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https://www.readbyqxmd.com/read/29239803/ultrasound-guided-ureteroscopy-in-children-safety-and-success
#1
Jeffrey C Morrison, Jason P Van Batavia, Kassa Darge, Christopher J Long, Aseem R Shukla, Arun K Srinivasan
INTRODUCTION: Ureteroscopy has been shown to be a highly efficacious and safe modality for the treatment of pediatric urolithiasis. However, conventional ureteroscopy relies on fluoroscopy for intraoperative guidance, exposing both patient and operating room personnel to ionizing radiation. Pediatric urolithiasis patients are at a particularly increased risk from this radiation exposure. The use of ultrasound in place of fluoroscopy for intraoperative guidance has emerged as one modification that can reduce radiation exposure during ureteroscopy...
October 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29239227/micro-costing-analysis-demonstrates-comparable-costs-for-lithovue%C3%A2-compared-to-reusable-flexible-fiberoptic-ureteroscopes
#2
Kazumi Taguchi, Manint Usawachintachit, David T Tzou, Benjamin Sherer, Ian Metzler, Dylan Isaacson, Marshall Stoller, Thomas Chi
INTRODUCTION: Reusable ureteroscope durability and need for repair are significant sources of expense and inefficiency for patients and urologists. Utilization of LithoVue™, a disposable flexible digital ureteroscope, may address some of these concerns. To identify its economic impact on clinical care, we performed a micro-cost comparison between flexible reusable fiberoptic ureteroscopes (URF-P6™) and LithoVue™. PATIENTS AND METHODS: For this prospective, single-center micro-costing study, all consecutive ureteroscopies performed during one week each in July and August 2016 utilized either URF-P6™ or LithoVue™ ureteroscopes respectively...
December 14, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29239226/the-efficacy-of-ureteroscopy-without-fluoroscopy-for-ureteral-and-renal-stones-in-pediatric-patients
#3
Mustafa Kirac, Giray Ergin, Burak Kopru, Yusuf Kibar, Hasan Biri
OBJECTIVES: In the pediatric population, there have been significant improvements in the treatment of stones in recent years. Conventionally, ureteroscopy (URS) and/or retrograde intrarenal surgery (RIRS) are techniques performed with fluoroscopy. When using fluoroscopy, problems, including malignancy, may arise due to radiation exposure in the patient, physician and operation room staff. The aim of this study is to evaluate the possibility of ureteroscopic treatment without fluoroscopy in children with ureteral and renal stones...
December 14, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29239225/ureteroscopic-high-frequency-dusting-utilizing-a-120-watt-holmium-laser
#4
James M Tracey, Galina Gagin, Duncan Morhardt, John M Hollingsworth, Khurshid R Ghani
INTRODUCTION & OBJECTIVE: Recently there has been interest in a dusting technique for lithotripsy during ureteroscopy (URS) utilizing high frequency and low pulse energy (HiFr-LoPE) settings. We assessed a 120 Watt holmium laser that permits high frequency (>50 Hz) dusting. MATERIALS AND METHODS: Consecutive URS cases performed by a single surgeon using the P120H (Lumenis, San Jose, CA) were reviewed. Lithotripsy was performed using HiFr-LoPE settings [50-80 Hz /0...
December 14, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29234533/trends-of-intervention-for-paediatric-stone-disease-over-the-last-two-decades-2000-2015-a-systematic-review-of-literature
#5
REVIEW
Amelia Pietropaolo, Silvia Proietti, Patrick Jones, Karan Rangarajan, Omar Aboumarzouk, Guido Giusti, Bhaskar K Somani
Objective: To ascertain the publication trends of interventions for paediatric kidney stone disease (KSD) we conducted a systematic review of literature over the last 16 years. Patients and methods: With a rise of paediatric KSD and related interventions, a systematic review using PubMed was done over the last 16 years for all published papers on 'Paediatric stone disease intervention - ureteroscopy (URS), shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), open stone surgery, and laparoscopic stone surgery'...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29224057/identifying-factors-associated-with-need-for-flexible-ureteroscope-repair-a-western-endourology-stone-west-research-consortium-prospective-cohort-study
#6
Kazumi Taguchi, Jonathan D Harper, Marshall L Stoller, Brian D Duty, Mathew D Sorensen, Roger L Sur, Manint Usawachintachit, David T Tzou, David L Wenzler, Dylan Isaacson, Angela Xu, Carissa Chu, Uwais B Zaid, Eric R Taylor, Krishna Ramaswamy, Thomas Chi
Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure...
December 9, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29224014/diagnostic-ureteroscopy-prior-to-radical-nephroureterectomy-for-upper-tract-urothelial-carcinoma-increased-the-risk-of-intravesical-recurrence
#7
Ping Tan, Nan Xie, Lu Yang, Liangren Liu, Zhuang Tang, Qiang Wei
OBJECTIVE: To assess the impact of diagnostic ureteroscopy (URS) prior to radical nephroureterectomy (RNU) on intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC). MATERIALS AND METHODS: A systematic literature search of the Medline, Embase, PubMed, and Cochrane library was performed in August 2017. Cumulative analyses of available hazard ratios (HRs) and their 95% CI were conducted using Stata version 12.0. RESULTS: Eleven studies including 4,057 participants were included, with a total of 1,403 patients diagnosed with IVR during the follow-up period...
