Intravenous suppression in retrograde intrarenal surgery (RIRS) for staghorn calculus

Alexandros Fiamengos, Nikolaos Kostakopoulos, Andreas Karagiannis, Maria Zerva, Litsa Mosaikou, Ruth Roussou, Athanasios G. Papatsoris

Abstract


We report a case of a 64 year old woman, extremely obese, treated with retrograde intrarenal surgery (RIRS) for a complete staghorn calculus under intravenous sedation. Due to severe commorbidities the patient could not undergo general or regional anesthesia. Laser lithotripsy was performed, resulting in clearance of the pelvic and middle pole stone burden.

 

Παρουσιάζουμε μια περίπτωση παχύσαρκης ασθενούς 64 ετών με πλήρη κοραλλιοειδή λιθίαση που αντιμετωπίστηκε με παλίνδρομη ενδονεφρική χειρουργική με ενδοφλέβια καταστολή. Η ασθενής λόγω συννοσηρότητας δε μπορούσε να υποβληθεί σε γενική ή περιοχική αναισθησία. Πραγματοποιήθηκε laser λιθοτριψία η οποία και είχε ως αποτέλεσμα την εξάλειψη του λιθιασικού φορτίου στη πύελο και τον άνω κάλυκα.


Keywords


staghorn calculus; intrarenal surgery; sedation; κοραλλιοειδής λιθίαση, παλίνδρομη ενδονεφρική χειρουργική, ενδοφλέβια καταστολή

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References


Desai M, Jain P, Ganpule A, Sabnis R, Patela S, Shrivastav P. Developments in technique and technology: The effect on the results of percutaneous nephrolithotomy for staghorn calculi. BJU Int. 2009; 104: 542 - 8.

Türk C, Knoll T, Petrik A, et al. Guidelines on Urolithiasis, European Association of Urology, March 2015.

Kiss T, Bluth T, Heller A. Anesthesia in endourological and robot - assisted intervention. Anaesthesist. 2012; 61: 733 - 44.

Papatsoris A; Sarica K. Flexible ureterorenoscopic management of upper tract pathologies. Urol Res. 2012; 40: 639 - 46.

Papatsoris A, Chrisofos M, Skolarikos A, et al. Update on intracorporeal laser lithotripsy. Minerva Med. 2013; 104: 55 - 60.

Breda A, Angerri O. Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol. 2014; 24: 179 - 83.

Zheng C, Xiong B, Wang H, Luo J, Zhang C, Wei W, Wang Y. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal stones > 2 cm: A meta - analysis. Urol Int 2014; 93: 417 - 24.

Zengin K, Tanik S, Karakoyunlu N, et al. Retrograde Intrarenal Surgery versus Percutaneous Lithotripsy to Treat Renal Stones 2 - 3 cm in Diameter. Biomed Res Int. 2015; Mar 3

(Epub ahead of print).

Cybulski PA, Joo H, Honey RJ. Ureteroscopy: anesthetic considerations. Urol Clin North Am. 2004; 31: 43 - 7.

Livadas KE, Varkarakis IM, Skolarikos A, et al. Ureteroscopic removal of mildly migrated stents using local anesthesia only. J Urol. 2007; 178: 1998 - 2001.

El - Husseiny T, Moraitis K, Maan Z, Papatsoris A. Percutaneous endourologic procedures in high - risk patients in the lateral decubitus position under regional anesthesia. J Endourol. 2009; 23: 1603 - 6.




DOI: http://dx.doi.org/10.19264/hj.v27i4.104