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| The role of ureteroscopy for treatment of staghorn calculi: A systematic review |
Etienne Xavier Kellerab,c,Vincent De Coninckab,d,Steeve Doiziab,Olivier Traxerb,*( )
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a Sorbonne Université, Service d’Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France
b Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020, Paris, France
c Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
d Department of Urology, AZ Klina, Brasschaat, Belgium |
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Abstract Objective: To define the role of ureteroscopy for treatment of staghorn calculi.
Methods: A systematic review was conducted using the Scopus and Medline databases. Original articles and systematic reviews were selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only studies relating to the role of ureteroscopy for treatment of staghorn calculi were included.
Results: In five studies on ureteroscopic monotherapy, stone-free rate (SFR) ranged from 33% to 93%, with a maximum four ureteroscopy sessions per patient and no major complications. Endoscopic combined intrarenal surgery (ECIRS) was compared with percutaneous nephrolithotomy (PNL) in two studies and reached significantly higher SFR (88%-91% vs. 59%-65%) and lower operative times (84-110 min vs. 105-129 min). The role of salvage ureteroscopy for residual stones after primary PNL has been highlighted by two studies with a final SFR of 83%-89%. One study reported on the feasibility of ureteroscopy for ureteral stones and same-session PNL for contralateral staghorn calculi, with a SFR of 92%.
Conclusion: Ureteroscopy plays a pivotal role in the setting of a combined approach to staghorn calculi. Ureteroscopy is also particularly suitable for clearance of residual stones. In specific cases, ureteroscopy may become the sole applicable therapeutic option to staghorn calculi. Technological advances and refinement of techniques suggest a major role of ureteroscopy for staghorn calculi treatment in close future.
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Received: 02 June 2019
Available online: 05 December 2019
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Corresponding Authors:
Olivier Traxer
E-mail: olivier.traxer@aphp.fr
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Staghorn calculi. (A) Complete staghorn calculi occupy the whole pyelocaliceal cavities; (B) Partial staghorn calculi have at least one calyceal branch attached to the renal pelvis.
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Flow chart of the literature search.
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Combined approach to staghorn calculi. (A) Complete staghorn calculi may preclude antegrade access to the pyelocaliceal cavities; (B) Primary retrograde approach allows for stone debulking by the means of flexible ureteroscopy with laser lithotripsy; (C) Antegrade guidewire insertion becomes possible after sufficient stone debulking. The arrow indicates the typical percutaneous way of insertion of a guidewire; (D) Synergistical use of the antegrade and retrograde approach. Flexible ureteroscopy is used for calyces that would be difficult to access with a nephroscope, alleviating the need for additional percutaneous tract dilations.
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| Topic | Patient position | Risks and limitations | | Anesthesia | Prone | Accidental extubation and endotracheal tube kinking, impaired ventilation and circulation, neck, eyeball and peripheral plexus injuries | | Puncture | Supine | Restricted area of puncture, greater amplitude of respiratory movements of the kidney (debated), more challenging upper pole calyceal puncture (debated), longer tract length with decreased nephroscope mobility (debated) | | Navigation | Supine | Restricted working space, rapid intrarenal pressure loss and collapse of pyelocaliceal cavities (debated, may become an advantage) | | Stone extraction | Prone | Lower probability for spontaneous stone evacuation over the percutaneous access sheath (exception: Use of the vacuum cleaner effect) | | Ureteroscopy | Prone | Restricted working space, unusual navigation (inverted anatomy), potentially higher risk for stool contamination |
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Risks and limitations of patient positioning for combined approaches to staghorn calculi (expert opinion).
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| [1] |
G.M. Preminger, D.G. Assimos, J.E. Lingeman, S.Y. Nakada, M.S. Pearle, J.S. Wolf Jr., et al. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol, 173(2005), pp. 1991-2000.
|
| [2] |
D.P. Viprakasit, M.D. Sawyer, S.D. Herrell, N.L. Miller. Changing composition of staghorn calculi. J Urol, 186(2011), pp. 2285-2290.
|
| [3] |
M. Daudon, P. Jungers. Stone composition and morphology: a window on etiology. J.J.T.H. Talati, D.M. Albala, Z. Ye (Eds.), Urolithiasis: basic science and clinical practice, Springer, London(2012), pp. p113-p140.