December 8, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/29222575/flexible-ureteroscopy-technique-tips-and-tricks
#8
REVIEW
Steeve Doizi, Olivier Traxer
During the last decades, the surgical management of kidney stones benefited of many technological advances and one of them is the development of flexible ureteroscopy (fURS). This tool, ancillary equipment such as graspers and baskets, and lithotripsy technique with Holmium:YAG laser underwent many improvements leading to a widening of its indications with diagnostic and therapeutic management of upper urinary tract pathologies such as urolithiasis and urothelial tumors. The objective of this review is to describe the surgical technique for fURS as well as tips and tricks for the treatment of renal stones...
December 8, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29219276/endourologic-strategies-for-a-minimally-invasive-management-of-urinary-tract-stones-in-patients-with-urinary-diversion
#9
FangLing Zhong, Gurioli Alberto, GuangMing Chen, Wei Zhu, FuCai Tang, Guohua Zeng, Ming Lei
OBJECTIVE: To present our experience in minimally invasive management of urinary tract stones in patients with urinary diversion. MATERIALS AND METHODS: We retrospectively reviewed 26 patients with urinary tract stones after cystectomy and urinary diversion. The types of urinary diversion were ileal conduit, colon conduit, ileal orthotopic neobladder in 19, 4, and 3 patients, respectively. At postoperative days 2, a plain KUB and urinary ultrasonography were performed in order to assess stone fragmentation or hydronephrosis...
December 11, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29212367/assessment-of-patient-and-surgical-variables-including-residency-training-level-on-adverse-events-after-ureteroscopy-for-ureteral-stones-a-multivariate-analysis
#10
Carrie Johans, Woodson Smelser, Chelsea DeRoche, Jack Campbell, James Cummings
Purpose With advances in technology, ureteroscopy is increasingly utilized for the management of urolithiasis. Previous studies have attempted to characterize the post-operative complication and readmission rates relative to the technical difficulty of the procedure. There is limited data exploring resident level of training and its effect on adverse outcomes in these cases. We review our experience with ureteroscopy to create a model to predict factors, including resident experience,that affect rates of post-operative complications Materials and Methods We reviewed ureteroscopies performed at our academic facility from January 2009 to December 2013...
December 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29201512/safety-and-efficacy-of-silodosin-and-tadalafil-in-ease-of-negotiation-of-large-ureteroscope-in-the-management-of-ureteral-stone-a-prosective-randomized-trial
#11
Rohit Bhattar, Vipin Jain, Vinay Tomar, Sher Singh Yadav
Objective: To evaluate the safety and efficacy of silodosin and tadalafil in ease of negotiation of large size ureteroscope (8/9.8 Fr) in the management of ureteral stone. Material and methods: Between June 2015 and May 2016, 86 patients presented with ureteral stone of size 6-15 mm were on consent randomly assigned to 1 of 3 outpatient treatment arms: silodosin (Group A), tadalafil (Group B), and placebo (Group C). After two weeks of therapy 67 patients underwent ureteroscopy, and ureteral orifice configuration, ureteroscopic negotiation, ureteral dilatation, operating time, procedural complication and drug related side effects were noted in each group...
December 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29189885/invited-review-the-tale-of-ecirs-endoscopic-combined-intrarenal-surgery-in-the-galdakao-modified-supine-valdivia-position
#12
REVIEW
Cesare Marco Scoffone, Cecilia Maria Cracco
Modern-day percutaneous nephrolithotomy (PNL) has undergone considerable evolution, mainly driven by the improvement in access techniques, endoscopic instrumentation technology, lithotripsy devices and drainage management. The introduction of the supine and supine-modified positions is also part of this evolution, enabling comfortable and safe procedures from an anaesthesiological point of view, and an easy combined retrograde surgery [Endoscopic Combined IntraRenal Surgery (ECIRS)], allowing tailoring of the procedure on the patient, the dynamic anatomy of the collecting system and the urolithiasis...
November 30, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29188308/ureteroscopy-from-the-recent-past-to-the-near-future
#13
REVIEW
José Manuel Reis Santos
Stone surgery is one of oldest surgical practices undertaken by man. Hippocrates refused to let his followers "cut for the stone" and it was only in February 1980, when the first human trial of shock wave therapy on a renal stone was performed with success that a new era in minimally invasive treatment (surgery) for stones was opened up and this condemnation was finally resolved in the Hippocratic Oath. Endoscopy, using natural orifices, supported by anaesthesia, incremented by technology and with access to all points along the urinary tract, began by competing with ESWL, but is now the treatment of choice in most cases...
