JaLCDOI 10.18926/AMO/54414
FullText URL 70_3_159.pdf
Author Yoshioka, Takashi| Otsuki, Hideo| Uehara, Shinya| Shimizu, Toshihiro| Murao, Wataru| Fujio, Koji| Fujio, Kei| Wada, Koichiro| Araki, Motoo| Nasu, Yasutomo|
Abstract Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the ʻ<65 groupʼ (<65 years old, n=108), the ʻ65-74 groupʼ (65-74 years old, n=42), and the ʻ 75 groupʼ ( 75 years old, n=39). The patientsʼ characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the 75 group had a significantly higher prevalence of hypertension compared to the<65 group. Compared to the<65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the 75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the 75 group were similar to those of the<65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors.
Keywords upper urinary tract calculi ureteroscopy (URS) holmium laser lithotripsy elderly patients stone-free rate (SFR)
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 159
End Page 166
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339204
Web of Science KeyUT 000379406100002
JaLCDOI 10.18926/AMO/54000
FullText URL 70_1_25.pdf
Author Otsuki, Hideo| Yoshioka, Takashi| Shimizu, Toshihiro| Nakanishi, Yusuke| Fujio, Kei| Murao, Wataru| Uehara, Shinya| Kikuchi, Hirosato| Fujio, Koji|
Abstract The effects of stone composition on transurethral lithotripsy (TUL) have not been sufficiently elucidated. The purpose of this study was to identify how calcium phosphate stone composition impacts TUL. Two hundred eighty-nine cases of semi-rigid and/or flexible TUL for upper urinary tract calculi were reviewed retrospectively. Inclusion criteria were a preoperative assessment by noncontrast computed tomography (NCCT) and a stone composition analysis. Small stones and those without calcium composition were excluded. Stone core radiodensity (SCR) was measured by taking the average of the upper 3 of 5 points in the proximity of the center of the stone on NCCT. Fifty-three patients with calcium phosphate composition (CaP) and 118 patients with calcium oxalate and without phosphate composition were eligible for analysis. SCR was significantly higher in the CaP group (p<0.01). The CaP patient group needed a significantly longer operation time (p=0.014) and more laser energy (p=0.085), and tended to have a lower rate of complete lithotripsy (p=0.096) and higher incidence of postoperative pyelonephritis (p=0.181). Stones containing calcium phosphate are harder, demand more laser energy, and require a longer operating time. NCCT evaluation can estimate stone composition preoperatively, and may be a useful tool for predicting operative outcomes.
Keywords ureteroscopic lithotripsy stone composition calcium phosphate radiodensity complication
Amo Type Original Article
Published Date 2016-02
Publication Title Acta Medica Okayama
Volume volume70
Issue issue1
Publisher Okayama University Medical School
Start Page 25
End Page 29
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26899606
Web of Science KeyUT 000371288700003