1.Extraction of a long-forgotten ureteral stent by ureteroscopic pneumatic lithotripsy.
Jun JIANG ; Fang-qiang ZHU ; Qing JIANG ; Luo-fu WANG
Chinese Medical Journal 2004;117(9):1435-1436
Aged
;
Humans
;
Lithotripsy
;
methods
;
Male
;
Stents
;
adverse effects
;
Ureteroscopy
2.Treatment of lower urethral calculi with extracorporeal shock-wave lithotripsy and pneumatic ureteroscopic lithotripsy: a comparison of effectiveness and complications.
Weide ZHONG ; Guangqiao ZENG ; Yuebin CAI ; Qishan DAI ; Jianbo HU ; Hong'ai WEI
Chinese Medical Journal 2003;116(7):1001-1003
OBJECTIVETo determine the efficacy and incidence of complications of extracorporeal shock-wave lithotripsy (ESWL) compared with pneumatic ureteroscopic lithotripsy (URSL) in the treatment of lower uretheral calculi.
METHODSFrom August 1997 to June 1999, 210 patients with lower ureteric calculi were treated with ESWL and the other 180 with URSL. The stones were fragmented with pneumatic lithotripter. The outcome was assessed by evacuation, retreatment and complication rates.
RESULTSESWL for lower ureteric calculi resulted in a stone evacuation rate of 78.1%, compared with 93.3% for URSL (P < 0.05). ESWL had a retreatment rate of 11.9% and a perforation rate of 0, while URSL caused perforation of ureters in 3.3% of patients and a refreatment of 2.2%.
CONCLUSIONFor the management of lower ureteric calculi, ESWL provides a non-invasive, simple and safe option, and URSL has a higher stone evacuation rate but causes ureter perforation more frequently than ESWL does. Both ESWL and URSL have their respective advantages. It is recommended, however, that URSL be extensively developed for better treatment efficacy, given that the operator has an adequate technical background.
Adolescent ; Adult ; Aged ; Female ; Humans ; Lithotripsy ; adverse effects ; methods ; Male ; Middle Aged ; Ureteroscopy ; Urethral Diseases ; therapy ; Urinary Calculi ; therapy
3.Extracorporeal shock-wave versus pneumatic ureteroscopic lithotripsy in treatment of lower ureteral calculi.
Guang-Qiao ZENG ; Wei-De ZHONG ; Yue-Bin CAI ; Qi-Shan DAI ; Jian-Bo HU ; Hong-Ai WEI
Asian Journal of Andrology 2002;4(4):303-305
AIMTo compare the efficacy and complications of extracorporeal shock-wave lithotripsy (SWL) and pneumatic ureteroscopic lithotripsy (URS) in the treatment of lower ureteral calculi.
METHODSFrom August 1997 to June 1999, 210 patients with calculi in the distal third of the ureter were treated with SWL and the other 180 with URS. The stones were fragmented with either HB-ESWL-V lithotripter or JML-93 pneumatic lithotripter through Wolf 7.5 approximately 9.0 Fr ureteroscope. The outcome was assessed in terms of stone clearance rate, re-treatment rate and complication incidence.
RESULTSThe stone clearance rate was 78.1 % with SWL and 93.3 % with URS (P<0.05). SWL had a re-treatment rate of 11.9 %, vs 2.2 % in the URS group (P<0.05). URS caused ureteral perforation in 3.3% of patients, while it was 0 with SWL (P<0.05). The differences in the incidence of other complications such as infection and stricture between the two groups were insignificant.
CONCLUSIONThough the selection of these two options depends on equipments available and the expertise of the operator, we recommend URS as the optimal treatment for distal ureteral calculi.
Adolescent ; Adult ; Aged ; Female ; Humans ; Lithotripsy ; adverse effects ; methods ; Male ; Middle Aged ; Treatment Outcome ; Ureteral Calculi ; therapy
4.Comparative study of pneumatic lithotripsy and holmium laser lithotripsy for ureteral stones.
