{"id":1586,"date":"2024-04-19T17:07:08","date_gmt":"2024-04-19T14:07:08","guid":{"rendered":"https:\/\/jemis.org\/?page_id=1586"},"modified":"2024-07-18T16:40:27","modified_gmt":"2024-07-18T13:40:27","slug":"safety-and-efficacy-of-ureteroscopy-for-the-treatment-of-large-impacted-proximal-ureteralstones","status":"publish","type":"page","link":"https:\/\/jemis.org\/bg\/safety-and-efficacy-of-ureteroscopy-for-the-treatment-of-large-impacted-proximal-ureteralstones\/","title":{"rendered":"\u0415\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442 \u0438 \u0431\u0435\u0437\u043e\u043f\u0430\u0441\u0442\u043d\u043e\u0441\u0442 \u043d\u0430 \u0440\u0435\u0442\u0440\u043e\u0433\u0440\u0430\u0434\u043d\u0430\u0442\u0430 \u0443\u0440\u0435\u0442\u0435\u0440\u043e\u0441\u043a\u043e\u043f\u0438\u044f \u043f\u0440\u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0435\u0442\u043e \u043d\u0430 \u043a\u0430\u043c\u044a\u043d\u0438 \u0438\u043d\u043a\u043b\u0430\u0432\u0438\u0440\u0430\u043d\u0438 \u0432 \u043f\u0440\u043e\u043a\u0441\u0438\u043c\u0430\u043b\u043d\u0430\u0442\u0430 \u0442\u0440\u0435\u0442\u0430 \u043d\u0430 \u0443\u0440\u0435\u0442\u0435\u0440\u0430"},"content":{"rendered":"\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p class=\"wp-block-paragraph\"><em><strong>Volume 12, Supplement <\/strong><\/em>1<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Original Article \/ Published: April 202<\/em>4<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">DOI:<a href=\"https:\/\/www.doi.org\/10.57045\/jemis\/1210424.pp20-22\">https:\/\/www.doi.org\/10.57045\/jemis\/1210424.pp20-22<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">P. Petrov, V. Todorova, O.Gatsev, K. Petkova, D. Petrova, I.Saltirov<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Abstract<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Introduction and objective: Management of large impacted proximal ureteral stones is often challenging due to the presence of mucosal edema, inflammation and angulations of the ureter. Improvements in ureteroscopic technology increased the efficacy and safety of ureteroscopy (URS) as a first-line treatment in large impacted stones in the proximal ureter. The objective of this retrospective study is to evaluate the efficacy and safety of URS for the management of impacted proximal ureteral stones \u2265 10 mm.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Material and methods: The medical records of 700 patients with ureteral stones, who underwent ureteroscopy and intracorporeal lithotripsy between January 2016 and \u0410pril 2024 were retrospectively reviewed. 179 patients had impacted stones \u2265 10 mm located in the proximal ureter \u2013 125 (70%) were stones sized 10\u00f715 mm and 54 (30%) \u2013 stones \u2265 15 mm. URS was performed with 8.6 or 6.4Fr semirigid ureteroscope and Holmium laser. Flexible URS was performed in cases with tortuous ureter or stone retropulsion. Data on patients\u2018 preoperative characterstics, stone-free rates, operating times, intra- and postoperative complications were analyzed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Results: Patients\u2019mean age was 54.1\u00b112.3 years and mean stone size &#8211; 14.7\u00b1.4.8 mm. 30 % of the patients had previous unsuccessful shock- wave lithotripsy of the stone. Mean operative time was 45.1\u00b115.7 min min and overall success rate \u2013 85.3%. 66.2% of patients were treated with semirigid URS and 33.8% &#8211; with flexible URS. On subgroup analysis patients with stones 10\u00f715 mm and patients with stones \u2265 15 mm had similar preoperative characteristics. Success rate after a single procedure was higher and operating times significantly shorter in the subgroup of stones sized 10\u00f715 mm (87.1% vs 71.3%, p=0.159 and 41.3\u00b112.9 vs 53.3\u00b121.3 min, p=0.040,respectively). There were no statistically significant differences between the two subgroups in intraoperative stent JJ placement (34.1% vs 50.0%, p=0.400), stone retropulsion (21.3% vs 23.1%, p=0.847) and overall postoperative complications rate (9.3% vs 0%, p=0.161).