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Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study
OBJECTIVES: To prospectively assess the safety and effectiveness of antegrade mini-percutaneous (miniperc) ureteroscopy (URS) and compare it with the conventional retrograde URS (RURS) approach in treating impacted proximal ureteric stones of 1–2 cm. PATIENTS AND METHODS: The study included 60 patie...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473252/ https://www.ncbi.nlm.nih.gov/pubmed/33029428 http://dx.doi.org/10.1080/2090598X.2020.1769385 |
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author | Elgebaly, Omar Abdeldayem, Hussein Idris, Faisal Elrifai, Alaa Fahmy, Ahmed |
author_facet | Elgebaly, Omar Abdeldayem, Hussein Idris, Faisal Elrifai, Alaa Fahmy, Ahmed |
author_sort | Elgebaly, Omar |
collection | PubMed |
description | OBJECTIVES: To prospectively assess the safety and effectiveness of antegrade mini-percutaneous (miniperc) ureteroscopy (URS) and compare it with the conventional retrograde URS (RURS) approach in treating impacted proximal ureteric stones of 1–2 cm. PATIENTS AND METHODS: The study included 60 patients admitted to the Department of Urology, Alexandria Main University Hospital, presenting with impacted proximal ureteric stones of 1–2 cm. Patients were randomly divided into two groups: Group A, were treated with RURS using a semi-rigid or flexible ureteroscope to access the stone; and Group B, were treated by antegrade miniperc URS, were a 14-F renal tract was obtained to pass a ureteric access sheath, then a flexible ureteroscope was used going downwards to the stone. Holmium laser was used for stone fragmentation. A JJ stent was inserted in all cases. Follow-up with non-contrast computed tomography was performed after 2 weeks. RESULTS: Both groups were comparable in terms of patient demographics and stone criteria. The stone-free rate was significantly higher in Group B (83.3%) compared to Group A (60%). The mean (SD) operative time was significantly shorter in Group A vs Group B, at 64.7 (±17.7) vs 112.0 (±15.3) min; while the mean lithotripsy time was comparable between the groups. The mean radiation exposure time was significantly less in Group A (11 s) compared to Group B (200 s). Both groups where comparable concerning minor complications, with no major complications. CONCLUSION: Antegrade miniperc flexible URS is safe and more effective than RURS for treating large impacted proximal ureteric stones. ABBREVIATIONS: ESWL: extracorporeal shockwave lithotripsy; KUB: plain abdominal radiograph of the kidneys, ureters and bladder; miniperc: mini-percutaneous; PCNL: percutaneous nephrolithotomy; PCS: pelvi-calyceal system; SFR: stone-free rate; (R)URS: (retrograde) ureteroscopy |
format | Online Article Text |
id | pubmed-7473252 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-74732522020-10-06 Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study Elgebaly, Omar Abdeldayem, Hussein Idris, Faisal Elrifai, Alaa Fahmy, Ahmed Arab J Urol Stones/Endourology OBJECTIVES: To prospectively assess the safety and effectiveness of antegrade mini-percutaneous (miniperc) ureteroscopy (URS) and compare it with the conventional retrograde URS (RURS) approach in treating impacted proximal ureteric stones of 1–2 cm. PATIENTS AND METHODS: The study included 60 patients admitted to the Department of Urology, Alexandria Main University Hospital, presenting with impacted proximal ureteric stones of 1–2 cm. Patients were randomly divided into two groups: Group A, were treated with RURS using a semi-rigid or flexible ureteroscope to access the stone; and Group B, were treated by antegrade miniperc URS, were a 14-F renal tract was obtained to pass a ureteric access sheath, then a flexible ureteroscope was used going downwards to the stone. Holmium laser was used for stone fragmentation. A JJ stent was inserted in all cases. Follow-up with non-contrast computed tomography was performed after 2 weeks. RESULTS: Both groups were comparable in terms of patient demographics and stone criteria. The stone-free rate was significantly higher in Group B (83.3%) compared to Group A (60%). The mean (SD) operative time was significantly shorter in Group A vs Group B, at 64.7 (±17.7) vs 112.0 (±15.3) min; while the mean lithotripsy time was comparable between the groups. The mean radiation exposure time was significantly less in Group A (11 s) compared to Group B (200 s). Both groups where comparable concerning minor complications, with no major complications. CONCLUSION: Antegrade miniperc flexible URS is safe and more effective than RURS for treating large impacted proximal ureteric stones. ABBREVIATIONS: ESWL: extracorporeal shockwave lithotripsy; KUB: plain abdominal radiograph of the kidneys, ureters and bladder; miniperc: mini-percutaneous; PCNL: percutaneous nephrolithotomy; PCS: pelvi-calyceal system; SFR: stone-free rate; (R)URS: (retrograde) ureteroscopy Taylor & Francis 2020-08-23 /pmc/articles/PMC7473252/ /pubmed/33029428 http://dx.doi.org/10.1080/2090598X.2020.1769385 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Stones/Endourology Elgebaly, Omar Abdeldayem, Hussein Idris, Faisal Elrifai, Alaa Fahmy, Ahmed Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study |
title | Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study |
title_full | Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study |
title_fullStr | Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study |
title_full_unstemmed | Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study |
title_short | Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: A prospective randomised study |
title_sort | antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1–2 cm: a prospective randomised study |
topic | Stones/Endourology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473252/ https://www.ncbi.nlm.nih.gov/pubmed/33029428 http://dx.doi.org/10.1080/2090598X.2020.1769385 |
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