PURPOSE: To achieve an almost 100% stone-free rate by means of further developing and standardizing the procedure. PATIENTS AND METHODS: 100 consecutive patients with single or multiple renal calculi were prospectively enrolled in the study. Flexible ureterorenoscopy was performed as a completely standardized operation by the same two experienced surgeons. Primary outcome was an "endoscopic" (immediate) stone-free status as determined by endoscopic inspection at the end of surgery. In cases of residual fragments, a reevaluation by CT was performed after 3 months. RESULTS: The endoscopic stone-free rate was 97%. In three patients with a cumulative stone size >20 mm, a completely stone-free status could not be achieved in the primary procedure. In these patients, a CT scan after 3 months showed complete clearance from all residual fragments in two; this translates into a primary (after one procedure) stone-free rate after 3 months of 99%. Medium cumulative stone size was 9.8 mm (4-40 mm); in 44 patients, multiple calculi were extracted. Forty-nine patients received a ureteral stent at the end of the operation; two patients had to have stent placement for new onset hydronephrosis and/or colicky pain or fever. Overall complication rate was 7%. Results are limited, because no routine CT scan was used to evaluate stone clearance. CONCLUSION: By means of a standardized surgical approach and use of technical equipment of the newest generation, it is possible to achieve very high stone-free rates without compromising safety. This approach, however, necessitates use of considerable resources, both technical/surgical and financial.
PURPOSE: To achieve an almost 100% stone-free rate by means of further developing and standardizing the procedure. PATIENTS AND METHODS: 100 consecutive patients with single or multiple renal calculi were prospectively enrolled in the study. Flexible ureterorenoscopy was performed as a completely standardized operation by the same two experienced surgeons. Primary outcome was an "endoscopic" (immediate) stone-free status as determined by endoscopic inspection at the end of surgery. In cases of residual fragments, a reevaluation by CT was performed after 3 months. RESULTS: The endoscopic stone-free rate was 97%. In three patients with a cumulative stone size >20 mm, a completely stone-free status could not be achieved in the primary procedure. In these patients, a CT scan after 3 months showed complete clearance from all residual fragments in two; this translates into a primary (after one procedure) stone-free rate after 3 months of 99%. Medium cumulative stone size was 9.8 mm (4-40 mm); in 44 patients, multiple calculi were extracted. Forty-nine patients received a ureteral stent at the end of the operation; two patients had to have stent placement for new onset hydronephrosis and/or colicky pain or fever. Overall complication rate was 7%. Results are limited, because no routine CT scan was used to evaluate stone clearance. CONCLUSION: By means of a standardized surgical approach and use of technical equipment of the newest generation, it is possible to achieve very high stone-free rates without compromising safety. This approach, however, necessitates use of considerable resources, both technical/surgical and financial.
Authors: Martin Schoenthaler; Noor Buchholz; Erik Farin; Hammad Ather; Christian Bach; Thorsten Bach; John D Denstedt; Hans-Martin Fritsche; Michael Grasso; Oliver W Hakenberg; Ralf Herwig; Thomas Knoll; Franklin Emmanuel Kuehhas; Evangelos Liatsikos; Peter Liske; Michael Marberger; Palle J S Osther; José Manuel Reis Santos; Kemal Sarica; Christian Seitz; Michael Straub; Olivier Traxer; Alberto Trinchieri; Ben Turney; Arkadiusz Miernik Journal: World J Urol Date: 2013-10-18 Impact factor: 4.226
Authors: Theodoros Tokas; Martin Habicher; Daniel Junker; Thomas Herrmann; Jan Peter Jessen; Thomas Knoll; Udo Nagele Journal: World J Urol Date: 2016-10-13 Impact factor: 4.226
Authors: Simon Hein; Arkadiusz Miernik; Konrad Wilhelm; Fabian Adams; Daniel Schlager; Thomas R W Herrmann; Jens J Rassweiler; Martin Schoenthaler Journal: World J Urol Date: 2015-10-23 Impact factor: 4.226