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Stone-Free Rate after Treating Kidney Stones Exceeding 10 mm via Flexible Ureteroscopy: Can Endoscopic Assessment Replace Low-Dose Computed Tomography Control?
Wilhelm, Konrad; Hahn, Oliver; Schoenthaler, Martin; Hein, Simon; Neubauer, Jakob; Schnabel, Marco; Neisius, Andreas.
Afiliación
  • Wilhelm K; Clinic of Urology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany, konrad.wilhelm@uniklinik-freiburg.de.
  • Hahn O; Department of Urology, University Medical Center Göttingen, Göttingen, Germany.
  • Schoenthaler M; Clinic of Urology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany.
  • Hein S; Clinic of Urology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany.
  • Neubauer J; Department of Radiology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany.
  • Schnabel M; Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany.
  • Neisius A; Department of Urology, Brüderkrankenhaus Trier, University of Mainz, Trier, Germany.
Urol Int ; 103(3): 326-330, 2019.
Article en En | MEDLINE | ID: mdl-31394535
INTRODUCTION: It is unclear whether endoscopic assessment of the stone-free rate after flexible ureteroscopy (fURS) is as effective as assessment with low-dose computed tomography (CT) scan. METHODS: Prospective documentation of patients with kidney stones > 10 mm diameter from 2 different centers (Freiburg, Regensburg), who underwent fURS and were declared to be endoscopically completely stone-free. Low-dose CT control performed 4-8 weeks postoperatively. RESULTS/CONCLUSION: Thirty-eight patients were treated between October 2015 and August 2016 (12 F, 26 M). Average age was 55.9 years (range 19-82, SD 17.24), and body mass index was 29.7 kg/m2 (range 23.5-42.5, SD 4.37). There were 2.0 (range 1-7, SD 1.55) stones with a mean diameter of 15 mm (range 10-40, SD 6.78) per kidney. Mean surgery time was 74 min (range 38-124, SD 24.28), and lithotripsy was necessary in 33 cases. CT was performed 5.4 weeks afterwards (range 4-8, SD 1.43). One patient had a 2 mm residual which was extracted by URS. Strictly speaking, endoluminal stone removal control failed in only that patient, yielding a negative predictive value of 97%. A routine postoperative CT scan would thus appear unnecessary in the case of negative endoscopic control for residual fragments and should be avoided to reduce radiation exposure. Further investigations with larger patient populations are necessary.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cálculos Renales / Tomografía Computarizada por Rayos X / Ureteroscopía / Ureteroscopios Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Urol Int Año: 2019 Tipo del documento: Article Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cálculos Renales / Tomografía Computarizada por Rayos X / Ureteroscopía / Ureteroscopios Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Urol Int Año: 2019 Tipo del documento: Article Pais de publicación: Suiza