Determinantes anatómicas del polo inferior del riñón para la resolución completa de litos mediante ureteroscopia flexible

Q4 Medicine Revista mexicana de urologia Pub Date : 2016-05-01 DOI:10.1016/j.uromx.2016.02.006

J.E. Sedano-Basilio, V. Cornejo-Davila, L. Trujillo-Ortiz, M. Cantellano-Orozco, G. Fernández-Noyola, C. Martínez-Arroyo, J.G. Morales-Montor, C. Pacheco-Gahbler

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Abstract

Background

Extracorporeal lithotripsy effectiveness is limited in lower calyx stones. Ureteroscopy currently enables complete access to the collecting system. Stones located in the lower pole at an infundibulopelvic angle < 70°, infundibular length > 3 cm, and infundibular width < 5 mm have a greater risk for residual stones.

Aim

To determine whether the anatomic variants of the left pole hinder stone resolution with flexible ureteroscopy.

Material and methods

A retrospective, analytic study was conducted. It included 109 cases of patients that underwent flexible ureteroscopy for lower pole stones (5-20 mm) diagnosed through tomography within the time frame of 2010-2015.

Results

Infundibular length was: 31.10 ± 7.53 and 27.27 ± 5.4 mm (p = 0.151), infundibular width: 10.36 ± 2.66 and 9.13 ± 2.1 mm (p = 0.094), and infundibulopelvic angle: 61.36 ± 7.23 and 74.63 ± 8.75° (p = 0.001) in patients with residual stones and in those with no evidence of stone burden, respectively.

Discussion

An infundibulopelvic angle < 70° has a 38-fold greater risk for residual stones in our population (95% CI: 4.24-29.12).

Conclusions

The infundibulopelvic angle had a statistically significant influence on stone-free status in patients in our population with stones in the lower pole that underwent flexible ureteroscopy.

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背景:体外碎石术在下萼结石中的效果有限。输尿管镜检查目前可以完全进入收集系统。位于骨盆底盂角下极的结石<70°，漏斗长度>3厘米，和漏斗宽度<5毫米结石残留风险较大。目的探讨左极解剖变异是否妨碍输尿管镜下结石的清除。材料与方法回顾性分析研究。本研究纳入2010-2015年期间109例经ct诊断为下极结石(5- 20mm)的输尿管软腔镜患者。结果结石残留组和无结石负担组的盂底长度分别为:31.10±7.53和27.27±5.4 mm (p = 0.151)，盂底宽度分别为:10.36±2.66和9.13±2.1 mm (p = 0.094)，盂底角分别为:61.36±7.23和74.63±8.75°(p = 0.001)。讨论漏斗骨盆角<在我们的人群中，70°的结石残留风险高出38倍(95% CI: 4.24-29.12)。结论输尿管软性镜下输尿管下极结石患者，输尿管骨盆角对无结石状态有统计学意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista mexicana de urologia Medicine-Urology

CiteScore

0.20

自引率

0.00%

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期刊介绍： Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.