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Girard, René. "The First Stone." Renascence 52, no. 1 (1999): 5–17. http://dx.doi.org/10.5840/renascence19995212.
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Hassan, Ihab, and Helen Garner. "The First Stone." World Literature Today 69, no. 4 (1995): 865. http://dx.doi.org/10.2307/40151803.
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Lastusaari, Mika, Taneli Laamanen, Marja Malkamäki, Kari O. Eskola, Aleksei Kotlov, Stefan Carlson, Edmund Welter, et al. "The Bologna Stone: history's first persistent luminescent material." European Journal of Mineralogy 24, no. 5 (September 26, 2012): 885–90. http://dx.doi.org/10.1127/0935-1221/2012/0024-2224.
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Pressman, Jeremy. "Throwing stones in social science: Non-violence, unarmed violence, and the first intifada." Cooperation and Conflict 52, no. 4 (April 8, 2017): 519–36. http://dx.doi.org/10.1177/0010836717701967.
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Social scientists treat stone-throwing as a non-violent act or argue that protest movements may be primarily non-violent despite stone-throwing. However, this study of an iconic example, the first intifada (Palestinian uprising, 1987–1993), demonstrates that stone-throwing is better characterized as unarmed violence. Definitions of violence underscore that throwing rocks is a violent act. Moreover, informed observers and data collected on stone-induced injuries during four years of the intifada illustrate the bodily harm caused by stones. The throwing of stones was central to the intifada and its identity and definition. Stone-throwing was the most visible tactic Palestinians used in the first intifada. Lastly, most scholars emphasize the protestors’ perceptions when it might be that the targets’ perceptions matter more for understanding definitions of (non-)violence and subsequent policy changes. These findings challenge important social science work and the mainstream Israeli and Palestinian narratives about the first intifada.
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Uribarri, Jaime. "The First Kidney Stone." Annals of Internal Medicine 111, no. 12 (December 15, 1989): 1006. http://dx.doi.org/10.7326/0003-4819-111-12-1006.
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Gold, Lionel. "Casting the first stone." Journal of Oral and Maxillofacial Surgery 47, no. 7 (July 1989): 772. http://dx.doi.org/10.1016/s0278-2391(89)80026-6.
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McGrane, Jenny. "Casting the first stone." Nursing Standard 6, no. 30 (April 15, 1992): 51. http://dx.doi.org/10.7748/ns.6.30.51.s57.
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Curthoys, Ann. "Helen Garner'sthe first stone." Australian Feminist Studies 10, no. 21 (March 1995): 203–11. http://dx.doi.org/10.1080/08164649.1995.9994777.
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Teixeira-Pinto, Amândio. "Repairing of Damaged Stone in Monuments and Stone Buildings." Advances in Science and Technology 69 (October 2010): 164–73. http://dx.doi.org/10.4028/www.scientific.net/ast.69.164.
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The main causes of rock degradation in stone buildings are discussed and the current methods of recovering damaged stones are summarized. The Alkaline Activation seems to present a great potential to deal with particular cases of damaged stones resulting mainly from fracture incidents provoked by physical actions, where the global substitution of the stone itself is not considered. A practical case of recovering granite on the windows frames of a beautiful chalet to be intended for the Municipal Archives at Vila Real is described, in what is considered to be the first experiment of this technique in recovering building stone.
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Priyosantoso, Bacilius Agung, and Sawkar Vijay Pramod. "Transperitoneal Laparoscopic Ureterolithotomy for Large Distal Ureteric Stone: The first Experience in Hasan Sadikin Hospital, Bandung." Jurnal llmu Bedah Indonesia 43, no. 1 (September 10, 2014): 61–64. http://dx.doi.org/10.46800/jibi-ikabi.v43i1.76.
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Background. Laparoscopic ureterolithotomy has become an alternative to open surgery for removing large stones that is not amenable to endoscopic treatment. In most of the published literature, laparoscopic ap- proach for lower ureteric stone is described to be less successful than middle and upper ureter. Identifica- tion in anatomical landmarks and exposing the distal ureter has been the major boundaries in establishing laparoscopic distal ureteral stone. We hope to provide clarity and feasibility that may increase our knowledge in laparoscopic ureterolithotomy for large distal ureteral stone.
Aim. The obbjective is to share our experience in laparoscopic ureterolithotomy for large distal ureteric stone with transperitoneal approach
Methods. A 37 years old male has been diagnosed with a right hydronephrosis due to proximal ureterolithiasis and stone at left calyx inferior, first and stone migrated to right distal ureter on 12 hours prior surgery. He underwent laparoscopic ureterolithotomy with transperitoneal approach.
Results. We successfully perform laparoscopic ureterolithotomy with transperitoneal approach on a 37 y.o male patient who diagnosed with a a right hydronephrosis due to distal ureterolithiasis and stone at left calyx inferior. Duration of operation was 45 minutes. Patient was discharged at 2nd postoperative day without any complications.
Conclusion. A Transperitoneal laparoscopic ureterolithotomy for distal ureteric stone is a safe and feasible technique that should be an options on every patients who plan to undergo distal ureterolithotomy especially large stone
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Xu, Chen, Ri-jin Song, Min-jun Jiang, Chao Qin, Xiao-lan Wang, and Wei Zhang. "Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients." Urologia Internationalis 94, no. 1 (July 29, 2014): 93–98. http://dx.doi.org/10.1159/000365578.
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Objective: To evaluate the efficiency and safety of flexible ureteroscopy (FURS) and holmium lithotripsy for intrarenal stones and to stratify the efficiency and safety by stone burdens of ≤20, 20-40, and ≥40 mm. Methods: Five hundred eighty-two patients with intrarenal stones were treated with FURS and holmium lithotripsy at a single department from August 2008 to October 2013. Stone size was evaluated by calculating the cumulative stone diameter of all intrarenal stones, and stone-free status was defined as the absence of any stone or stone fragment <1 mm in the kidney. Results: Data analysis revealed a mean stone burden of 21.8 ± 7.6 mm. The overall primary stone-free rate (SFR) was 65.3%, which increased to 89.0% 6 months after the first surgery. Complications developed in 6.7% of patients. A significant difference was found between lower-calyx stones and other stones (p < 0.001; p = 0.006), while noncalcium stones had a much higher SFR than calcium stones (p < 0.001; p = 0.04). Conclusion: Our study showed that the overall renal SFR with the use of FURS and holmium lithotripsy was satisfactory, with a relatively low complication rate. We believe that FURS with holmium lithotripsy could be a valuable choice for patients with renal stones, especially for patients with a cumulative stone burden ≤40 mm.
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Joshi, HN, Rm Karmacharya, R. Shrestha, B. Shrestha, IJ De Jong, and RKM Shrestha. "Outcomes of Extra Corporeal Shock Wave Lithotripsy in Renal and Ureteral Calculi." Kathmandu University Medical Journal 12, no. 1 (October 12, 2015): 51–54. http://dx.doi.org/10.3126/kumj.v12i1.13639.