Xue-Chao LI ; Ying LIU ; Jiang-Gen YANG ; Dao-Heng ZHANG
Journal of Central South University(Medical Sciences) 2005;30(5):601-603
OBJECTIVE:
To compare the efficacy and safety of endoscopic laser lithotripsy (LL) and endoscopic pneumatic lithotripsy (PL) for ureteral stones.
METHODS:
We retrospectively analyzed the clinical data of 415 patients with ureteral calculi treated with endoscopic laser lithotripsy (n = 214 ) and pnumatic lithotripsy (n = 201 ).
RESULTS:
The overall successful fragmentation rate of all ureteral stones in a single session of the LL group was higher than that of the PL group (95% vs. 69%, P < 0.01). The average stonefree time of the LL group was shorter than that of the PL group (18 days vs. 31 days, P < 0.01). No complications such as perforation during the operation were observed in the LL group whereas 3 perforations occurred in the PL group.
CONCLUSION
LL has its advantage over PL in its better clinical effect for the stone fragmentation and low complication rate and is an effective and safe treatment for ureteral stones.
Adolescent
;
Adult
;
Aged
;
Female
;
Holmium
;
Humans
;
Lithotripsy, Laser
;
adverse effects
;
methods
;
Male
;
Middle Aged
;
Retrospective Studies
;
Ureteral Calculi
;
therapy
;
Ureteroscopy
5.Clinical Features and Outcomes of Endoscopic Treatment for Stones in Stemware-Shaped Common Bile Ducts: A Multicenter Data Analysis.
Jee Young HAN ; Don Haeng LEE ; Seok JEONG ; Hyun Jong CHOI ; Jong Ho MOON ; Joung Ho HAN ; Chang Il KWON ; Tae Hoon LEE ; Jong Jin HYUN ; Jae Chul HWANG ; Dong Hee KOH
Gut and Liver 2015;9(6):800-804
BACKGROUND/AIMS: Various anatomical features of the biliary tree affect ability to remove difficult common bile duct (CBD) stones. In this study, we evaluated the clinical characteristics and outcomes of the endoscopic treatment of stones in stemware-shaped CBDs. METHODS: Thirty-four patients with a stone and a stemware-shaped CBD who were treated at different tertiary referral centers from January 2008 to December 2012 were studied retrospectively. When stone removal failed, percutaneous or direct peroral cholangioscopic lithotripsy, endoscopic retrograde biliary drainage, or surgery was performed as a second-line procedure. RESULTS: The overall success rate of the first-line procedure was 41.2%. Five of the 34 patients (14.7%) experienced procedure-related complications. No procedure-related mortality occurred. Mechanical lithotripsy was required to completely remove stones in 13 patients (38.2%). Conversion to a second-line procedure was required in 20 patients (58.8%). Mechanical lithotripsy was needed in 75% and 66.7% of those with a stone size of <1 cm or > or =1 cm, respectively. Stone recurrence occurred in two patients (9.1%) after 6 months and 27 months, respectively. CONCLUSIONS: The endoscopic treatment of stones in a stemware-shaped CBD is challenging. The careful assessment of difficult CBD stones is required before endoscopic procedures.
Adult
;
Aged
;
Aged, 80 and over
;
Cholangiopancreatography, Endoscopic Retrograde/adverse effects/methods
;
Choledocholithiasis/complications/*surgery
;
Common Bile Duct/*anatomy & histology/surgery
;
Endoscopy, Gastrointestinal/adverse effects/*methods
;
Female
;
Humans
;
Lithotripsy/adverse effects/*methods
;
Male
;
Middle Aged
;
Treatment Outcome
6.High-power holmium laser with percutaneous nephrolithotripsy for kidney calculi.
Ying-hao SUN ; Xiao-feng GAO ; Lin-hui WANG ; Xia SHENG ; Xu GAO ; Xi-zhi WANG
Chinese Journal of Surgery 2005;43(18):1209-1211
OBJECTIVETo assess the efficacy and safety of the high-power holmium laser with percutaneous nephrolithotripsy for kidney calculi.
