Evidence for Ureterorenoscopy and Laser Fragmentation (URSL) for Large Renal Stones in the Modern Era

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• 作者：Robert Geraghty ; Omar Abourmarzouk ; Bhavan Rai…
• 关键词：Renal ; Calculi ; Laser ; Large ; Review
• 刊名：Current Urology Reports
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：16
• 期：8
• 全文大小：650 KB
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• 作者单位：Robert Geraghty (1)
  Omar Abourmarzouk (2)
  Bhavan Rai (3)
  Chandra Shakhar Biyani (4)
  Nicholas J. Rukin (5)
  Bhaskar K. Somani (1)
  
  1. Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK
  2. University of Wales, Cardiff, UK
  3. Ninewells Hospital, Dundee, UK
  4. Pinderfields Hospital, Yorkshire, UK
  5. Wolverhampton Hospital, Wolverhampton, UK
  
• 刊物主题：Urology/Andrology; Nephrology;
• 出版者：Springer US
• ISSN：1534-6285

文摘

Large renal stones (>2?cm) are managed with percutaneous nephrolithotomy (PCNL), which has a good stone-free rate (SFR) but a relatively high incidence of complications graded Clavien ?. We wanted to review the literature for the use of ureterorenoscopy and laser fragmentation (URSL) for the management of these stones. A systematic review was done from 1990 to April 2014 for all English language articles reporting on a minimum of 10 patients for stones >2?cm in size (done by 2 reviewers independently) in accordance with the PRISMA and Cochrane review guidelines. A total of 379 articles were identified and after screening for the titles (54) and abstracts (29), 12 papers (651 patients) were included. The male to female ratio was 356:232 with a mean age of 54?years (range 16-6?years). With a mean stone size of 2.7?cm (2-.15?cm) and the mean operating time of 96?min (28-38?min); the SFR was 91?% (1.45 procedures/patient). The overall number of complications was 58 (8.6?%) of which 26 (4.5?%) were complications classed Clavien ? (haematuria with subcapsular haematoma/clot retention-7; ureteral perforation-7; steinstrasse-5; sepsis/pyelonephritis-5; prostatitis-1; cerebrovascular accident-1). Ureterorenoscopy for large renal stones in the modern era has good SFR with a small risk of major complications.