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Background Since the introduction in early 1980s, Extracorporeal Shockwave Lithotripsy (ESWL) became the accepted first line treatment modality for renal and upper ureteric stones. It is simple, safe and effective noninvasive procedure which can be performed without anaesthesia in outpatient basis. The objective of this study was to determine the efficacy of ESWL to achieve complete stone clearance in the patients with different sizes of renal and upper ureteric stones.Objective The aim of this study was to assess the outcome, efficacy and complications of ESWL in the treatment for renal and ureteric stones in terms of the site and the size of the stone in the patients presented at Dhulikhel Hospital Kathmandu University Hospital.Method In this prospective study a total of 430 (214 renal and 216 ureteric) cases of urinary stone disease in 257 male and 173 female patients treated by ESWL at Dhulikhel Hospital, Kathmandu University Teaching Hospital during time period of May 2010 to June 2012 were included. Data of patients with renal and ureteric stones were evaluated for stone site, size, and number of sessions. Data were analyzed using spss 13.0.Result Out of 430 cases, the overall stone free rate in after 1st session was 341 (79.3%) at one month and in three months follow up (3 sessions) it was increased up to 414 (96.3%). In 16 (3.7%) patients treatment was failed. Average size of the stone was 12.24 (SD± 3.65) mm.Stone free rate was 154 (72%) in the case of renal and 187 (86.6%) in the case of ureteric stones in first session. In three months follow up (three sessions) it was 204 (95.4%) and 210 (97.2%) respectively for renal and ureteric stones. In relation to size the stone free rate in <10mm, 10-15mm and > 15mm was 97%, 97% and 90%.Conclusion ESWL is the first line preferred choice for renal and upper ureteric stones which provides the maximum stone free rate in the case of stone size smaller than 1.5cm.Kathmandu University Medical Journal Vol.12(1) 2014: 51-54
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Din Awan, Saif Ud, Ahmad Nawaz Bhatti, and Ayesha Naureen Awan. "Ureterorenoscopy, a review of first three years of experience for ureteric stone disease." Professional Medical Journal 26, no. 10 (October 10, 2019): 1712–18. http://dx.doi.org/10.29309/tpmj/2019.26.10.4133.
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Objectives: Ureterorenoscopy is a diagnostic and therapeutic modality, used for different ureteral and renal pathologies. It has virtually replaced open surgery for ureteric calculi. Study Design: Observational. Setting: Urology Department of Sargodha Medical College, Sargodha. Period: 2011-2015. Material and Methods: All cases who underwent URS for stone disease during the study period were included in the study. The initial criterion was a bit strict, due to minimum experience, which limited only clinically fit patients with no co-morbid illnesses, with stone size of 1 cm or less, located in middle or preferable in distal ureter, single stone was also preferred, but later the criterion was relaxed with gain confidence. The procedures were performed under general anesthesia using R Wolf Ureterorenoscope. Results: The total number of cases included in the study were 332 of which 189 were males and 143 were females. Average age being 42.82 years. The total number of stones managed were 354 (in 22 cases the stones were bilateral). The average size of stones was 1.2 cm. DJ stent was used in 78 cases. Complications were observed in 14.76 percent cases (2.71% major and 12.05% minor). No deaths occurred in the study group. Conclusion: Uretero renoscopy is an excellent tool for the management of ureteral stone disease so much so that these cases, after sufficient experience, can be managed as day cases. The complication rate can be controlled by careful patient selection. Being intuitive and stopping the procedure on the very first hint of something going wrong like the scope being stuck or requiring excessive force. Strictures should not be traversed without adequate prior dilatation. The operator should have sufficient experience with open surgery.
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Hossain, TMS, M. Asaduzzaman, MN Uddin, MH Rahman, MU Jahan, and AKMZI Bhuiyan. "Percutaneous nephrolithotomy-a versatile technique for both simple and complex renal stone." Bangladesh Medical Research Council Bulletin 39, no. 3 (September 4, 2014): 99–103. http://dx.doi.org/10.3329/bmrcb.v39i3.20308.
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Percutaneous Nephrolithotomy is currently the preferred first line treatment for simple & complex renal calculi. The technique also being used increasingly for smaller stones that have failed ESWL. Aim of the study is to share our experience in PCNL in course of time. This study was conducted from January 2009 to December 2012, 131 patients with 142 renal units of 5-75 yrs of age, PCNL were performed in NIKDU, BSMMU & JBFH. Stone were classified into simple (isolated renal pelvis or isolated calyceal stones) or complex (partial or complete staghorn stones, renal pelvic stone with accompanying calyceal stones). The stone size was 1.5-5cm approximately. We asses our initial puncture technique, need for multi-tract, supra 12th rib access, stone free rate, operative duration, postoperative complication, number of transfusion and hospital stay. Operative durations were 60 min -180 minutes. Puncture technique improved in course of time. 14 patients need multi-puncture and tract, all are supra 12th access. Out of 142 renal units 120 (83%) were stone free after first procedure, another 22 need and auxiliary procedure, (5 2nd look PCNL, 6 URS, 11 ESWL) to become stone free result in a 95% stone free rate. Complications occurred in 17 procedures which dealt accordingly. This study revealed PCNL is an effective, versatile safe and cosmetically acceptable procedure for all age groups in simple and complex renal stone. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20308 Bangladesh Med Res Counc Bull 2013; 39: 99-103
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Gnawali, Arun, Rahul Pathak, Rajesh Pandey, Prem Krishna Khadga, Sashi Sharma, Anurag Jha, Rabin Hamal, and Dinesh Koirala. "Endoscopic Extraction of CBD Stone: single centre experience in tertiary care centre." Journal of Advances in Internal Medicine 9, no. 1 (May 28, 2020): 29–33. http://dx.doi.org/10.3126/jaim.v9i1.29164.
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Background and Aims: Introduction: Endoscopic Retrograde Cholangiopancreatography(ERCP) has become the first line treatment for patients with common bile duct (CBD) stones. This technique may fail, however, due to presence of a large stone, multiple stones, periampullary diverticula or CBD stricture. The aim of this study was to evaluate the success of CBD cannulation, Endoscopic Sphincterotomy(EST) and CBD clearance in initial attempt, identify the failures of stone extraction and assess the post-ERCP complications.
Methods: A prospective study was carried out over the period of January 2019 to January 2020 on 100 consecutive patients with CBD stones. ERCP was done and the stone size and number recorded. EST was performed using a diathermy unit with a cutting current and stones were extracted using a Balloon catheter or a Dormia basket.
Results: Of the 100 patients, 44 were male and 56 were female with mean age of 52}17years. Selective CBD cannulation and cholangiogram was achieved in 90%, EST was successful in 90% and complete stone clearance was achieved in first attempt in 46 patients (59%). 52 patients had difficult CBD stone. There were nine complications, most of which rapidly resolved on conservative treatment (four post-ERCP pancreatitis, three bleeding and one retroperitoneal perforation) and one mortality in an old lady due to PSVT that couldn’t be directly attributed to ERCP. Among patients with Stone less than 15 mm in diameter(n=58), stone was removed successfully in 45 patients(78%) whereas in patients with stones over 15 mm (n=20) only one was removed successfully (5%) at initial attempt. Of these 32 patients with residual stones, 13 were referred for surgery and 19 had insertion of biliary stent to be followed by repeat ERCP.
Conclusion: Endoscopic therapy is a simple, effective and safe method of treatment in patients with CBD stone.
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Diri, Akif, Tolga Karakan, Mustafa Resorlu, Mucahit Kabar, and Cankon Germiyanoglu. "Intraperitoneal stone migration during percutaneos nephrolithotomy." Archivio Italiano di Urologia e Andrologia 86, no. 4 (December 30, 2014): 293. http://dx.doi.org/10.4081/aiua.2014.4.293.
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Percutaneos nephrolithotomy (PNL) is the standard care for renal stones larger than 2 cm. The procedure has some major and minor complications. Renal pelvis laceration and stone migration to the retroperitoneum is one of the rare condition. We report the first case of intraperitoneal stone migration during PNL.
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Kodati, Venkata Ramana, Anthony T. Tu, Ravindra Nath, and Jacob L. Turumin. "Analysis of Urinary Calculi of Mixed and Unusual Composition: Raman Spectroscopic Investigation." Applied Spectroscopy 47, no. 3 (March 1993): 334–37. http://dx.doi.org/10.1366/0003702934066604.
