Publications by authors named "Emiliani E"
Article Synopsis
- The study aimed to develop a machine-learning model to predict the risk of sepsis following retrograde intrarenal surgery (RIRS) for kidney stones, including data from 1,552 patients across 16 centers.* -
- Inclusion criteria for patients were specified, and certain conditions like concomitant ureteral stones were excluded, with antibiotic treatments used where applicable.* -
- The Random Forest algorithm outperformed other machine-learning models, achieving high precision, recall, and accuracy, and a web-based version of the predictive tool is available for use in clinical settings.*
Article Synopsis
- A new digital single-use flexible ureteroscope, the Pusen direct in scope suction (DISS) 7.5Fr, was evaluated in a study across six medical centers for parameters like manoeuvrability, visibility, and efficiency during laser lithotripsy for kidney stones.
- The study included 57 patients with a majority undergoing pre-stenting; results showed a high satisfaction rate among surgeons, with an initial stone free rate of 84.21% and quality parameters rated positively on a Likert scale.
- The Pusen DISS scope demonstrated overall good performance and satisfaction, prompting all participating surgeons to express a willingness to use it in future procedures, indicating potential benefits for future
Purpose: Traditionally, bilateral urolithiasis treatment involved staged interventions due to safety concerns. Recent studies have shown that same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) is effective, with acceptable complication rates. However, there's no clear data on the optimum laser for the procedure.
View Article and Find Full Text PDFArticle Synopsis
- Social media is integral to modern life, influencing interactions between patients and urologists, offering both educational and communication opportunities.
- While patients can benefit from support networks, the accuracy of online health information is often questionable, raising concerns about misinformation.
- For urologists, social media can enhance networking and research but also poses risks, such as mental health impacts and ethical issues regarding patient privacy and consent.
Kidney stones are becoming increasingly common, affecting up to 10% of adults. A small percentage are of monogenic origin, such as Dent's disease (DD). DD is a syndrome that causes low-molecular-weight proteinuria, hypercalciuria, nephrolithiasis, and nephrocalcinosis.
View Article and Find Full Text PDFPurpose: To assess the incidence of the most common intra- and early postoperative complications following RIRS in a large series of patients with kidney stones.
Methods: We conducted a retrospective analysis of patients with kidney stones who underwent RIRS across 21 centers from January 2018 to August 2021, as part of the Global Multicenter Flexible Ureteroscopy Outcome (FLEXOR) Registry.
Results: Among 6669 patients undergoing RIRS, 4.
Background: Stone nomogram by Micali et al., able topredict treatment failure of shock-wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) in the management of single 1-2 cm renal stones, was developed on 2605 patients and showed a high predictive accuracy, with an area under ROC curve of 0.793 at internal validation.
View Article and Find Full Text PDFIntroduction: Ionizing radiation is used daily during endourological procedures. Despite the dangers of both deterministic and stochastic effects of radiation, there is a lack of knowledge and awareness among urologists. This study reviewed the literature to identify the radiation exposure (RE) of urologists during endourological procedures.
View Article and Find Full Text PDFObjective: To perform a comprehensive narrative review that will examine the risk factors and treatment outcomes of arterial pseudoaneurysm following laser flexible ureteroscopy (F-URS).
Methods: A retrospective case series and a review of literature was performed. Clinical records from three patients treated for postoperative arterial pseudoaneurysm from January of 2021 to November 2023 were identified.
Background And Objective: Different training programs have been developed to improve trainee outcomes in urology. However, evidence on the optimal training methodology is sparse. Our aim was to provide a comprehensive description of the training programs available for urological robotic surgery and endourology, assess their validity, and highlight the fundamental elements of future training pathways.
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- The study aimed to assess how the position of the ureteroscope and the ureteral access sheath (UAS) affects fluid flow during retrograde intrarenal surgery (RIRS).
- Researchers analyzed data from 74 patients, finding that upper and middle calyces had higher outflow rates compared to lower calyx regardless of UAS position, but adjusting the UAS to a lower position decreased flow rates in the upper/middle calyces while increasing it in the lower calyx.
- The results indicate that while there is a statistically significant improvement in fluid dynamics in the lower calyx when the UAS is lower, the overall absolute changes in upper and middle calyceal
Article Synopsis
- - The study aimed to assess radiation protection practices among endourologists in Europe, focusing on compliance with recommendations from the International Commission on Radiation Protection (ICRP) and measuring annual radiation exposure from 2017 to 2020.