METHODSThe high-power (60 W: 3.0 J x 20 Hz) holmium laser with percutaneous nephrolithotripsy was performed on 52 patients with single kidney pelvic or calyceal stones (average stone diameter 3.1 cm), 36 patients with multi-kidney pelvic and calyceal stones (average diameter 2.8 cm), 24 patients with staghorn stones (average diameter 6.8 cm). The duration of stone surgery, stone-free rate and complication were assessed.
RESULTSThe mean duration of stone surgery was 44 min, the stone-free rate was 66% (74/112) after the first session, 89% (100/112) at the end of session. 3 patients had high fever after percutaneous nephrolithotripsy, no other adverse events were noted.
CONCLUSIONSThe high-power holmium laser with percutaneous nephrolithotripsy can fragments calculi quickly and reduces the length of time of operation. It is an effective and safe technique for kidney calculi.
Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Female ; Holmium ; administration & dosage ; Humans ; Kidney Calculi ; therapy ; Lithotripsy, Laser ; adverse effects ; methods ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; Treatment Outcome
7.Peyronie's disease and low intensity shock wave therapy: Clinical outcomes and patient satisfaction rate in an open-label single arm prospective study in Australian men.
Korean Journal of Urology 2015;56(11):775-780
PURPOSE: To evaluate the efficacy, safety and patient satisfaction outcomes following low intensity extracorporeal shock wave therapy (LiESWT) in men with Peyronie's disease (PD) using a standardised protocol. MATERIALS AND METHODS: In this open-label single arm prospective study, patients with PD were enrolled following informed consent. Patient demographics, change in penile curvature and plaque hardness, International Index of Erectile Function (IIEF)-5 score, and overall satisfaction score (on a 5-point scale) were recorded. Treatment template consists of 3000 shock waves to the Peyronie's plaque over 20 minutes, twice weekly for 6 weeks. RESULTS: The majority of patients have PD history longer than 6 months (mean, 12.8 months; range, 6-28 months). Two thirds of patients have received and failed oral medical therapy. There were improvements in penile curvature (more than 15 degrees in 33% of men), plaque hardness (60% of men) and penile pain (4 out of 6 men) following LiESWT. There was a moderate improvement in IIEF-5 score (>5 points reported in 20% of men). No complication was reported and the majority of patients were satisfied (rated 4 out of 5; 70% of men) and would recommend this therapy to others. CONCLUSIONS: In a carefully selected group of men with PD, LiESWT appears to be safe, has moderate efficacy and is associated with high patient satisfaction rate in the short term.
Adult
;
Age Distribution
;
Aged
;
Feasibility Studies
;
Humans
;
Lithotripsy/adverse effects/*methods
;
Male
;
Middle Aged
;
Pain/prevention & control
;
*Patient Satisfaction
;
Penile Induration/pathology/*surgery
;
Prospective Studies
;
Treatment Outcome
8.Successful cure of a patient with urosepsis using a combination of extracorporeal membrane oxygenation and continuous renal replacement therapy: A case report and literature review.
Chun-Yan ZHU ; Ai-Jun PAN ; Qing MEI ; Ting CHEN
Chinese Journal of Traumatology 2020;23(6):372-375
Holmium laser lithotripsy (HLL) is one of the common surgical methods for urolithiasis. It causes minor surgical trauma, but complications are not rare. Extracorporeal membrane oxygenation (ECMO) treatment of sepsis is common, but venoarterial (VA)-ECMO treatment of urosepsis has not been reported yet. In this article, we reported a 67-year-old female patient with refractory septic shock caused by HLL under percutaneous nephroscope, involving breathing, heart, kidney and other organs, and organs support treatment was ineffective for the patient. Finally, we successfully treated the patient under VA-ECMO with continuous renal replacement therapy (CRRT). Combined ECMO and CRRT may provide a solution for addressing refractory sepsis. Here we present the case and review relevant literature, so as to provide a treatment strategy for patients with refractory urogenic sepsis and to reduce the mortality rate.