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Raman spectroscopic analysis of kidney stones of mixed composition and of unusual stones is presented. Raman spectroscopy was used to analyze the chemical composition of kidney stones without extraction. A kidney stone sample was irradiated by laser light of 514.5 nm, and the scattered light was analyzed by a Raman spectrometer. The first stone was determined to be a mixture of calcium oxalate dihydrate and hydroxyapatite and the second one to be a mixture of calcium oxalate monohydrate, uric acid, and hydroxyapatite. The third and fourth stones were not mixed-composition stones, but rather stones with unusual composition. One was concluded to be carboxyapatite, and the other was mucoprotein-type stone. The present investigation indicates that Raman spectroscopy is a useful tool for direct analysis of kidney stone without going through the usual procedure of crushing, extracting, and carrying out tedious wet chemical analysis.
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Oak, Ju Hyun, Chang Nyol Paik, Woo Chul Chung, Kang-Moon Lee, and Jin Mo Yang. "Risk Factors for Recurrence of Symptomatic Common Bile Duct Stones after Cholecystectomy." Gastroenterology Research and Practice 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/417821.
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Purpose. The recurrence of CBD stone is still observed in a considerable number of patients. The study was to evaluate the risk factors for recurrence of symptomatic CBD stone in patients who underwent cholecystectomy after the removal of CBD stone.Methods. The medical records of patients who underwent removal of CBD stone with subsequent cholecystectomy were reviewed. The risk factors for the recurrence of symptomatic CBD stone were compared between the recurrence and the nonrecurrence group.Results. The mean follow-up period was 40.6 months. The recurrence of symptomatic CBD stones was defined as the detection of bile duct stones no sooner than 6 months after complete clearance of CBD stones, based on symptoms or signs of biliary complication. 144 patients (68 males, 47.2%) were finally enrolled and their mean age was 59.8 (range: 26~86) years. The recurrence of CBD stone occurred in 15 patients (10.4%). The mean period until first recurrence was 25.9 months. The presence of type 1 or 2 periampullary diverticulum and multiple CBD stones were the independent risk factors.Conclusion. For the patients with type 1 or 2 periampullary diverticulum or multiple CBD stones, careful followup is needed for the risk in recurrence of symptomatic CBD stone.
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Coulom, Rémi. "CRAZY STONE WINS FIRST UEC CUP." ICGA Journal 31, no. 1 (March 1, 2008): 42–44. http://dx.doi.org/10.3233/icg-2008-31107.
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Roberts, Shirley. "Constance Stone – Australia's First Woman Doctor." Journal of Medical Biography 3, no. 1 (February 1995): 1–7. http://dx.doi.org/10.1177/096777209500300101.
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Bean, C. "First record ofLigula intestinalisfrom stone loach." Journal of Fish Biology 50, no. 2 (February 1997): 455–56. http://dx.doi.org/10.1006/jfbi.1996.0309.
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Makkai, M. "Stone duality for first order logic." Advances in Mathematics 65, no. 2 (August 1987): 97–170. http://dx.doi.org/10.1016/0001-8708(87)90020-x.
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Djozic, Jasenko, Jovo Bogdanovic, Vuk Sekulic, Milan Popov, Miso Dukic, and Goran Marusic. "The use of rigid ureteroscope in the treatment of ureteral steinstrasse after extracorporeal shockwave lithotripsy of renal calculi: Case report." Medical review 57, no. 11-12 (2004): 597–600. http://dx.doi.org/10.2298/mpns0412597d.
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Introduction Exracorporeal shockwave lithotripsy (ESWL) is the first choice for patients with urolithiasis. Increased use of endoscopic techniques provided increased use of ureteroscopic lithotripsy in the treatment of stones located in distal ureter, as well as ESWL. Rigid ureteroscope is usually used in the management of distal ureter stones, while middle and upper ureter stones should be treated by flexible ureteroscope or ESWL. At Urology Clinic in Novi Sad, ureteroscopy has been used since 1986, and more than 1000 procedures have been preformed with success rate of over 95% (100% when we were able to reach the stone). The aim of this report is to show the destruction of stone along the ureter, using a rigid ureteroscope, shortly after the ESWL treatment of kidney stones. Case report A 46-year-old woman was admitted to the Clinic with "steinstrasse" along the ureter, two weeks following ESWL of kidney stones. Primarily, she underwent ESWL without J-J stenting, at another urologic department. On admission to our Clinic, she complained of pain, nausea, mild temperature. An urgent diagnosis was carried out and left sided "steinstrasse" with hydronephrosis was confirmed by ultrasound, plain X-ray, laboratory findings. Ureteroscopy was performed under spinal anesthesia by rigid ureteroscope and the stone was destroyed along the ureter, even the pyelon was explored at the end of the procedure. The patient was advised to take a lot of fluids with diuretics and 80% of stones were eliminated in the first week after the procedure. At the first control, a month later, the patient was stone free. Conclusion Rigid ureteroscope is a therapeutic option for distal ureteral stones, just as ESWL with comparable and reproducible results. This case confirms the fact that in strictly selected cases, and careful work of skilled urologists, rigid ureteroscope can be used for successful stone destruction in the middle and upper ureter.
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Korolyova, Svetlana Yu. "Boulder Stones in Legends about the First Inhabitants of the Region: Dynamics of Ethnocultural Tradition in Northern Prikamye." Izvestia of the Ural federal university. Series 2. Humanities and Arts 22, no. 4 (202) (2020): 29–47. http://dx.doi.org/10.15826/izv2.2020.22.4.061.
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This article is devoted to the traditional mechanisms of semioticisation of natural landscape, which are considered with reference to revered boulder stones of Northern Prikamye. The approach chosen by the author is determined by modern trends in the study of the cult of stones, more particularly, the shift from the search for “traces of paganism” to other possible models that influenced the existing mythological ideas and practices. The author closely examines two ethno-local traditions functioning in Komi-Permyak District, Perm Region, i.e. in Yusvinsky and Gainsky Districts. The research material includes ethnographic facts and folklore texts of the nineteenth — early twenty-first centuries, including the records of ethnographer L. S. Gribova and new field data, some of which have not been published before. In one of the cases, in the village of Arkhangelskoe, Yusvinsky District, two competing etiological interpretations of the boulder are found. The Christian explanation (the stone is the “saddle” of prophet Elijah) is gradually replacing the “heroic” version of the appearance of the stone (the “saddle” that fell from the bogatyr’s horse). The main subject of the storytelling is multiple movements of the boulder in space, overcoming the natural immobility of the stone and serving — along with stories about the healings of people — confirming its “miraculous” properties. The second case was recorded in a remote, inaccessible part of Gainsky District. There, boulders serve as a materialised memory of the first inhabitants of the region — brothers-bogatyrs / strongmen. There are contaminated plots in which the local hero Pera replaces St Stefan Permsky floating on a stone. The criterion for the special semiotic status of the stone, its separation from the neutral landscape, is the appearance of its own name (oronym). Apparently, the forms of veneration of the three stones described in the article, known from the evidence of the nineteenth century onwards, did not develop until the settlement of these territories at the end of the sixteenth — first third of the seventeenth centuries, in a situation of contacts with Russian peasants. Taking into account data from over a century allows the author to show the flexibility of the Komi-Permyak tradition aimed at mythologising boulder stones.
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Hawken, James, and Jim Portal. "Clearance of Cystic Duct Remnant Stones Using a SpyGlass Retrieval Basket during Single-Operator Cholangioscopy at ERCP." Journal of Digestive Endoscopy 12, no. 01 (March 2021): 056–57. http://dx.doi.org/10.1055/s-0040-1715282.
