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8 Fr flexible ureteroscope was placed into the working tract of a nephroscope. This method increased the reach of the rigid nephroscope (Figure 4) without causing much iatrogenic tissue injury. A 20 Fr nephrostomy was inserted for post-operative drainage. The total operation time was 1 h and 27 min, and the estimated blood loss was 100 mL. No complications occurred after the surgery, and the nephrostomy tube was removed 3 days after the operation. The total hospital course was 5 days.
Source publication
Percutaneous nephrolithotomy (PCNL) is the treatment of choice for staghorn stones. However, residual stones in calyces remain a challenge due to the limited angle which makes the approach difficult. The new operative technique of endoscopic combined intrarenal surgery (ECIRS), which integrates the advantages of PCNL and retrograde intrarenal surge...
Context in source publication
Context 1
... used the nephroscope to locate the upper part of the middle calx and upper calyx where we thought residual stones may exist. Under assistance (Figure 2), the operator inserted an 8 Fr fURS into the working channel of the nephroscope ( Figure 3). The high-power holmium laser was then used to fragment visible stones as far as possible. ...
Similar publications
Introduction
This study aims to review the current role of endoscopic combined intrarenal surgery (ECIRS) in the management of renal stones, with a focus on its efficacy and safety. The secondary outcome was to highlight the tips and tricks to improve the urologist’s experience with ECIRS.
Methods
A scoping review of the literature, in accordance...
Citations
... Compared with flexible cystoscope, flexible ureteroscope has a larger bending angle at the front end and a wider observation range. In recent years, several studies have been carried out on antegrade flexible ureteroscopy-assisted PNL (aPNL) for the treatment of staghorn calculi, but all of them were retrospective studies with small samples or case reports [18,19]. The existing constraints on reusable flexible ureteroscope assisted PNL include a high initial purchase cost, vulnerabilities, high expenditures for repair, and a risk of cross-infection [20]. ...
... Previous studies have suggested that PNL combined with anterograde flexible ureteroscope is a preferred treatment for staghorn calculi, but they were retrospective studies or case reports [18,19]. Therefore, we conducted the prospective randomized controlled trial to thoroughly investigate the efficiency and safety of aPNL. ...
The aim is to compare the efficacy and safety between single percutaneous nephrolithotomy (sPNL) and antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) for the treatment of staghorn calculi. A prospective randomized controlled study was conducted at the Second Hospital of Tianjin Medical University. A total of 160 eligible patients were included, with 81 in the sPNL group and 79 in the aPNL group. The study first compared the overall differences between sPNL and aPNL. Then, the patients were divided into two subgroups: Group 1 (with less than 5 stone branches) and Group 2 (with 5 or more stone branches), and the differences between the two subgroups were further analyzed. The results showed that aPNL had a higher stone-free rate (SFR) and required fewer percutaneous tracts, with a shorter operation time compared to sPNL (P < 0.05). Moreover, aPNL significantly reduced the need for staged surgery, particularly in patients with 5 or more stone branches. Moreover, there were no significant differences in the changes of hemoglobin levels and the need for blood transfusions between the sPNL and aPNL groups, and the incidence of multiple tracts was lower in the aPNL group. The two groups showed comparable rates of perioperative complications. We concluded that aPNL resulted in a higher SFR for staghorn calculi, and required fewer multiple percutaneous tracts, reduced the need for staged surgery, and had a shorter operative time than PNL alone, especially for patients with 5 or more stone branches. Furthermore, aPNL did not increase the incidence of surgical complications.
