Initial Results of Laser Ureteroscopy Treatment for Lithiasis of the Upper Urinary Tract at Aristide Le Dantec Hospital in Dakar (Senegal)
Notice bibliographique
Résumé
Background: In Africa, lithogenesis was initially considered rare and it was mostly caused by infections. Recent studies suggest that obesity, change in dietary habits (milk, dairy products) and hot climate can contribute to an increase of the condition in the region. Over the past decades, the management of upper urinary tract urolithiasis has evolved significantly with minimally invasive techniques. The challenge for sub-Saharan countries is related with the acquisition and the training for minimally invasive treatment. In fact, open surgery has less indications in the management of urolithiasis. The aim of this study is to evaluate the preliminary results of ureteroscopic laser treatment for upper urinary tract lithiasis in our hospital. Methods: This was a prospective, descriptive study realized between June 2016 and December 2018. The patients included were those who had ureteroscopic laser treatment for upper urinary tract lithiasis. The treatment was performed under general anesthesia by two surgeons. The studied parameters were: age, sex, patient medical history, comorbidities, renal function, cytobacteriological examination of urine, characteristics of lithiasis, intra and postoperative complications (using the Clavien–Dindo classification), ureteroscopic laser failures (frequency and causes). Success of treatment was defined by: the absence of a residual fragment at the renal and ureteral level or of a residual fragment <4 mm at the renal level on the control imaging. Data analysis was done with IBM SPSS Statistic 23 software. Statistical significance was considered when P < 0.05. Results: This study involved 43 patients. The mean age was 40.84 years ± 15.33 years. The age group between 30 and 39 years was predominant. The sex ratio was 1.26. Nephritic colic was the circumstance of discovery in 93.02%. The Uro-CT scan performed in all our patients, revealed kidney stones in 16.3% and ureteral stones in 83.7%. The right side was the most involved in 55.8%. The mean size of the stones was 12.2 mm ± 4.89 at the renal level and 12.05 mm ± 5.54 at the ureteral level. The semi-rigid ureteroscope was used in 88.37% and the flexible ureteroscope in 11.63%. The lithiasis was visualized in 74.4% of cases. Laser fragmentation was performed in 69.77% of cases. A J stent was placed after 72.1% of cases. Pelvic ureteral stripping and pelvic ureteral aspiration were realized in one case each. Acute pyelonephritis (ANP) was observed in 25.6% of patients. There were 75% fragment free at postoperative control. Any factors associated with treatment failure were not found.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».