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AbstractExtraction of stones from a cystic duct remnant following cholecystectomy poses a significant therapeutic dilemma. Surgical intervention has historically been required due to difficulty accessing the cystic duct remnant during conventional endoscopic retrograde cholangiopancreatography. Single-operator cholangioscopy can access the cystic duct remnant, enabling electrohydraulic lithotripsy and stone extraction. Method of stone extraction has seldom been described in this developing field. Clearing duct remnant stones using guidewire placement and an extractor balloon have been reported. This is the first reported case of cystic duct remnant stone extraction using a SpyGlass retrieval basket.
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Singh, Prince, Felicity T. Enders, Lisa E. Vaughan, Eric J. Bergstralh, John J. Knoedler, Amy E. Krambeck, John C. Lieske, and Andrew D. Rule. "Stone Composition Among First-Time Symptomatic Kidney Stone Formers in the Community." Mayo Clinic Proceedings 90, no. 10 (October 2015): 1356–65. http://dx.doi.org/10.1016/j.mayocp.2015.07.016.
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Obata, Taisuke, Koichiro Tsutsumi, Hironari Kato, Toru Ueki, Kazuya Miyamoto, Tatsuhiro Yamazaki, Akihiro Matsumi, et al. "Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography for the Treatment of Common Bile Duct Stones in Patients with Roux-en-Y Gastrectomy: Outcomes and Factors Affecting Complete Stone Extraction." Journal of Clinical Medicine 10, no. 15 (July 27, 2021): 3314. http://dx.doi.org/10.3390/jcm10153314.
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Background: Endoscopic retrograde cholangiopancreatography (ERCP) for extraction of common bile duct (CBD) stones in patients with Roux-en-Y gastrectomy (RYG) remains technically challenging. Methods: Seventy-nine RYG patients (median 79 years old) underwent short-type double-balloon enteroscopy-assisted ERCP (sDBE-ERCP) for CBD stones at three referral hospitals from 2011–2020. We retrospectively investigated the treatment outcomes and potential factors affecting complete stone extraction. Results: The initial success rates of reaching the papilla of Vater, biliary cannulation, and biliary intervention, including complete stone extraction or biliary stent placement, were 92%, 81%, and 78%, respectively. Of 57 patients with attempted stone extraction, complete stone extraction was successful in 74% for the first session and ultimately in 88%. The adverse events rate was 5%. The multivariate analysis indicated that the largest CBD diameter ≥ 14 mm (odds ratio (OR), 0.04; 95% confidence interval (CI), 0.01–0.58; p = 0.018) and retroflex position (OR, 6.43; 95% CI, 1.12–36.81; p = 0.037) were independent predictive factors affecting complete stone extraction achievement. Conclusions: Therapeutic sDBE-ERCP for CBD stones in a relatively elderly RYG cohort, was effective and safe. A larger CBD diameter negatively affected complete stone extraction, but using the retroflex position may be useful for achieving complete stone clearance.
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Sergi, R., F. Capocasale, C. Caccamo, and A. Scopelliti. "Reno-ureteral stones treated by ESWL: First two years of experience." Urologia Journal 64, no. 4 (August 1997): 468–70. http://dx.doi.org/10.1177/039156039706400425.
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– Extracorporeal shock-wave lithotripsy (ESWL) is one of the greatest steps forward that modern medicine has taken and has revolutionised treatment of reno-ureteral stones. The authors describe their first two years of experience in using a lithotriptor which, together with other surgical and endoscopic procedures, has enabled them to deal with all problems related to renal stone therapy. Three hundred and twenty sessions were carried out, 65% for renal stones and 35% ureteral. Stones in the kidney and upper ureter were crushed in 93.7% of cases and in the pelvic ureter in 59%. A second ESWL session was needed for 6 patients. No significant complications were encountered.
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Tefekli, Ahmet, and Fatin Cezayirli. "The History of Urinary Stones: In Parallel with Civilization." Scientific World Journal 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/423964.
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The roots of modern science and history of urinary stone disease go back to theAncient EgyptiansandMesopotamia. Hippocrates defined the symptoms of bladder stones. The first recorded details of “perineal lithotomy” were those of Cornelius Celsus. Ancient Arabic medicine was based mainly on classical Greco-Roman works. Interestingly, the Fourth Lateran Council in 1215 forbade physicians from performing surgical procedures, as contact with blood or body fluids was viewed as contaminating to men. With Renaissance new procedures could be tried on criminals. The first recorded suprapubic lithotomy was carried out by Pierre Franco in 1561. In 1874, Bigelow developed a lithotrite, which was introduced into the bladder under anaesthesia (called as “litholopaxy”). Young was the first to report ureteroscopy (1929). With advances in intracorporeal lithotripsy techniques, ureteroscopy became the treatment of choice for ureteric stones. In 1976, Fernstrom and Johannson established percutaneous access to remove a renal stone. However, with the introduction of the first extracorporeal shock wave machine in 1980, a dramatic change in stone management was observed. Civilization in parallel with scientific developments has brought us to a point where we try not to “cut” our patients for stone disease, as Hippocrates admonishes, but rather manage them with minimal invasive alternatives.
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El-Assmy, Ahmed, Ahmed R. El-Nahas, Mohamed E. Abo-Elghar, Ibrahim Eraky, Mahmoud R. El-Kenawy, and Khaled Z. Sheir. "Predictors of Success after Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal Calculi Between 20—30 mm: A Multivariate Analysis Model." Scientific World JOURNAL 6 (2006): 2388–95. http://dx.doi.org/10.1100/tsw.2006.370.
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The first-line management of renal stones between 20—30 mm remains controversial. The Extracorporeal Shock Wave Lithotripsy (ESWL) stone-free rates for such patient groups vary widely. The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL in such controversial groups. Between January 1990 and January 2004, 594 patients with renal stones 20—30 mm in length underwent ESWL monotherapy. Stone surface area was measured for all stones. The results of treatment were evaluated after 3 months of follow-up. The stone-free rate was correlated with stone and patient characteristics using the Chi-square test; factors found to be significant were further analyzed using multivariate analysis.Repeat ESWL was needed in 56.9% of cases. Post-ESWL complications occurred in 5% of cases and post-ESWL secondary procedures were required in 5.9%. At 3-month follow-up, the overall stone-free rate was 77.2%. Using the Chi-square test, stone surface area, location, number, radiological renal picture, and congenital renal anomalies had a significant impact on the stone-free rate. Multivariate analysis excluded radiological renal picture from the logistic regression model while other factors maintained their statistically significant effect on success rate, indicating that they were independent predictors. A regression analysis model was designed to estimate the probability of stone-free status after ESWL. The sensitivity of the model was 97.4%, the specificity 90%, and the overall accuracy 95.6%.Stone surface area, location, number, and congenital renal anomalies are prognostic predictors determining stone clearance after ESWL of renal calculi of 20—30 mm. High probability of stone clearance is obtained with single stone ≤400 mm2 located in renal pelvis with no congenital anomalies. Our regression model can predict the probability of the success of ESWL in such controversial groups and can define patients who would need other treatment modality.
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Jang, Dong Kee, Sang Hyub Lee, Dong Won Ahn, Woo Hyun Paik, Jae Min Lee, Jun Kyu Lee, Ji Kon Ryu, and Yong-Tae Kim. "Factors associated with complete clearance of difficult common bile duct stones after temporary biliary stenting followed by a second ERCP: a multicenter, retrospective, cohort study." Endoscopy 52, no. 06 (February 27, 2020): 462–68. http://dx.doi.org/10.1055/a-1117-3393.
