Introduction: Extracorporeal Shock Wave Lithotripsy (ESWL) is currently the recommended treatment for intra-renal calculi smaller than 2 cm. However the low Stone Free Rate (SFR) in lower pole calculi gives rise to new techniques, such us retrograde intrarenal surgery (RIRS), for improve the surgery outcomes.
Objective: To compare the efficacy of a treatment with ESWL with RIRS, in terms of SFR after surgery, in patients with kidney stones up to 15 mm in the lower pole.
Material And Methods: A prospective study was carried out in order to assess the results of ESWL and RIRS in patients with lower pole stones less than 15 mm. Among a total of 55 patients, 31 were underwent to ESWL (Group 1) and the remaining 24 to RIRS (Group 2). Clinical data recorded, including general characteristics of each patient, were: calculi size, side, operative time, complications according to Clavien scale, SFR and the presence of residual fragments at 2 months post-treatment assessed by a CT scan. STATA 11 was used to perform the statistical analysis.
Results: There were no differences for general descriptors among groups with the exception of a significantly longer operative time for RIRS. The rates of SFR and residual fragments lesser than 3 mm. were lower in the RIRS group than in ESWL ones. RIRS also showed a lower rate of clinically significant fragments (0% vs 42.3%. P < .05). In the subgroup of patients with stones between 10/15 mm RIRS showed higher SFR (75% vs. 41.2%) and a lower rate of stones>3 mm (0% vs. 58.8%), being statistically significant (P < .05). Clavien III or higher complications were not reported in any of the groups.
Conclusions: In the treatment of lower pole stone RIRS has the same results than ESWL in terms of SFR. Regarding absence of a clinically significant residual fragment, RIRS was superior to ESWL. A bigger sample size is required in order to confirm this results.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.acuro.2014.08.003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The prognostic impact of molecular classification in endometrial cancer that undergoes fertility-sparing treatment.
Int J Gynecol Cancer
January 2025
Department of Gynecology, European Institute of Oncology, IEO, IRCCS, Milan, Italy. Electronic address:
Objective: No biomarkers are available to predict treatment response in patients with endometrial cancers who undergo fertility-sparing treatment. Therefore, we aimed to evaluate the prognostic role of molecular classification.
Methods: Patients with endometrial cancer who underwent fertility-sparing treatment with progestins between 2005 and 2021 were retrospectively identified.
Performance of molecular classification in predicting oncologic outcomes of fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer.
Int J Gynecol Cancer
January 2025
Nazionale dei Tumori di Milano, Fondazione IRCCS Istituto Gynecological Oncology Unit, Milan, Italy.
Objective: Endometrial cancers can be classified into 4 molecular sub-groups: (1) POLE mutated (POLEmut), (2) mismatch repair deficiency/microsatellite-instable (MMRd/MSI-H), (3) TP53-mutant or p53 abnormal (p53abn), and (4) no specific mutational profile (NSMP). Although molecular classification is increasingly applied in oncology, its role in guiding fertility-sparing treatments for endometrial cancer remains unclear. This study examines the prognostic role of molecular classification in fertility-sparing treatment and its potential to guide treatment decisions.
View Article and Find Full Text PDFPhysiological and cerebral hemodynamic changes during routine nursing procedures for very preterm infants.
Arch Pediatr
January 2025
Institut des Neurosciences Cellulaires et Intégratives, CNRS UPR 3212 / Université de Strasbourg, Strasbourg, France; CHU Strasbourg, Médecine et Réanimation du nouveau-né, Service de Pédiatrie 2, Pôle médico chirurgical Pédiatrique de Hautepierre, Avenue Molière, 67091 Strasbourg, FR, France.
Background: Care procedures for preterm infants can induce stress that may disrupt homeostasis, possibly altering cerebral perfusion or oxygenation. We evaluated the physiological and cerebral oxygenation changes during the routine care of very preterm infants.
Methods: We analyzed the changes in heart and respiratory rates and in systemic and regional cerebral oxygen saturation of 27 very preterm infants, defining three care periods of 5 min each: 30 min before care, 30 min during care, and 30 min after care.
Subcutaneous Lower Pole Release as Double Bubble Prevention in Constricted Base Breasts: The "Plus One" Augmentation Technique.
Aesthet Surg J
January 2025
Department of Plastic and Aesthetic Surgery, Sana Kliniken Duesseldorf GmBH, Graeulinger Strasse, Duesseldorf, Germany.
Background: Breasts with a broad base, constricted inframammary fold (IMF) and a short distance between the nipple and the IMF are predisposed to form a double bubble (DB) deformity. Most publications have focused on the correction of a DB rather than on its prevention and thorough analysis of the IMF.
Objectives: Introduction of a third dissection plane in breast augmentation for preventing or correcting DB deformities.
Concurrent Renorrhaphy During Renal Mass Excision in Laparoscopic Nephron-Sparing Surgery: A Novel Surgical Technique.
Urol Res Pract
January 2025
Department of Urology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye.
Objective: Laparoscopic nephron sparing surgery (NSS) can be performed by mainly 2 methods, offclamp or on-clamp. Continuous bleeding during the off-clamp method may impair the clear visualization of the border between the tumor and parenchyma, even though it is done safely in experienced hands. Therefore, some surgical modifications may be needed during mass excision and renorraphy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!