Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Surgical options for kidney stone removal:An overview of main procedures Christos Rafail Karathanasis Medical School, European University Cyprus Abstract Percutaneous Nephrolithotomy • Technique:A1 cm incision is made in the flank to access the Kidney stones, or nephrolithiasis, represent a prevalent urological kidney directly with a nephroscope via anAmplatz sheath. disorder with significant morbidity, affecting up to 12% of men and 6% of women during their lifetime. While most stones pass • Anesthesia: General anesthesia; patient prone or supine. spontaneously, 10–20% of cases require surgical intervention. This • Stone Removal: Mechanical fragmentation, lithotripsy, or laser.A overview explores three primary surgical options for kidney stone nephrostomy tube is placed after the procedure. removal: ureteroscopy (URS), percutaneous nephrolithotomy • Advantages: Best for large stones (>2 cm), very effective. • Complications: Hemorrhage, infection (possible sepsis), injury to (PCNL), and extracorporeal shockwave lithotripsy (ESWL). Each nearby organs, failure of stone clearance. 4 procedure offers unique benefits and is selected based on stone size, location, and patient-specific factors. URS provides direct access with minimal invasiveness, PCNL is preferred for larger or complex stones, and ESWL is favored for its noninvasive approach in small stone cases. This abstract summarizes the indications, techniques, and potential complications of these interventions, aiming to inform clinical decision-making and optimize patient outcomes. Introduction Arenal stone is a cluster of crystals composed of minerals and salts that are formed inside the kidneys. The type of renal calculi is Figure 2“Percutaneous Nephrolithotomy (PCNL) Penrith, Sydney, Australia | Mini- determined by their main constituent. Calcium stones constitute the PERC (Mini PCNL) Sydney.” Kidneystoneclinic.com.au, 2019, most common type of kidney stones.Although kidney stones rarely www.kidneystoneclinic.com.au/percutaneous-nephrolithotomy-pcnl-including-mini- perc-mini-pcnl.html. result in a life-threatening event, they can still impose a significant risk of morbidity. Furthermore, nephrolithiasis causes excruciating pain, and it is worth mentioning that many women rate the pain as worse than childbirth. 2 Extracorporeal Shockwave Lithotripsy • Technique: High-energy shockwaves from outside the body fragment the stones while the patient lies on a water cushion. Aims • Anesthesia: General anesthesia or IV sedation. The aim of this poster is to inform medical students about the main • Stone Removal: Stones <10 mm are ideal, fragments pass surgical interventions of renal stones. Information is provided about naturally. the surgical procedures, as well as the advantages and disadvantages • Advantages: Noninvasive, minimal recovery time. of each one. • Complications: Risk of urinary tract infections (UTI), bacteremia, kidney hematomas, and possible ureteral blockage (steinstrasse). 5 Methods Databases Searched • PubMed • Google Scholar (August 2024 – October 2024) Search Terms • "Renal stone" • "Ureterolithiasis" • " Percutaneous nephrolithotomy" • " Extracorporeal Shockwave Lithotripsy " Figure 3“Lithotripsy ESWL | Bowie MD | Kidney Stone Treatment.” MAUA, www.mauamd.com/lithotripsy-eswl-kidney-stones-treatment-greenbelt-md-annapolis- Inclusion Criteria md-washington-dc/. • RCTs, cohort studies, systematic reviews Exclusion Criteria Conclusion • Non-English studies Nephrolithiasis is a prevalent health issue that can lead to intense • Abstracts, editorials, opinions • No full-text available pain in those affected.Advances in surgical techniques have provided several effective and minimally invasive options for stone removal. Fortunately, only a small percentage of renal stones require surgery. The three most used procedures are Ureteroscopy, Percutaneous Nephrolithotomy, and Extracorporeal Shockwave Lithotripsy. Results Ureteroscopy Although all three methods are successful in treating kidney stones, each has specific indications, benefits, and potential complications • Technique:Arigid or flexible scope with a camera is inserted that should be carefully considered. through the urethra to the bladder and up the ureter to locate and remove stones. • Anesthesia: General anesthesia; patient in dorsal lithotomy position. References 1)Glazer, Kelly, et al. “Ureterolithiasis.” Nih.gov, StatPearls Publishing, 20Apr. 2024, • Stone Removal: Small stones are extracted with a basket; larger www.ncbi.nlm.nih.gov/books/NBK560674/#article-30818.s8.Accessed 21 Oct. stones are broken with a laser.Atemporary stent is often placed 2024. afterward. 2)Advanced Urology Institute. “Chelsie Ferrell, PA: The Pain and Risks of Kidney • Advantages: Minimally invasive, high success rate, direct Stones |Advanced Urology Institute.”Advanced Urology Institute, 4 Aug. 2023, visualization. www.advancedurologyinstitute.com/chelsie-ferrell-pa-the-pain-and-risks-of-kidney- • Complications: Rare; may include ureteral injury, stent stones/.Accessed 20 Oct. 2024. 3 3)Operarme.com. “Ureteroscopy: What It Is, What It Is Used For,Advantages and discomfort, or residual stones. Risks.” Operarme.com, Operarme.es, 3 July 2017, www.operarme.com/blog/ureteroscopy-what-it-is-what-it-is-used-for-advantages- and-risks/.Accessed 23 Oct. 2024. 4)Dang, Quynh-Chi . “PCNL Surgery Procedure Steps & Techniques | BackTable Urology.” BackTable, 12 Oct. 2022, www.backtable.com/shows/urology/articles/pcnl-procedure-surgery-techniques. Accessed 26 Oct. 2024. 5)Manzoor, Hassan, et al. “Extracorporeal Shockwave Lithotripsy.” Nih.gov, StatPearls Publishing, 6 May 2024, Figure 1admin. “URETEROSCOPY.” Csfsurgery.com, CSF Surgery, 22 May 2022, www.ncbi.nlm.nih.gov/books/NBK560887/#article-21488.s4.Accessed 21 Oct. www.csfsurgery.com/ureteroscopy/. Accessed 18 Oct. 2024. 2024.