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Abstract Background Although temporary endoscopic biliary stenting is considered effective for difficult common bile duct (CBD) stones, few studies have investigated the optimal conditions for complete stone clearance at the second endoscopic retrograde cholangiopancreatography (ERCP) after temporary biliary stenting. We aimed to evaluate factors associated with complete clearance. Methods Patients with difficult CBD stones (a large [≥ 20 mm] or multiple [≥ 3 sized ≥ 15 mm] CBD stones) were retrospectively enrolled from three institutions. Patients who underwent temporary biliary stenting at the first ERCP were analyzed. Double-pigtail plastic stents (7 or 10 Fr) were placed with the proximal ends above the stones. Complete clearance rate and stone size reduction at the second ERCP, and factors associated with complete clearance were evaluated using univariate and multivariate analyses. Results 85 patients were enrolled (mean age 74.5 years [SD 11.3]; 47 women). Stone size and CBD diameter significantly decreased during the interval. The overall complete stone clearance rate was 64.7 % (55/85) at the second ERCP. The mean stone size reduction was 5.6 mm (SD 6.8). In multivariate analysis, complete clearance rate was significantly lower in male patients, in patients aged > 80 years, and in stones > 25 mm initially, but was significantly higher when 7-Fr stents were placed and stone size was reduced by > 5 mm. Conclusion Use of 7-Fr rather than 10-Fr plastic stents was beneficial for complete clearance of difficult CBD stones after temporary biliary stenting; older male patients as well as patients with initial stones > 25 mm had a lower clearance rate.
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Shrestha, Naresh Man. "Semi-Rigid Pneumatic Ureteroscopicremoval of Ureteric Stone; Seven Years Experience At Nepalgunj Medical College." Journal of Nepalgunj Medical College 13, no. 2 (February 6, 2017): 10–12. http://dx.doi.org/10.3126/jngmc.v13i2.16534.
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Background: The present study aimed to report the outcomes of ureteroscopy (URS) treatment of ureteric stone with semi-rigid pneumatic ureteroscopic lithotripsy.Method: This was a prospective observational study of the patients who underwent ureteroscopic removal of ureteric stone in the department of surgery, urology unit, Nepalgunj Medical College from January 2009 to July 2015. All patients underwent urereroscopic removal of stones located at different levels of the ureter using semi-rigid 8/9.8 Fr ureteroscope.Result: 1251 patients with ureteric stones who underwent URS during the study period. Out of 1251 patients, in 1211 (96.80%) stone was removed in first setting, 10(0.79%) patients needed second setting of URS to remove stones. The overall failure rate was 1.59%. The common complications of URS observed were perforations of the ureteric wall (20%), retropulsion of ureteric stone into kidney (35%) and urosepsis (45%) which necessitated ureterolithotomy, Extra Corporeal Shock Wave Lithotripsy (ESWL) and antibiotic therapy, respectively. Two (0.15%) patients died and the cause was urosepsis with multiorgan failure in both.Conclusion: Most of the ureteric stone can be removed in a single setting of URS. However, some complications such as, ureteral trauma, difficulty in fragmentation of a stone, retropulsion of stone into the kidney and a fatal urosepsismay occur in few cases. Therefore, URS is a useful modality to remove the ureteric stones despite its few complications.JNGMC Vol. 13 No. 2 December 2015, page: 10-12
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Somani, Rushabhkumar C., and Chirag K. Sangada. "Study of the safety and efficacy of minimally invasive percutaneous nephrolithotomy in the management of large and complex renal stone." International Surgery Journal 7, no. 3 (February 26, 2020): 725. http://dx.doi.org/10.18203/2349-2902.isj20200812.
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Background: Nephrolithiasis is highly prevalent across all demographic groups in the india and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity. Objective of this study to evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy (PCNL) in the management of large and complex renal stone.Methods: This retrospective study includes 75 renal calculi patients with 100 renal units with large and complicated stone >20 mm. Stones were classified into simple (isolated renal pelvis or isolated calyceal stones) or complex (partial or complete stag horn stones, renal pelvis stones with accompanying calyceal stones). Then various parameter like decrease haemoglobin, surgical complication, creatinine level, duration of surgery etc were compared between simple and complex stones patients by calculation p value using online student t test calculator. P value less than 0.01 considered as a difference of significance.Results: The mean stone size was 35.5±20.37 mm and mean operative duration was 60±35.3 min. In all, cases 60 (80%) were stone-free after the first procedure and another 10 needed an auxiliary procedure (5 second-look PCNL, 3 extracorporeal shockwave lithotripsy-ESWL, 2 ureterorenoscopy, and) to become stone-free, resulting in a 93.33% stone-free rate. Complications occurred in 9 procedures (12%).Conclusions: From this study, it would be concluded that Minimally invasive PCNL provided significantly higher stone-free rate and efficiency quotient for management of urinary calculi. Overall complications are usually observed in patients having intraoperative hypotension and increased intra operative time.
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Sreedharan, Jayadevan, LJ John, HAM Aly Freeg, and J. Muttappallymyalil. "Urolithiasis in male patients: A pilot study on the ethnic differences and clinical profile." Nepal Journal of Epidemiology 4, no. 4 (September 30, 2014): 393–98. http://dx.doi.org/10.3126/nje.v4i4.11359.
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Background Ethnicity play a role in the occurrence of urinary stones, probably related to climatic, environmental and dietary factors in ethnic groups. The association between ethnicity, age, clinical profile, stone size with type of ureteric stones among males with urolithiasis was studied. Materials and Methods Male patients (>18 years) with lower ureteral stones size <10mm attending outpatient department of Urology, at a private hospital, Ajman over a period of one year were included. Ethics approval was obtained from Institutional Ethics Committee. Data was retrieved from the case records which included socio-demographic variables (age, ethnicity), clinical profile (ureteric colic, duration of pain, other complaints), and laboratory investigations (type of stone, stone size). Descriptive and inferential statistics were performed with SPSS-20 and p values <0.05 considered significant. Results 185 male patients were included. Mean age was 41.5 (7.3) years, range (22-71) years. Out of the total, 81 (43.8%) patients were Asians, 81(43.8%) Arabs and 23 (12.4%) were of other ethnicity. Most patients (95.1%) presented with ureteric pain. 49 (26.5%) had family history of stone disease where calcium oxalate monohydrate and uric acid stones were common, with majority being first degree relation. Data on stone type was available for 90 patients; of which, 21 were calcium oxalate monohydrate, 33-calcium oxalate dehydrate, 24-uric acid and remaining 12 other form of stones. Average age for different types of stone was 38.3, 41.6, 39.4 and 42.8 years for calcium oxalate monohydrate, calcium oxalate dehydrate, uric acid and other types respectively. Conclusion Uric acid stones were more prevalent among Asians and calcium oxalate-dehydrate stones among Arabs. Future studies can be conducted among multiethnic population focusing on dietary pattern and stone analysis.DOI: http://dx.doi.org/10.3126/nje.v4i4.11359 Nepal Journal of Epidemiology 2014; 4(4):393-98
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Jasim Mohammed Alzaidy, Othman, and Reyad Ahmed Farhood. "Extra-Corporeal Shock Wave Lithotriposy ( ESWL ) for Lower Ureteral Stone." Diyala Journal of Medicine 19, no. 2 (December 15, 2020): 174–79. http://dx.doi.org/10.26505/djm.19025670920.