- - A survey of 10 endourologists revealed that while most use basic protective gear such as lead aprons and thyroid shields, advanced protections like leaded gloves and glasses are less common; additionally, the mean radiation exposure was below safety thresholds for the chest, eyes, and extremities.
- - The findings indicated that endourologists effectively adhered to radiation safety standards, with the ALARA (As Low As Reasonably Achievable) protocol in place to further minimize exposure during procedures like per
Objective: To compare same-sitting bilateral vs unilateral retrograde intrarenal surgery (RIRS) in elderly patients, focusing on postoperative complications and stone-free rates (SFR).
Methods: Data from 2 multicenter databases, FLEXible ureteroscopy Outcomes Registry (FLEXOR) (unilateral RIRS) and same sitting bilateral-retrograde intrarenal surgery (SSB-RIRS) (bilateral RIRS), were analyzed, considering only patients aged 70+ with preoperative computed tomography. Patients were categorized into Group 1 (bilateral RIRS) and Group 2 (unilateral RIRS).
Article Synopsis
- The study investigates the effectiveness of retrograde intrarenal surgery (RIRS) for treating patients with asymptomatic incidental renal stones (AIRS) amidst debates on treatment approaches.
- A total of 640 patients were analyzed, revealing a median stone size of 12 mm and a stone-free rate (SFR) of 68.8%, with factors like the type of laser used and the presence of multiple stones impacting outcomes.
- The findings suggest RIRS can be a viable option for AIRS, with low complication rates, highlighting a favorable SFR and the need for further exploration into the treatment methods for incidental renal stones.
Context: Thulium fiber laser (TFL) emerged as a competitor of holmium:yttrium aluminum garnet (Ho:YAG) laser for the treatment of urinary stones.
Objective: To compare the efficacy between Ho:YAG and TFL for laser lithotripsy of renal and ureteral stones.
Evidence Acquisition: A literature search was conducted using PubMed/Medline, Embase, and Web of Science databases to identify reports published until May 2023.
Background: Both clinicians and patients use social media to post about health care issues such as kidney stone disease, but their perspectives may differ.
Objective: To evaluate content and themes regarding kidney stone surgery shared by patients and urologists on Instagram.
Design Setting And Participants: A search was performed on Instagram using the term "kidney stone surgery".
Introduction: The area of paediatric endourology is unique and is recognised to be challenging, and it requires a certain level of focused training and expertise. Our aim was to conduct a worldwide survey in order to gain an overview regarding the current practice patterns for minimally invasive treatments of paediatric upper urinary tract stone patients.
Material And Methods: The survey was distributed between December 2021 and April 2022 through urology sections and societies in United Kingdom, Latin America and Asia.
Context: Laser performance for lithotripsy is currently reported using units of measurement such as J/mm, mm/J, mm/s, s/mm, and mm/min. However, there are no current standardized definitions or terminology for these metrics. This may lead to confusion when assessing and comparing different laser systems.
View Article and Find Full Text PDFAdvances in laser technology and surgical telescopic systems have propelled retrograde intrarenal surgery (RIRS) to the forefront as a viable alternative to percutaneous nephrolithotomy (PCNL). Currently, RIRS is being increasingly utilized as a treatment option, even for kidney stones larger than 2 cm. In this narrative review, we aimed to take a snapshot of current practice in renal stone treatment and the latest technological and technical developments and to evaluate the efficacy of RIRS in larger renal stones.
View Article and Find Full Text PDFTo explore beliefs and practice patterns of urologists regarding intrarenal pressure (IRP) during ureteroscopy (URS). A customized questionnaire was designed in a 4-step iterative process incorporating a systematic review of the literature and critical analysis of topics/questions by six endourologists. The 19-item questionnaire interrogated perceptions, practice patterns, and key areas of uncertainty regarding ureteroscopic IRP, and was disseminated via urologic societies, networks, and social media to the international urologic community.
View Article and Find Full Text PDFFlexible ureteroscopy (fURS) with laser lithotripsy is currently the gold standard surgical treatment for ureteral and kidney stones with a maximum diameter of 2 cm [...
View Article and Find Full Text PDFBackground: There has been a consistent increase in the last decades in prevalence of renal stones in elderly.
Aims: To evaluate outcomes of retrograde intrarenal surgery (RIRS) for renal stones in elderly and factors associated with postoperative complications and residual fragments (RFs).
Methods: Data from 12 centers were retrospectively reviewed.