system obstruction in 15 (34%) patients, failed extracorporeal shock-wave lithotripsy (SWL) occurred in 14 (32%) patients, unilateral multiple stones in 18 (41%) patients, and multiple bilateral stones in 3 (7%). In 29 (66%) patients, the stone was located in the inferior calyx. Perioperative and financial outcomes were also evaluated. RESULTS: 50 procedures were performed in 44 patients. The mean stone burden on preoperative CT scan was 11.5 ± 5.8 mm. The mean operative time was 61.3 ± 29.4 min. The stone free rate was 93.1% after one procedure and 97.7% after a second procedure, with overall complication rate of 8%. Therapeutic success occurred in 92% and 93% of patients with lower pole stones and SWL failure, respectively. Treatment failure of a single session was associated with presence of a stone size larger than 15 mm (p = 0.007), but not associated with inferior calyx location (p = 0.09). Surgical disposables were responsible for 78% of overall costs. CONCLUSION: Flexible ureteroscopy using holmium laser is a safe and effective option for the treatment of upper urinary tract calculi. In addition, it can be considered an attractive option as salvage therapy after SWL failure or kidney calculi associated with ureteral stones. Stone size larger than 15 mm is associated with single session treatment failure. |
| first_indexed | 2024-12-22T20:58:24Z |
| format | Article |
| id | doaj.art-254652717265438cba97e27f5da0d044 |
| institution | Directory Open Access Journal |
| issn | 1677-5538 1677-6119 |
| language | English |
| last_indexed | 2024-12-22T20:58:24Z |
| publishDate | 2008-03-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-254652717265438cba97e27f5da0d0442022-12-21T18:12:53ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-55381677-61192008-03-0134214315010.1590/S1677-55382008000200003Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculiMarcello CocuzzaJose R. Colombo JrAntonio L. CocuzzaFrederico MascarenhasFabio VicentiniEduardo MazzucchiMiguel SrougiOBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithotripsy were evaluated. Renal stones were associated with collecting system obstruction in 15 (34%) patients, failed extracorporeal shock-wave lithotripsy (SWL) occurred in 14 (32%) patients, unilateral multiple stones in 18 (41%) patients, and multiple bilateral stones in 3 (7%). In 29 (66%) patients, the stone was located in the inferior calyx. Perioperative and financial outcomes were also evaluated. RESULTS: 50 procedures were performed in 44 patients. The mean stone burden on preoperative CT scan was 11.5 ± 5.8 mm. The mean operative time was 61.3 ± 29.4 min. The stone free rate was 93.1% after one procedure and 97.7% after a second procedure, with overall complication rate of 8%. Therapeutic success occurred in 92% and 93% of patients with lower pole stones and SWL failure, respectively. Treatment failure of a single session was associated with presence of a stone size larger than 15 mm (p = 0.007), but not associated with inferior calyx location (p = 0.09). Surgical disposables were responsible for 78% of overall costs. CONCLUSION: Flexible ureteroscopy using holmium laser is a safe and effective option for the treatment of upper urinary tract calculi. In addition, it can be considered an attractive option as salvage therapy after SWL failure or kidney calculi associated with ureteral stones. Stone size larger than 15 mm is associated with single session treatment failure.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382008000200003uretercalculiLithotripsyHolmium laser |
| spellingShingle | Marcello Cocuzza Jose R. Colombo Jr Antonio L. Cocuzza Frederico Mascarenhas Fabio Vicentini Eduardo Mazzucchi Miguel Srougi Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi International Brazilian Journal of Urology ureter calculi Lithotripsy Holmium laser |
| title | Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi |
| title_full | Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi |
| title_fullStr | Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi |
| title_full_unstemmed | Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi |
| title_short | Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi |
| title_sort | outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi |
| topic | ureter calculi Lithotripsy Holmium laser |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382008000200003 |
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