November 29, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29180300/variation-in-spending-around-surgical-episodes-of-urinary-stone-disease-findings-from-michigan
#14
Juan San Juan, Hechuan Hou, Khurshid R Ghani, James M Dupree, John M Hollingsworth
PURPOSE: To help rein in surgical spending, there is growing interest in the application of payment bundles to common outpatient procedures like ureteroscopy (URS) and shockwave lithotripsy (SWL). However, before urologists can move to such a payment system, they need to know where their episode costs are concentrated. MATERIALS AND METHODS: Using claims data from the Michigan Value Collaborative, we identified patients who underwent URS or SWL at hospitals in Michigan (2012 to 2015)...
November 24, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29179565/american-urological-association-antibiotic-best-practice-statement-and-ureteroscopy-does-antibiotic-stewardship-help
#15
Daniel Greene, Bradley C Gill, Bryan Hinck, Yaw A Nyame, Nima Almassi, Krishnamurthi Venkatesh, Mark Noble, Sri Sivalingam, Manoj Monga
PURPOSE: To determine compliance with American Urological Association (AUA) antimicrobial prophylaxis best practice statement and whether the use of postoperative antibiotics is associated with lower rates of postoperative urinary tract infection (UTI) in patients with nephroureterolithiasis and a negative preoperative urine culture undergoing ureteroscopy. MATERIALS AND METHODS: A retrospective review of all adult patients undergoing ureteroscopy from 2013-2014 for stone disease with a negative preoperative urine was conducted...
November 27, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29174945/preoperative-predictors-of-nonorgan-confined-disease-in-upper-tract-urothelial-carcinoma-differ-between-china-and-the-united-states
#16
Nirmish Singla, Dong Fang, Xiaohong Su, Zhengqing Bao, Zhenpeng Cao, Haley Robyak, Gengyan Xiong, Lei Zhang, Solomon Woldu, Ryan Hutchinson, Arthur Sagalowsky, Yair Lotan, Xuesong Li, Liqun Zhou, Jay D Raman, Vitaly Margulis
OBJECTIVE: To compare preoperative predictors of nonorgan-confined (NOC) disease in patients with upper-tract urothelial carcinoma (UTUC) from the United States (US) and China. METHODS: Clinicopathologic data of patients with UTUC treated surgically at tertiary care facilities in the US or China from 1998 to 2015 were, retrospectively, compiled. Patient characteristics, preoperative imaging, cytology, ureteroscopic findings, and serum markers (neutrophil-to-lymphocyte ratio, estimated glomerular filtration rate, hemoglobin, and albumin) were evaluated...
November 23, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29170856/robot-assisted-flexible-ureteroscopy-an-update
#17
REVIEW
Jens Rassweiler, Marcel Fiedler, Nikos Charalampogiannis, Ahmet Sinan Kabakci, Remzi Saglam, Jan-Thorsten Klein
The role of flexible ureteroscopy (FURS) in the management of nephrolithiasis has increased due to the improved armamentarium. However, FURS still represents a challenging technique limiting its diffusion. Similar to previous experiences in laparoscopy, recently developed robotic devices may significantly compensate for the ergonomic deficiencies of FURS. Based on a short description of the history of robotic devices for laparoscopy, this article summarizes all current developments of robotic FURS. In 2008, robotic FURS was first reported using the Sensei-Magellan system designed for interventional cardiology...
November 23, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29170855/laparoscopic-and-robotic-surgery-for-stone-disease
#18
REVIEW
Renato N Pedro, Noor Buchholz
Treatment for stone disease has evolved drastically during the past 3-4 decades. Ureteroscopy, percutaneous nephrolithotomy along with SWL, provides the means to treat practically all urinary tract stones with minimal invasion to the patients. However, for complex stone case scenarios where open surgery is being considered, a less invasive and better tolerated option such as laparoscopy (robot assisted or not) can be performed. The present manuscript reviews role of laparoscopic and robotic surgery in treating urinary tract stones...
November 23, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29168415/clinically-intractable-chronic-unilateral-hematuria-successful-treatment-with-renal-segmental-artery-embolization
#19
Jae Chun Park, Gyoo-Sik Jung, Jin Ho Lee, Joong Kyung Kim
Chronic unilateral hematuria (CUH) is characterized by intermittent or continuous gross hematuria that cannot be diagnosed using standard radiology and hematology. The authors report a case of CUH with no discrete lesion at ureteroscopy, successfully treated by selective renal artery embolization. Renal artery embolization could be a treatment option for selected patients with clinically intractable CUH.
November 23, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/29161894/new-advanced-bench-model-for-flexible-ureteroscopic-training-the-smart-simulator
#20
Takaaki Inoue, Shinsuke Okada, Shuzo Hamamoto, Tadashi Matsuda
Smart Simulator is a new advanced bench training model for achieving proficiency in flexible ureteroscopy (fURS). Its important features are portability and the ability to simulate breathing-induced kidney movements, model pyelocalices similar to those in humans, create a situation closely resembling a fURS field, and create papillae of a size equivalent to that of the access sheath. Smart Simulator thus creates a situation more closely resembling that in a clinical setting than the other bench training models for fURS...
November 22, 2017: Journal of Endourology
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