|
| [4] |
K.M. Al-Kohlany, A.A. Shokeir, A. Mosbah, T. Mohsen, A.M. Shoma, I. Eraky, et al. Treatment of complete staghorn stones: a prospective randomized comparison of open surgery versus percutaneous nephrolithotomy. J Urol, 173(2005), pp. 469-473.
|
| [5] |
J. Cohen, S. Cohen, M. Grasso. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi. BJU Int, E127(2013), pp. e180-E131. 10.1111/j.1464-410X.2012.11352.x.
doi: 10.1111/j.1464-410X.2012.11352.x
|
| [6] |
Y. Aso, N. Ohta, M. Nakano, Y. Ohtawara, A. Tajima, K. Kawabe. Treatment of staghorn calculi by fiberoptic transurethral nephrolithotripsy. J Urol, 144(1990), pp. 17-19.
|
| [7] |
M. Grasso, M. Conlin, D. Bagley. Retrograde ureteropyeloscopic treatment of 2 cm or greater upper urinary tract and minor Staghorn calculi. J Urol, 160(1998), pp. 346-351.
|
| [8] |
J.C. Wheat, W.W. Roberts, J.S. Wolf Jr. Multi-session retrograde endoscopic lithotripsy of large renal calculi in obese patients. Can J Urol, 16(2009), pp. 4915-4920.
|
| [9] |
K.B. Scotland, B. Rudnick, K.A. Healy, S.G. Hubosky, D.H. Bagley. Retrograde ureteroscopic management of large renal calculi: a single institutional experience and concise literature review. J Endourol, 32(2018), pp. 603-607.
|
| [10] |
R.J. Kahnoski, J.E. Lingeman, T.A. Coury, R.E. Steele, P.G. Mosbaugh. Combined percutaneous and extracorporeal shock wave lithotripsy for staghorn calculi: an alternative to anatrophic nephrolithotomy. J Urol, 135(1986), pp. 679-681.
|
| [11] |
J.W. Segura, D.E. Patterson, A.J. LeRoy. Combined percutaneous ultrasonic lithotripsy and extracorporeal shock wave lithotripsy for struvite staghorn calculi. World J Urol, 5(1987), pp. 245-247.
|
| [12] |
S. Meretyk, O.N. Gofrit, O. Gafni, D. Pode, A. Shapiro, A. Verstandig , et al. Complete staghorn calculi: random prospective comparison between extracorporeal shock wave lithotripsy monotherapy and combined with percutaneous nephrostolithotomy. J Urol, 157(1997), pp. 780-786.
|
| [13] |
T. Lehman, D.H. Bagley. Reverse lithotomy: modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women. Urology, 32(1988), pp. 529-531.
|
| [14] |
M. Grasso, R. Nord, D.H. Bagley. Prone split leg and flank roll positioning: simultaneous antegrade and retrograde access to the upper urinary tract. J Endourol, 7(1993), pp. 307-310.
|
| [15] |
M. Grasso, G. Lang, F.C. Taylor. Flexible ureteroscopically assisted percutaneous renal access. Tech Urol, 1(1995), pp. 39-43.
|
| [16] |
M. Grasso, G. Lang, P. Loisides, D. Bagley, F. Taylor. Endoscopic management of the symptomatic caliceal diverticular calculus. J Urol, 153(1995), pp. 1878-1881.
|
| [17] |
J. Landman, R. Venkatesh, D.I. Lee, J. Rehman, M. Ragab, M. Darcy , et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol, 169(2003), pp. 64-67.
|
| [18] |
C.G. Marguet, W.P. Springhart, Y.H. Tan, A. Patel, S. Undre, D.M. Albala , et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. BJU Int, 96(2005), pp. 1097-1100.
|
| [19] |
C.F. Kidd, M.J. Conlin. Ureteroscopically assisted percutaneousrenal access. Urology, 61(2003), pp. 1244-1245.
|
| [20] |
S. Hamamoto, T. Yasui, A. Okada, S. Koiwa, K. Taguchi, Y. Itoh , et al. Efficacy of endoscopic combined intrarenal surgery in the prone split-leg position for staghorn calculi. J Endourol, 29(2015), pp. 19-24.