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Background: The optimal treatment of ureteral stones, particularly the lower ureteral stone, still controversial[5,13,15,18]. Objective: To assess the success rate of ESWL and tamsulosin in lower ureteral stone. Also to identify the parameters that affects the success rate of ESWL in the lower ureteral stone. Patients and Methods: Prospective study has been done on thirty-six patients sequentially selected from referred cases to the ESWL department in Sulaimania Teaching Hospital in the period from June, 2010 to January, 2011). All had radioopaque lower ureteric stone (from the lower border of sacroiliac joint to uretero-vesical junction). Stones ranging from (5.8 to14mm), twenty in the left side and sixteen in the right side , age ranging from (10 to 78 years), and only four of them had double J-stent (within 1 week before ESWL). Weekly follow up of all patients were done by U/S and twice-weekly by KUB for 6 weeks. Results: Twenty four cases (66.7%) were free of stone, five cases (13.9%) had residual stone and seven cases (19.4%) failed to respond, the most important two parameters that affect the result are the size of stone and number of sessions. Conclusion: ESWL is safe and useful, and it is considered to be the first favorable line of intervention for lower ureteric stones after failure of watchful waiting and medical expulsion therapy especially those without complications like obstruction. Keywords: Lower ureteric stone, extracorporeal shock wave lithotripsy
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Robles-Medranda, Carlos, Miguel Soria-Alcívar, Roberto Oleas, Jorge Baquerizo-Burgos, Miguel Puga-Tejada, Manuel Valero, and Hannah Pitanga-Lukashok. "Digital per-oral cholangioscopy to diagnose and manage biliary duct disorders: a single-center retrospective study." Endoscopy International Open 08, no. 06 (May 25, 2020): E796—E804. http://dx.doi.org/10.1055/a-1153-8950.
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Abstract Background and study aims Digital, per-oral cholangioscopy (POCS) allows diagnosis of biliary ducts disorders and treatment for complicated stones. We aimed to determine the diagnostic accuracy of digital POCS systems for stricture lesions and the factors precluding complete biliary stone clearance. Patients and methods We performed a retrospective analysis of a prospective database of 265 consecutive patients referred for POCS between December 2016 and July 2018. We first analyzed the diagnostic accuracy of digital POCS for malignant and benign stricture lesions in 147 patients. Then, we analyzed the factors associated with complete or partial biliary stone clearance achieved with electrohydraulic lithotripsy (EHL) delivered via POCS in 118 patients. Results In the diagnostic group, digital POCS achieved 91 % visual-impression sensitivity, 99 % specificity, 99 % positive and 91 % negative predictive values, and 63.64 positive and 0.09 negative likelihood ratios for malignancy diagnosis. In the therapeutic group, complete biliary stone clearance was achieved by EHL in 94.9 % patients; the mean stone size was 20 mm (10–40 mm). In multivariable analyses, a stone size > 20 mm (OR: 1.020, P < 0.001) and the number of stones ≥ 3 (OR: 1.276, P < 001) was associated with partial biliary stone clearance. Adverse events were reported in 3.3 % patients; no deaths were reported 30 days after the procedure. Conclusions Digital POCS has excellent diagnostic efficacy for biliary lesions. EHL via POCS is effective for complicated biliary stone clearance. Stone size (> 20 mm) and the number of stones (≥ 3) are associated with partial biliary stone clearance.
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Ozcan, Nevzat, Ahsun Riaz, and Guven Kahriman. "Percutaneous Management of Biliary Stones." Seminars in Interventional Radiology 38, no. 03 (August 2021): 348–55. http://dx.doi.org/10.1055/s-0041-1731373.
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AbstractBile duct stone disease is the most common causes of nonmalignant bile duct obstructions. The range of common bile duct stone formation in patients with cholecystectomy is 3 to 14.7%. Hepatolithiasis, although endemic in some parts of the world, is a rare disease that is difficult to manage. Endoscopic intervention is accepted as the first-line management of common bile duct stones. However, when the bile duct cannot be cannulated for various reasons, the endoscopic procedure fails. In this circumstance, percutaneous approach is an alternative technique for the nonsurgical treatment of bile duct stones. This article reviews the indications, technique, outcomes, and complications of the percutaneous treatment of bile duct stone disease.
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Laube, Norbert, Michael Pullmann, Stefan Hergarten, and Albrecht Hesse. "Influence of Urinary Stones on the Composition of a 24-Hour Urine Sample." Clinical Chemistry 49, no. 2 (February 1, 2003): 281–85. http://dx.doi.org/10.1373/49.2.281.
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Abstract Background: It can be assumed that stones in the urinary tract continuously increase in size by incorporating material from urine. Consequently, urine will exhibit depleted concentrations of lithogenic constituents when urinary stones are present in the patient’s urinary tract. Methods: To calculate the influence of the depletion effect, we considered two different models of stone growth. In the first model, the increase in stone size depends only on the urinary concentration of a lithogenic substance; the second model also considers the surface area of the growing stone. The case of only one kidney being affected by stone formation is considered separately. We discuss example calculations involving the formation of calcium oxalate. Results: The calculated depletion effects are of a nonnegligible order of magnitude. Assuming both a measured oxalate concentration of, e.g., 0.37 mmol/L and a reasonable in vivo stone growing rate of 10 mm3/day, a relative underestimation of the real “in situ” oxalate concentration between ∼21% (model 1) and ∼42% (model 2) occurs. The depletion effect increases markedly with increasing stone growth rate. Conclusions: Metabolic status can be evaluated correctly only in patients who have been declared “stone-free”, e.g., after stone removal. Because the expected stone-related depletion effect in most cases is of high clinical relevance, we recommend estimating the effect of the order of magnitude of the depletion on actual urinary composition.
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Andryukhin, Michail I., Sergey A. Golovanov, Anastasia M. Polikarpova, Michail Y. Prosiannikov, Leonid A. Nersisyan, Nariman K. Gadzhiev, Nair S. Tagirov, Vladimir M. Obidnyak, and Ruslan M. Solh. "Staghorn stones’ composition analysis features." Pediatrician (St. Petersburg) 8, no. 5 (December 15, 2017): 61–66. http://dx.doi.org/10.17816/ped8561-66.
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The lack of standards in the analysis of the chemical composition of the staghorn stones leads to a decrease in the effectiveness of metaphylaxis, and especially in those cases where the volume of the stone is much larger than the volume of the stone fragment being studied. The aim of this study was to develop standards in order to determine the composition of the staghorn calculi. In the Institute of urology from 2015 to 2016, we identified patients with urolithiasis, staghorn-stone nephrolithiasis who were eventually hospitalized. All patients underwent percutaneous nephrolithotripsy, and fragments of the stone were taken in order to analyze its chemical composition. An analysis of the composition of various fragments taken from different zones of the same calculus was made. Patients were divided into 4 groups depending on the composition of the stone. The first group included patients with a predominance of phosphate in the internal layer of the pelvic fragment of the stone, the second group – with a predominance of oxalates, the third – with a predominance of urates, the fourth – with cystine stones. Our experience, while doing stone analysis, showed that the composition did not coincide in 77% of cases, and in 41,6% of cases a new component in the chemical composition of the stone appeared. Complete coincidence of the composition in the cortical and internal layer of the stone was detected in 35% of the cases, and component coincidence in 58% of cases. In the cortical and internal layers of the pelvic fragments, the total and component coincidence of the composition was 38% and 58%, respectively. Thus, we show the importance of chemical analysis of stones and that the composition of the stone may vary, depending on its location. Timely detection of changes in the nature of the stone allows an adequate treatment of urolithiasis.
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Maydeo, Amit P., Rungsun Rerknimitr, James Y. Lau, Abdulrahman Aljebreen, Saad K. Niaz, Takao Itoi, Tiing Leong Ang, et al. "Cholangioscopy-guided lithotripsy for difficult bile duct stone clearance in a single session of ERCP: results from a large multinational registry demonstrate high success rates." Endoscopy 51, no. 10 (June 27, 2019): 922–29. http://dx.doi.org/10.1055/a-0942-9336.