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Conclusion: The results of this study suggest that URS is a safe and effective treatment for management of patients with large impacted proximal ureteral stones. Larger stone size was a predictor of lower success rate after a single procedure.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"691\" height=\"746\" data-id=\"1541\" src=\"https:\/\/jemis.org\/wp-content\/uploads\/2024\/06\/cover-short_2024_supp.png\" alt=\"\" class=\"wp-image-1541\" srcset=\"https:\/\/jemis.org\/wp-content\/uploads\/2024\/06\/cover-short_2024_supp.png 691w, https:\/\/jemis.org\/wp-content\/uploads\/2024\/06\/cover-short_2024_supp-278x300.png 278w, https:\/\/jemis.org\/wp-content\/uploads\/2024\/06\/cover-short_2024_supp-11x12.png 11w\" sizes=\"auto, (max-width: 691px) 100vw, 691px\" \/><figcaption class=\"wp-element-caption\">Volume 11, Issue 1<\/figcaption><\/figure>\n<\/figure>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button has-custom-width wp-block-button__width-100 is-style-fill\"><a class=\"wp-block-button__link has-light-gray-color has-text-color wp-element-button\" href=\"https:\/\/jemis.org\/wp-content\/uploads\/2024\/07\/2024_Sup_Article-7-summary.pdf\" style=\"border-radius:8px\" target=\"_blank\" rel=\"noreferrer noopener\">Article [pdf]<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords<\/strong>: <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">ureteroscopy, proximal ureteralstones<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>How to cite this article<\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">P. Petrov, V. Todorova, O.Gatsev, K. Petkova, D.Petrova, I.Saltirov. Safety and efficacy of ureteroscopy for the treatment of large impacted proximal ureteral stones. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2024; 12(1): 20-22<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Corresponding author<\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Petar Petrov<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Military Medical Academy of Sofia, Departament of Urology and Nephrology, 3 \u201cGeorgi Sofiiski\u201d blvd., Sofia 1606<br>e-mail: p.r.petrov7@gmail.com<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Volume 12, Supplement 1 Original Article \/ Published: April 2024<span class=\"more-button\"><a href=\"https:\/\/jemis.org\/bg\/safety-and-efficacy-of-ureteroscopy-for-the-treatment-of-large-impacted-proximal-ureteralstones\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\">\u0415\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442 \u0438 \u0431\u0435\u0437\u043e\u043f\u0430\u0441\u0442\u043d\u043e\u0441\u0442 \u043d\u0430 \u0440\u0435\u0442\u0440\u043e\u0433\u0440\u0430\u0434\u043d\u0430\u0442\u0430 \u0443\u0440\u0435\u0442\u0435\u0440\u043e\u0441\u043a\u043e\u043f\u0438\u044f \u043f\u0440\u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0435\u0442\u043e \u043d\u0430 \u043a\u0430\u043c\u044a\u043d\u0438 \u0438\u043d\u043a\u043b\u0430\u0432\u0438\u0440\u0430\u043d\u0438 \u0432 \u043f\u0440\u043e\u043a\u0441\u0438\u043c\u0430\u043b\u043d\u0430\u0442\u0430 \u0442\u0440\u0435\u0442\u0430 \u043d\u0430 \u0443\u0440\u0435\u0442\u0435\u0440\u0430<\/span><\/a><\/span><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/full-width-page.php","meta":{"footnotes":""},"class_list":["post-1586","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/pages\/1586","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/comments?post=1586"}],"version-history":[{"count":6,"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/pages\/1586\/revisions"}],"predecessor-version":[{"id":1630,"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/pages\/1586\/revisions\/1630"}],"wp:attachment":[{"href":"https:\/\/jemis.org\/bg\/wp-json\/wp\/v2\/media?parent=1586"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}