|
| [21] |
G. Ibarluzea, C.M. Scoffone, C.M. Cracco, M. Poggio, F. Porpiglia, C. Terrone , et al. Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access. BJU Int, 100(2007), pp. 233-236.
|
| [22] |
E.A.C. Neto, A.I. Mitre, C.M. Gomes, M.A. Arap, M. Srougi. Percutaneous nephrolithotripsy with the patient in a modified supine position. J Urol, 178(2007), pp. 165-168.
|
| [23] |
T. Manohar, P. Jain, M. Desai. Supine percutaneous nephrolithotomy: effective approach to high-risk and morbidly obese patients. J Endourol, 21(2007), pp. 44-49.
|
| [24] |
C.M. Scoffone, C.M. Cracco, M. Cossu, S. Grande, M. Poggio, R.M. Scarpa. Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: a new standard for percutaneous nephrolithotomy? Eur Urol, 54(2008), pp. 1393-1403.
|
| [25] |
C.M. Scoffone, C.M. Cracco. Invited review: the tale of ECIRS (Endoscopic Combined IntraRenal Surgery) in the Galdakao-modified supine Valdivia position. Urolithiasis, 46(2018), pp. 115-123.
|
| [26] |
D. Lai, Y. He, Y. Dai, X. Li. Combined minimally invasive percutaneous nephrolithotomy and retrograde intrarenal surgery for staghorn calculi in patients with solitary kidney. PLoS One, 7 ( 2012), Article e48435.
|
| [27] |
W. Zhong, Z. Zhao, L. Wang, S. Swami, G. Zeng. Percutaneous-based management of Staghorn calculi in solitary kidney: combined mini percutaneous nephrolithotomy versus retrograde intrarenal surgery. Urol Int, 94(2015), pp. 70-73.
|
| [28] |
J. Wen, G. Xu, C. Du, B. Wang. Minimally invasive percutaneous nephrolithotomy versus endoscopic combined intrarenal surgery with flexible ureteroscope for partial staghorn calculi: a randomised controlled trial. Int J Surg, 28(2016), pp. 22-27.
|
| [29] |
G. Xu, X. Li, Y. He, Z. He. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney. Urol Res, 40(2012), pp. 745-749.
|
| [30] |
G. Zeng, Z. Zhao, W. Wu, W. Zhong. Combination of debulking single-tract percutaneous nephrolithotomy followed by retrograde intrarenal surgery for staghorn stones in solitary kidneys. Scand J Urol, 48(2014), pp. 295-300.
|
| [31] |
D.J. Jones, M.J. Kellett, J.E. Wickham. Percutaneous nephrolithotomy and the solitary kidney. J Urol, 145(1991), pp. 477-479. discussion 9-80.
|
| [32] |
M.Y. Wong. Evolving technique of percutaneous nephrolithotomy in a developing country: Singapore General Hospital experience. J Endourol, 12(1998), pp. 397-401.
|
| [33] |
H.D. Nguyen, Y.H. Tan, M.Y. Wong. Percutaneous nephrolithotomy in the management of complex upper urinary tract calculi: the Singapore General Hospital experience. Ann Acad Med Singapore, 31(2002), pp. 516-519.
|
| [34] |
A.A. Shokeir, A.R. El-Nahas, A.M. Shoma, I. Eraky, M. El-Kenawy, A. Mokhtar, et al. Percutaneous nephrolithotomy in treatment of large stones within horseshoe kidneys. Urology, 64(2004), pp. 426-429.
|
| [35] |
S. Symons, C.S. Biyani, S. Bhargava, H.C. Irvine, J. Ellingham, J. Cartledge , et al. Challenge of percutaneous nephrolithotomy in patients with spinal neuropathy. Int J Urol, 13(2006), pp. 874-879.
|
| [36] |
E.N. Liatsikos, P. Kallidonis, J.U. Stolzenburg, M. Ost, F. Keeley, O. Traxer , et al. Percutaneous management of staghorn calculi in horseshoe kidneys: a multi-institutional experience. J Endourol, 24(2010), pp. 531-536.
|
| [37] |
A.R. El-Nahas, I. Eraky, A.A. Shokeir, A.M. Shoma, A.M. El-Assmy, N.A. El-Tabey, et al. Percutaneous nephrolithotomy for treating staghorn stones: 10 years of experience of a tertiary-care centre. Arab J Urol, 10(2012), pp. 324-329.