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Abstract Background Peroral cholangioscopy (POCS) can be useful for difficult bile duct stone clearance. Large prospective multinational data on POCS-guided lithotripsy for clearing difficult bile duct stones in a single session of endoscopic retrograde cholangiopancreatography (ERCP) are missing. Methods Patients with difficult bile duct stones (defined as one or more of: largest stone diameter ≥ 15 mm, failed prior attempt at stone clearance, impacted, multiple, hepatic duct location, or located above a stricture) were enrolled at 17 centers in 10 countries. The principal endpoint was stone clearance in a single ERCP procedure using POCS. Results 156 patients underwent 174 sessions of POCS-guided electrohydraulic or laser lithotripsy. Stone clearance had failed in a previous ERCP using traditional techniques in 124/156 patients (80 %), while 32 /156 patients (21 %) were referred directly to POCS-guided therapy based on preprocedural assessment of the difficulty of stone clearance. In 101/156 patients (65 %), there were impacted stones. POCS-guided stone clearance was achieved in a single POCS procedure in 125 /156 patients (80 %, 95 % confidence interval [CI] 73 % – 86 %), and was significantly more likely for stones ≤ 30 mm compared with > 30 mm (odds ratio 7.9, 95 %CI 2.4 – 26.2; P = 0.002). Serious adverse events occurred in 3/156 patients (1.9 %, 95 %CI 0.4 % – 5.5 %), and included pancreatitis, perforation due to laser lithotripsy, and cholangitis (n = 1 each), all resolved within 1 week. Conclusion POCS-guided lithotripsy is highly effective for clearance of difficult bile duct stones in a single procedure and successfully salvages most prior treatment failures. It may also be considered first-line therapy for patients with difficult choledocholithiasis to avoid serial procedures.
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Atmoko, Widi, Ponco Birowo, and Nur Rasyid. "Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years." F1000Research 5 (August 30, 2016): 2106. http://dx.doi.org/10.12688/f1000research.9509.1.
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Objectives: Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Methods: We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. Results: The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery (p = 0.01), stone burden (p = < 0.001), and type of anesthesia (p = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; p 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; p 0.00] were significant independent risk factors for stone-free.
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Atmoko, Widi, Ponco Birowo, and Nur Rasyid. "Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years." F1000Research 5 (September 30, 2016): 2106. http://dx.doi.org/10.12688/f1000research.9509.2.
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Objectives: Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Methods: We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. Results: The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery (p = 0.01), stone burden (p = < 0.001), and type of anesthesia (p = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; p 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; p 0.00] were significant independent risk factors for stone-free.
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Franch, L., A. Rippa, D. Arena, P. Franch, C. Sangalli, and N. Nicolai. "ESWL Monotherapy." Urologia Journal 64, no. 1 (February 1997): 14–18. http://dx.doi.org/10.1177/039156039706400102.
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Between February 1988 and December 1995, 1563 consecutive patients who had never previously been treated for ureteral stones were admitted to our hospital: 1535 (98%) underwent primary ESWL (with Lithostar plus) with fractioned doses and 28 (2%) needed primary endosurgery. At present 1327 (87%) patients can be evaluated. Up to 6,000 SW were given to 733 (55%) patients: 93% achieved complete clearance. Of the 594 (45%) patients who completed treatment, 195 (33%) achieved complete clearance with first treatment, 27 (5%) required endosurgery and 372 (62%) were treated again, of whom 279 (75%) were made stone-free. Overall 877 (66%) were stone-free following first treatment; 1156 (87%) following second treatment and 171 (13%) were failures. Lumbar (9% failure) and ≤0.6 cm (6% failure) stones gave higher success rates. Auxiliary pre-ESWL manoeuvres were reduced from 112/352 (32%) prior to 1990 to 75/975 (8%) after 1990, without affecting outcome (failures were 11 and 13.6% respectively). In-situ ESWL is a safe therapy for ureteral stones and in our experience capable of rendering 87% of patients stone-free.
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Denburg, Michelle R., Kristen Koepsell, Jung-Jin Lee, Jeffrey Gerber, Kyle Bittinger, and Gregory E. Tasian. "Perturbations of the Gut Microbiome and Metabolome in Children with Calcium Oxalate Kidney Stone Disease." Journal of the American Society of Nephrology 31, no. 6 (May 7, 2020): 1358–69. http://dx.doi.org/10.1681/asn.2019101131.
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BackgroundThe relationship between the composition and function of gut microbial communities and early-onset calcium oxalate kidney stone disease is unknown.MethodsWe conducted a case-control study of 88 individuals aged 4–18 years, which included 44 individuals with kidney stones containing ≥50% calcium oxalate and 44 controls matched for age, sex, and race. Shotgun metagenomic sequencing and untargeted metabolomics were performed on stool samples.ResultsParticipants who were kidney stone formers had a significantly less diverse gut microbiome compared with controls. Among bacterial taxa with a prevalence >0.1%, 31 taxa were less abundant among individuals with nephrolithiasis. These included seven taxa that produce butyrate and three taxa that degrade oxalate. The lower abundance of these bacteria was reflected in decreased abundance of the gene encoding butyryl-coA dehydrogenase (P=0.02). The relative abundance of these bacteria was correlated with the levels of 18 fecal metabolites, and levels of these metabolites differed in individuals with kidney stones compared with controls. The oxalate-degrading bacterial taxa identified as decreased in those who were kidney stone formers were components of a larger abundance correlation network that included Eggerthella lenta and several Lactobacillus species. The microbial (α) diversity was associated with age of stone onset, first decreasing and then increasing with age. For the individuals who were stone formers, we found the lowest α diversity among individuals who first formed stones at age 9–14 years, whereas controls displayed no age-related differences in diversity.ConclusionsLoss of gut bacteria, particularly loss of those that produce butyrate and degrade oxalate, associates with perturbations of the metabolome that may be upstream determinants of early-onset calcium oxalate kidney stone disease.
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Hamal, Bhairab Kumar, Bharat Bahadur Bhandari, and Narayan Thapa. "Extracorporeal Shock Wave Lithotripsy in Management of Urolithiasis." Journal of Patan Academy of Health Sciences 1, no. 1 (July 20, 2015): 4–7. http://dx.doi.org/10.3126/jpahs.v1i1.13007.
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Introductions: Since 1980, when Chaussy in West Germany first demonstrated the efficacy of Dornier prototype lithotripsy HM1, extra corporeal shock wave lithotripsy has become a convenient, noninvasive, outpatient procedure used to fragment urinary stones. It is a standard internationally accepted first line preferred option for the management of renal stone less than 2.5 cm size. Methods: A cross sectional study was conducted in the department of surgery of Shree Birendra Hospital on outpatient department basis during the period of March 2002 to February 2012. All consecutive patients presenting with renal and upper ureteric stones detected either on X-ray or ultrasound of the Kidney- Ureter-Bladder who were treated with extra corporeal shock wave lithotripsy. Descriptive analysis included age, sex, stone location, need of total session, use of double J stent and complications. Results: Total 710 diagnosed cases of urolithiasis were taken for the study. The youngest age was 16 years and oldest 69 years of age. Overall stone clearance rate was 73.52%. The stone free rate for upper, middle, and lower calyx were 85.94%, 90.20% and 50.52% respectively. Conclusions: Extracorporeal shock wave lithotripsy was successful in the management of the stones smaller than 2.5 cm in all caliceal locations and minimal morbidity.Plain Language Summary ESWL with new generation Lithotripter was safe and effective in adult out patients with urolithiasis less than 2.5 cm in functioning kidney without distal obstruction or urine infection. Stone clearance was 70%. DJ stenting was done in stone larger than 2 cm. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13007 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):4-7
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Çakıroğlu, Basri, Erkan Eyyupoğlu, Aydin Ismet Hazar, Bekir Sami Uyanik, and Bariş Nuhoğlu. "Metabolic assessment of recurrent and first renal calcium oxalate stone formers." Archivio Italiano di Urologia e Andrologia 88, no. 2 (July 4, 2016): 101. http://dx.doi.org/10.4081/aiua.2016.2.101.
