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Evidence for ureterorenoscopy and laser fragmentation (URSL) for large renal stones in the modern era

Evidence for ureterorenoscopy and laser fragmentation (URSL) for large renal stones in the modern era
Evidence for ureterorenoscopy and laser fragmentation (URSL) for large renal stones in the modern era

Large renal stones (>2 cm) are managed with percutaneous nephrolithotomy (PCNL), which has a good stone-free rate (SFR) but a relatively high incidence of complications graded Clavien ≥ 3. We wanted to review the literature for the use of ureterorenoscopy and laser fragmentation (URSL) for the management of these stones. A systematic review was done from 1990 to April 2014 for all English language articles reporting on a minimum of 10 patients for stones >2 cm in size (done by 2 reviewers independently) in accordance with the PRISMA and Cochrane review guidelines. A total of 379 articles were identified and after screening for the titles (54) and abstracts (29), 12 papers (651 patients) were included. The male to female ratio was 356:232 with a mean age of 54 years (range 16-86 years). With a mean stone size of 2.7 cm (2-3.15 cm) and the mean operating time of 96 min (28-238 min); the SFR was 91 % (1.45 procedures/patient). The overall number of complications was 58 (8.6 %) of which 26 (4.5 %) were complications classed Clavien ≥ 3 (haematuria with subcapsular haematoma/clot retention-7; ureteral perforation-7; steinstrasse-5; sepsis/pyelonephritis-5; prostatitis-1; cerebrovascular accident-1). Ureterorenoscopy for large renal stones in the modern era has good SFR with a small risk of major complications.

Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Kidney Calculi, Lasers, Male, Middle Aged, Operative Time, Treatment Outcome, Ureteroscopy, Urinary Retention, Young Adult, Journal Article, Meta-Analysis, Review
1534-6285
54
Geraghty, Robert
ef19149e-530f-4749-9740-0902fed96fe1
Abourmarzouk, Omar
8ed14756-ec2a-4302-b322-744e50f6aedb
Rai, Bhavan
e1156207-bfd1-4f89-b0aa-9e55fc54235b
Biyani, Chandra Shakhar
6f81d3fc-905a-41b1-b12e-a9a960d7f8c9
Rukin, Nicholas J
30714cb4-88de-4fbd-a957-4762b8cc8fb5
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Geraghty, Robert
ef19149e-530f-4749-9740-0902fed96fe1
Abourmarzouk, Omar
8ed14756-ec2a-4302-b322-744e50f6aedb
Rai, Bhavan
e1156207-bfd1-4f89-b0aa-9e55fc54235b
Biyani, Chandra Shakhar
6f81d3fc-905a-41b1-b12e-a9a960d7f8c9
Rukin, Nicholas J
30714cb4-88de-4fbd-a957-4762b8cc8fb5
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Geraghty, Robert, Abourmarzouk, Omar, Rai, Bhavan, Biyani, Chandra Shakhar, Rukin, Nicholas J and Somani, Bhaskar K (2015) Evidence for ureterorenoscopy and laser fragmentation (URSL) for large renal stones in the modern era. Current Urology Reports, 16 (8), 54. (doi:10.1007/s11934-015-0529-3).

Record type: Review

Abstract

Large renal stones (>2 cm) are managed with percutaneous nephrolithotomy (PCNL), which has a good stone-free rate (SFR) but a relatively high incidence of complications graded Clavien ≥ 3. We wanted to review the literature for the use of ureterorenoscopy and laser fragmentation (URSL) for the management of these stones. A systematic review was done from 1990 to April 2014 for all English language articles reporting on a minimum of 10 patients for stones >2 cm in size (done by 2 reviewers independently) in accordance with the PRISMA and Cochrane review guidelines. A total of 379 articles were identified and after screening for the titles (54) and abstracts (29), 12 papers (651 patients) were included. The male to female ratio was 356:232 with a mean age of 54 years (range 16-86 years). With a mean stone size of 2.7 cm (2-3.15 cm) and the mean operating time of 96 min (28-238 min); the SFR was 91 % (1.45 procedures/patient). The overall number of complications was 58 (8.6 %) of which 26 (4.5 %) were complications classed Clavien ≥ 3 (haematuria with subcapsular haematoma/clot retention-7; ureteral perforation-7; steinstrasse-5; sepsis/pyelonephritis-5; prostatitis-1; cerebrovascular accident-1). Ureterorenoscopy for large renal stones in the modern era has good SFR with a small risk of major complications.

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More information

e-pub ahead of print date: 17 June 2015
Published date: August 2015
Keywords: Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Kidney Calculi, Lasers, Male, Middle Aged, Operative Time, Treatment Outcome, Ureteroscopy, Urinary Retention, Young Adult, Journal Article, Meta-Analysis, Review

Identifiers

Local EPrints ID: 419240
URI: http://eprints.soton.ac.uk/id/eprint/419240
ISSN: 1534-6285
PURE UUID: 5333c51d-24d4-4df9-b6ee-efa770b31ff1

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Date deposited: 09 Apr 2018 16:30
Last modified: 13 Mar 2019 18:44

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