Aged
;
Extracorporeal Membrane Oxygenation/methods*
;
Female
;
Humans
;
Lasers, Solid-State/adverse effects*
;
Lithotripsy, Laser/methods*
;
Postoperative Complications/therapy*
;
Renal Replacement Therapy/methods*
;
Shock, Septic/therapy*
;
Treatment Outcome
;
Urinary Tract Infections/therapy*
;
Urolithiasis/surgery*
9.Percutaneous Papillary Large Balloon Dilation during Percutaneous Cholangioscopic Lithotripsy for the Treatment of Large Bile-Duct Stones: A Feasibility Study.
Jee Young HAN ; Seok JEONG ; Don Haeng LEE
Journal of Korean Medical Science 2015;30(3):278-282
When access to a major duodenal papilla or endoscopic retrograde cholangiopancreatography has failed, percutaneous transhepatic cholangioscopic lithotripsy (PTCS-L) may be useful for removing common bile duct (CBD) stones. However, the feasibility and usefulness of percutaneous transhepatic papillary large-balloon dilation (PPLBD) during PTCS-L for the removal of large CBD stones has not been established. We aimed to determine the safety and efficacy of PPLBD for the treatment of large CBD stones. Eleven patients with large CBD stones in whom the access to the major papilla or bile duct had failed were enrolled prospectively. Papillary dilation was performed using a large (12-20 mm) dilation balloon catheter via the percutaneous transhepatic route. Post-procedure adverse events and efficacy of the stone retrieval were measured. The initial success rate of PPLBD was 100%. No patient required a basket to remove a stone after PPLBD. Electrohydraulic lithotripsy was required in 2 (18.2%) patients. The median time to complete stone removal after PPLBD was 17.8 min and no adverse events occurred after PPLBD. Asymptomatic hyperamylasemia was not encountered in any patients. This study indicates that PPLBD is safe and effective for removal of large CBD stones.
Ampulla of Vater/surgery
;
Bile Ducts/*surgery
;
Cholangiopancreatography, Endoscopic Retrograde
;
Choledocholithiasis/*surgery
;
Feasibility Studies
;
Gallstones/surgery
;
Humans
;
Hyperamylasemia
;
Lithotripsy/adverse effects/*methods
;
Prospective Studies
;
Sphincterotomy, Endoscopic/*methods
;
Treatment Outcome
;
Urinary Bladder Calculi/*surgery
10.Percutaneous Papillary Large Balloon Dilation during Percutaneous Cholangioscopic Lithotripsy for the Treatment of Large Bile-Duct Stones: A Feasibility Study.
Jee Young HAN ; Seok JEONG ; Don Haeng LEE
Journal of Korean Medical Science 2015;30(3):278-282
When access to a major duodenal papilla or endoscopic retrograde cholangiopancreatography has failed, percutaneous transhepatic cholangioscopic lithotripsy (PTCS-L) may be useful for removing common bile duct (CBD) stones. However, the feasibility and usefulness of percutaneous transhepatic papillary large-balloon dilation (PPLBD) during PTCS-L for the removal of large CBD stones has not been established. We aimed to determine the safety and efficacy of PPLBD for the treatment of large CBD stones. Eleven patients with large CBD stones in whom the access to the major papilla or bile duct had failed were enrolled prospectively. Papillary dilation was performed using a large (12-20 mm) dilation balloon catheter via the percutaneous transhepatic route. Post-procedure adverse events and efficacy of the stone retrieval were measured. The initial success rate of PPLBD was 100%. No patient required a basket to remove a stone after PPLBD. Electrohydraulic lithotripsy was required in 2 (18.2%) patients. The median time to complete stone removal after PPLBD was 17.8 min and no adverse events occurred after PPLBD. Asymptomatic hyperamylasemia was not encountered in any patients. This study indicates that PPLBD is safe and effective for removal of large CBD stones.
Ampulla of Vater/surgery
;
Bile Ducts/*surgery
;
Cholangiopancreatography, Endoscopic Retrograde
;
Choledocholithiasis/*surgery
;
Feasibility Studies
;
Gallstones/surgery
;
Humans
;
Hyperamylasemia
;
Lithotripsy/adverse effects/*methods
;
Prospective Studies
;
Sphincterotomy, Endoscopic/*methods
;
Treatment Outcome
;
Urinary Bladder Calculi/*surgery