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Objectives: This study aimed to demonstrate the dominant role of metabolic disorders in the formation of calcium oxalate stones in patients with recurrent urolithiasis, as well as in patients experiencing their first episode of urolithiasis. Patients and Methods: The records of the patients who attended our kidney stone outpatient clinics between 2008 and 2012 were reviewed, and the data of 318 calcium oxalate stone patients who had undergone a metabolic assessment were retrospectively analysed. The patients were divided in two groups. The first group included the patients who presented with their first episode of urolithiasis (Group 1, n = 170), and the second group included patients with recurrent urolithiasis (Group 2, n = 148); intergroup comparisons of metabolic disorders were performed. Results: A significant difference was found between the two groups in mean urine calcium levels (Group 1, 0.25; Group 2, 0.31; p = 0.001); the mean serum calcium level was found to be significantly higher although at less extent in Group 2 (Group 1, 9.4; Group 2, 9.6); p = 0.04). Significant differences were also found in mean urine citrate (Group 1, 481.9; Group 2, 397.2, p < 0.0001) and oxalate levels (Group 1, 22.1; Group 2, 28.5; p < 0.0001) . Conclusions: This study revealed a metabolic tendency to hypercalciuria in calcium oxalate stone patients, predominantly in those with recurrent calcium oxalate urolithiasis. Urinary oxalate excretion was found to be higher in recurrent urolithiasis in comparison to the first episode of calcium oxalate urolithiasis and urinary citrate excretion lower in recurrent urolithiasis.
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Assimos, Dean G. "Re: Stone Composition among First-Time Symptomatic Kidney Stone Formers in the Community." Journal of Urology 195, no. 2 (February 2016): 383–84. http://dx.doi.org/10.1016/j.juro.2015.10.092.
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Malfilatre, Claudine, Erwan Hallot, Philippe Boulvais, Marc Poujol, Annick Chauvin, Denis Gapais, Marie-Pierre Dabard, Sylvie Bourquin, and Didier Pallix. "Fingerprinting the provenance of building stones: a case study on the Louvigné and Lanhélin granitic rocks (Armorican massif, France)." Bulletin de la Société Géologique de France 185, no. 1 (January 1, 2014): 13–31. http://dx.doi.org/10.2113/gssgfbull.185.1.13.
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Abstract Two examples of granitic stones from Brittany (western France) commercialized under the names of “gris-bleu de Louvigné” and “bleu de Lanhélin” were characterized in order to explore how the provenance of a building stone can be traced back with a maximum of confidence. For this purpose, petrographical, geochemical and magnetic characteristics, representing more than 70 quantitative and qualitative variables, were compiled for a total of 32 samples. We have defined two reference populations for these building stones and have extracted their discriminative characteristics. We have then compared four randomly selected samples and two foreign commercial counterparts of these stones to the reference populations. Discriminative variables differ from one case of comparison to the other, which indicates that a combination of various tools and variables will be generally required to unequivocally fingerprint the origin of a given granitic stone. Where several quarries are mining a single geological unit within a composite intrusion, the provenance of a granitic rock can be defined at the scale of the intrusion. In addition, stones coming from two different intrusions from the same batholith can be distinguished. We conclude that the provenance of any granitic building stone is identifiable, especially if the intrinsic variability of a population of samples representative of that stone has been previously circumscribed. This study underlines that the compilation of databases for building stone identity cards is an essential first step toward the creation of official labels guaranteeing stone provenances.
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Angsuwatcharakon, Phonthep, Santi Kulpatcharapong, Wiriyaporn Ridtitid, Chaloemphon Boonmee, Panida Piyachaturawat, Pradermchai Kongkam, Wattana Pareesri, and Rungsun Rerknimitr. "Digital cholangioscopy-guided laser versus mechanical lithotripsy for large bile duct stone removal after failed papillary large-balloon dilation: a randomized study." Endoscopy 51, no. 11 (February 20, 2019): 1066–73. http://dx.doi.org/10.1055/a-0848-8373.
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Abstract Background Endoscopic papillary large-balloon dilation (EPLBD) allows for the complete removal of large common bile duct (CBD) stones without fragmentation; however, a significant proportion of very large stones and stones floating above a tapering CBD require lithotripsy. Mechanical lithotripsy and cholangioscopy-guided laser lithotripsy are both effective for stone fragmentation. This study aimed to directly compare, for the first time, the efficacy of these two techniques in terms of stone clearance rate, procedure duration, patient radiation exposure, and safety. Methods 32 patients with very large CBD stones or with stones floating above a tapering CBD, and in whom extraction after standard sphincterotomy and/or EPLBD had failed, were randomly assigned to mechanical lithotripsy or cholangioscopy-guided laser lithotripsy at two tertiary referral centers. Crossover was allowed as a rescue treatment if the assigned technique failed. Results Patients’ demographic data were not different between the two groups. Mechanical lithotripsy had a significantly lower stone clearance rate in the first session compared with laser lithotripsy (63% vs. 100%; P < 0.01). Laser lithotripsy rescued 60% of patients with failed mechanical lithotripsy by achieving complete stone clearance within the same session. Radiation exposure of patients was significantly higher in the mechanical lithotripsy group than in the laser lithotripsy group (40 745 vs. 20 989 mGycm2; P = 0.04). Adverse events (13% vs. 6%; P = 0.76) and length of hospital stay (1 vs. 1 day; P = 0.27) were not different. Conclusions Although mechanical lithotripsy is the standard of care for a very large CBD stone after failed EPLBD, where available, cholangioscopy-guided laser lithotripsy is considered the better option for the treatment of this entity as it provides a higher success rate and lower radiation exposure.
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Sapkota, Prakash, Y. B. Tambey, Sunil Thapa, and Rajan Shakya. "Initial Experience of Percutaneous Nephrolithotomy at Lumbini Medical College." Journal of Lumbini Medical College 1, no. 1 (June 30, 2013): 35. http://dx.doi.org/10.22502/jlmc.v1i1.11.
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Introduction: Renal stone disease is a challenging problem in urologic practice especially in our locality because of large stone burden and recurrence. Since ,the early 1980s when percutaneous nephrolithotomy (PCNL) was established for management of renal stones, open surgical procedures have virtually been replaced. PCNL is a safe, effective and minimally invasive approach compared to open surgery for patients with large single, multiple or staghorn stones. The aim of this prospective study was to evaluate and to review our experience with PCNL in management of renal and upper ureteric stones.
Methods: Prospective study carried out at Lumbini Medical College and Teaching Hospital during 1stJanuary 2011 to 31st October 2011. Sixty patients were evaluated and subjected to PCNL. After clinical investigations like ultrasonography (USG) and intravenous urography (IVU), once patients were found to have renal or upper ureteric stones they were informed and explained about PCNL, its likely complications, probable hospital stay, the cost of treatment and data were recorded along with the operative time, estimated blood loss, stone burden, stone-free rate, length of hospitalization and complications .Patients were followed up after three months to rule out recurrence of stones by plain abdominal x-ray of kidney, ureter and bladder and USG.
Results: Out of 60 patients 35 were male and 25 were female (M: F=1.4:1) with mean age of 37 years and were subjected to PCNL monotherapy. With the average stone size of 3.26cm, the mean operative time was 78 minutes. Complete stone removal achieved by PCNL alone in 60 cases, with insignificant residual small stones we achieved 97% stone clearance rate. The mean hospital stay was 3.7 days. No Serious complications were encountered, 9 (15%) patients required blood transfusion and 3 (5%) patients developed transient post-operative pyrexia.
Conclusion: PCNL is the first line treatment option for management of large renal stones which as monotherapy has advantages in removal of renal and upper ureteric stones and achieving excellent results with minimal morbidity.