|
| [38] |
S. Yan, F. Xiang, S. Yongsheng. Percutaneous nephrolithotomy guided solely by ultrasonography: a 5-year study of >700 cases. BJU Int, 112(2013), pp. 965-971.
|
| [39] |
L. Chen, M.L. Sha, D. Li, J. Zhuo, C.Y. Jiang, Y.P. Zhu , et al. Treatment for residual stones using flexible ureteroscopy and holmium laser lithotripsy after the management of complex calculi with single-tract percutaneous nephrolithotomy. Lasers Med Sci, 32(2017), pp. 649-654.
|
| [40] |
E. Kaya, T. Ebilo?lu, M. Zor, S. Yal??n, A.E. Co?uplugil, S. Bedir. The outcome of percutaneous nephrolithotomy on ≥50 mm staghorn and multiple calyceal stones. Turk J Urol, 44(2018), pp. 148-152.
|
| [41] |
P.F. Shen, N. Liu, W.R. Wei, P. Xu, S. Li, Y.H. Luo , et al. Simultaneous ureteroscopic lithotripsy and contralateral percutaneous nephrolithotomy for ureteral calculi combined with renal staghorn calculi. Int J Urol, 22(2015), pp. 943-948.
|
| [42] |
F. Marini, F. Martino, V. Alfano, R. Valente. Combined therapy of staghorn calculi with ureteronephroscopy (URS) and extracorporeal shock wave lithotripsy (ESWL) . Arch Esp Urol, 42(1989), pp. 945-947.
|
| [43] |
S.P. Dretler. Ureteroscopic fragmentation followed by extracorporeal shock wave lithotripsy: a treatment alternative for selected large or staghorn calculi. J Urol, 151(1994), pp. 842-846.
|
| [44] |
S. Mugiya, K. Suzuki, T. Ushiyama, K. Fujita. Combined treatment of staghorn calculi by fiberoptic transurethral nephrolithotripsy and extracorporeal shock wave lithotripsy. Int J Urol, 5(1998), pp. 129-133.
|
| [45] |
C. Turk, A. Skolarikos, A. Neisius, A. Petrik, C. Seitz, K. Thomas. EAU guidelines on urolithiasis, last update March 2019. Available at: https://uroweb.org/guideline/urolithiasis, Accessed 18th Mar 2019
|
| [46] |
D. Assimos, A. Krambeck, N.L. Miller, M. Monga, M.H. Murad, C.P. Nelson , et al. Surgical management of stones: American Urological Association/Endourological Society guideline, PART II. J Urol, 196(2016), pp. 1161-1169.
|
| [47] |
S. Undre, S. Olsen, N. Mustafa, A. Patel. “Pass the ball!” Simultaneous flexible nephroscopy and retrograde intrarenal surgery for large residual upper-pole staghorn stone. J Endourol, 18(2004), pp. 844-847.
|
| [48] |
G. Giusti, S. Proietti M.E. Rodriguez-Socarras, B.H. Eisner, G. Saitta, G. Mantica, , et al. Simultaneous Bilateral Endoscopic Surgery (SBES) for patients with bilateral upper tract urolithiasis: technique and outcomes. Eur Urol, 74(2018), pp. 810-815.
|
| [49] |
E.X. Keller, V. De Coninck, O. Traxer. Next-generation fiberoptic and digital ureteroscopes. Urol Clin North Am, 46(2019), pp. 147-163.
|
| [50] |
X. Deng, L. Song, D. Xie, D. Fan, L. Zhu, L. Yao , et al. A novel flexible ureteroscopy with intelligent control of renal pelvic pressure: an initial experience of 93 cases. J Endourol, 30(2016), pp. 1067-1072.
|
| [51] |
J. Huang, D. Xie, R. Xiong, X. Deng, C. Huang, D. Fan , et al. The application of suctioning flexible ureteroscopy with intelligent pressure control in treating upper urinary tract calculi on patients with a solitary kidney. Urology, 111(2018), pp. 44-47.
|
| [52] |
Traxer, E.X. Keller. Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser. World J Urol (2019), 10.1007/s00345-019-02654-5.
doi: 10.1007/s00345-019-02654-5
|
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