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Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones
Introduction: PCNL remains the gold standard for larger kidney stones. Reducing the operating time of PCNL and its complication rate seems to be the next logical step in optimizing this classical technique. To achieve these objectives, some new methods of lithotripsy emerge. We present the data of a...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136977/ https://www.ncbi.nlm.nih.gov/pubmed/37189473 http://dx.doi.org/10.3390/diagnostics13081372 |
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author | Cauni, Victor-Mihail Tanase, Florin Mihai, Bogdan Gorecki, Gabriel-Petre Ples, Liana Sima, Romina-Marina Persu, Cristian |
author_facet | Cauni, Victor-Mihail Tanase, Florin Mihai, Bogdan Gorecki, Gabriel-Petre Ples, Liana Sima, Romina-Marina Persu, Cristian |
author_sort | Cauni, Victor-Mihail |
collection | PubMed |
description | Introduction: PCNL remains the gold standard for larger kidney stones. Reducing the operating time of PCNL and its complication rate seems to be the next logical step in optimizing this classical technique. To achieve these objectives, some new methods of lithotripsy emerge. We present the data of a single, high-volume, academic center with combined ultrasonic and ballistic lithotripsy in PCNL using the Swiss LithoClast(®) Trilogy device. Materials and Methods: We designed a prospective, randomized study including patients who underwent PCNL or miniPerc with lithotripsy using the new EMS Lithoclast Trilogy or EMS Lithoclast Master. The procedure was carried out with all patients in prone position, by the same surgeon. The working channel size was 24 Fr–15.9 Fr. We evaluated the stones’ features, operative time, fragmentation time, complications, stone clearance rate and stone-free rate. Results: Our study included 59 patients, 38 females and 31 males, of an average age of 54.5 years old. The Trilogy group included 28 patients and the comparator included 31 patients. Urine culture was positive in seven cases which required seven days of antibiotics. The mean stone diameter was 35.6 mm with a mean Hounsfield unit (HU) of 710.1. The average number of stones was 2.08 (6 complete staghorn stones and 12 partial staghorn stones). A total of 13 patients presented a JJ stent (46.4%). We found a very significant difference in all the parameters favoring the Trilogy device. The most important result in our opinion is the probe active time, which was almost six times shorter in the Trilogy group. The stone clearance rate was about double in the Trilogy group, leading to shorter overall and intra-renal operating times. The overall complication rate was 17.9% in the Trilogy group and 23% in the Lithoclast Master group. The mean hemoglobin drop was 2.1 g/dL with a mean creatinine rise of 0.26 mg/dL. Conclusions: Swiss LithoClast(®) Trilogy, a device combining ultrasonic and ballistic energy, is a safe and efficient method of lithotripsy for PCNL, proving statistically significant benefits over its predecesor. It can achieve the goal of reducing complication rates and operative times for PCNL. |
format | Online Article Text |
id | pubmed-10136977 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101369772023-04-28 Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones Cauni, Victor-Mihail Tanase, Florin Mihai, Bogdan Gorecki, Gabriel-Petre Ples, Liana Sima, Romina-Marina Persu, Cristian Diagnostics (Basel) Article Introduction: PCNL remains the gold standard for larger kidney stones. Reducing the operating time of PCNL and its complication rate seems to be the next logical step in optimizing this classical technique. To achieve these objectives, some new methods of lithotripsy emerge. We present the data of a single, high-volume, academic center with combined ultrasonic and ballistic lithotripsy in PCNL using the Swiss LithoClast(®) Trilogy device. Materials and Methods: We designed a prospective, randomized study including patients who underwent PCNL or miniPerc with lithotripsy using the new EMS Lithoclast Trilogy or EMS Lithoclast Master. The procedure was carried out with all patients in prone position, by the same surgeon. The working channel size was 24 Fr–15.9 Fr. We evaluated the stones’ features, operative time, fragmentation time, complications, stone clearance rate and stone-free rate. Results: Our study included 59 patients, 38 females and 31 males, of an average age of 54.5 years old. The Trilogy group included 28 patients and the comparator included 31 patients. Urine culture was positive in seven cases which required seven days of antibiotics. The mean stone diameter was 35.6 mm with a mean Hounsfield unit (HU) of 710.1. The average number of stones was 2.08 (6 complete staghorn stones and 12 partial staghorn stones). A total of 13 patients presented a JJ stent (46.4%). We found a very significant difference in all the parameters favoring the Trilogy device. The most important result in our opinion is the probe active time, which was almost six times shorter in the Trilogy group. The stone clearance rate was about double in the Trilogy group, leading to shorter overall and intra-renal operating times. The overall complication rate was 17.9% in the Trilogy group and 23% in the Lithoclast Master group. The mean hemoglobin drop was 2.1 g/dL with a mean creatinine rise of 0.26 mg/dL. Conclusions: Swiss LithoClast(®) Trilogy, a device combining ultrasonic and ballistic energy, is a safe and efficient method of lithotripsy for PCNL, proving statistically significant benefits over its predecesor. It can achieve the goal of reducing complication rates and operative times for PCNL. MDPI 2023-04-08 /pmc/articles/PMC10136977/ /pubmed/37189473 http://dx.doi.org/10.3390/diagnostics13081372 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cauni, Victor-Mihail Tanase, Florin Mihai, Bogdan Gorecki, Gabriel-Petre Ples, Liana Sima, Romina-Marina Persu, Cristian Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones |
title | Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones |
title_full | Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones |
title_fullStr | Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones |
title_full_unstemmed | Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones |
title_short | Single-Center Experience with Swiss LithoClast(®) Trilogy for Kidney Stones |
title_sort | single-center experience with swiss lithoclast(®) trilogy for kidney stones |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136977/ https://www.ncbi.nlm.nih.gov/pubmed/37189473 http://dx.doi.org/10.3390/diagnostics13081372 |
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